Abstract:A large number of tragic drug-induced events worldwide have warned the necessity to pay attention to the safety of drugs. Drug regulatory authorities and marketing license holders are obliged to collect information on adverse drug reactions as early as possible and develop different risk management plans for different drugs to maximize the safety of drug users. In the whole life cycle management of drugs, signal detection is an important part of post-marketing safety monitoring. This paper introduces the basic principle of disproportionality analysis used in post-marketing adverse drug reaction surveillance and potential biases and bias control methods in data analysis, and discusses machine learning method for signal detection and the standardization of signal detection report, so as to improve the accuracy and timeliness of signal detection.

Abstract:Objective To explore the factors affecting the cognition of elderly women with white matter lesions (WML) and to look for potential biological markers of dementia in this population. Methods A total of 149 elderly woman patients with WML and 48 elderly woman patients without WML who were treated in the outpatient department and ward in Department of Neurology, The First Affiliated Hospital of Naval Medical University (Second Military Medical University) and Kongjiang Hospital of Yangpu District of Shanghai from Jan. to Jun. 2020 were enrolled. The patients were divided into non-WML group (control group, n=48), mild WML group (n=72) and moderate to severe WML group (n=77) according to the severity of WML. WML patients were divided into dementia group (n=58) and non-dementia group (n=91) according to the mini-mental state exam (MMSE) scores. The levels of interleukin (IL)-1β, IL-6, tumor necrosis factor α (TNF-α), 25-hydroxyvitamin D (25(OH)D) and prolactin were compared between groups, and logistic regression model was used to analyze the correlations between these factors and the occurrence of dementia in elderly women with WML. In addition, receiver operating characteristics (ROC) curve was drawn to study the diagnostic value of 25(OH)D combined with prolactin for dementia in elderly women with WML. Results Compared with the control group, the serum 25(OH)D levels of patients in the mild and moderate to severe WML groups were significantly lower ([13.34±3.85] ng/mL,[12.73±3.77] ng/mL vs[15.82±4.07] ng/mL, P<0.01). The serum inflammatory factor levels of patients in the mild and moderate to severe WML groups were increased significantly compared with those of patients in the control group, such as IL-1β ([75.14±16.03] pg/mL,[75.42±14.38] pg/mL vs[53.96±13.55] pg/mL, P<0.01), IL-6 (35.70[28.92, 40.67] pg/mL, 35.29[28.97, 43.41] pg/mL vs 22.38[18.04, 27.20] pg/mL, P<0.01), TNF-α (72.72[55.68, 88.63] pg/mL, 71.52[60.26, 85.85] pg/mL vs 50.93[38.93, 60.48] pg/mL, P<0.01). The levels of serum 25(OH)D, uric acid, prolactin and cortisol in the dementia group were lower than those in the non-dementia group (25(OH)D:[11.77±3.63] ng/mL vs[13.83±3.72] ng/mL, P<0.01; uric acid:[331.02±150.31] μmol/L vs[380.16±128.02] μmol/L, P<0.05; prolactin:[231.72±79.39] μIU/mL vs[276.84±99.66] μIU/mL, P<0.01; cortisol:[287.38±149.58] nmol/L vs[358.45±155.32] nmol/L, P<0.01). The results of multivariate logistic regression analysis suggested that serum 25(OH)D (odds ratio[OR]=0.821, 95% confidence interval[CI] 0.717-0.940, P=0.004) and prolactin (OR=0.994,95% CI 0.989-1.000, P=0.042) were protective factors for dementia in elderly women with WML after adjusting for age. The combination of 25(OH)D and prolactin had moderate diagnostic value for dementia in elderly women with WML, and the area under ROC curve was 0.745 (P<0.001). Conclusion Serum 25(OH)D and prolactin levels are associated with dementia in elderly women with WML, and are expected to be potential biomarkers for early diagnosis of dementia in this population.

Abstract:Objective To observe the effects of different doses of metformin combined with insulin and insulin alone on bone metabolism-related biochemical parameters in patients with type 1 diabetes mellitus, and to explore the effect of metformin on bone metabolism. Methods In this retrospective study, 128 adult patients with type 1 diabetes mellitus were assigned to observation group or control group according to the treatment methods. Among them, 67 patients in the observation group were treated with metformin combined with insulin to control blood glucose, while 61 patients in the control group were treated with insulin alone. Blood glucose, glycosylated hemoglobin, 25-hydroxyvitamin D (25(OH)D), bone specific alkaline phosphatase (BALP), N-terminal mid-fragment of osteocalcin (N-MID OC), serum calcium, serum phosphorus, urinary calcium to creatinine ratio and lumbar vertebra bone mineral density (BMD) were collected before and after treatment for 72 weeks in the 2 groups to analyze the effect of metformin combined with insulin on bone metabolism. According to the dose of metformin, the patients in the observation group were divided into low-dose (0.5 g/d) group (n=20), medium-dose (1.0 g/d) group (n=23) and high-dose (1.5 g/d) group (n=24). The effects of different doses of metformin on bone metabolism parameters of patients were analyzed. Results Before treatment, there were no significant differences in blood glucose, glycosylated hemoglobin or bone metabolism-related parameters between the observation group and the control group (all P>0.05). After 72 weeks of treatment, blood glucose and glycosylated hemoglobin in the 2 groups were significantly lower than those before treatment (all P<0.05), but there was no significant difference between the 2 groups (both P>0.05). After treatment, BALP, N-MID OC and lumbar vertebra BMD in the observation group were higher than those before treatment and those after treatment in the control group (all P<0.05), while 25(OH)D, serum calcium, serum phosphorus and urinary calcium to creatinine ratio had no significant differences compared with those before treatment or those in the control group (all P>0.05). In the control group, there were no significant differences in lumbar vertebra BMD or bone metabolism-related parameters before and after treatment (all P>0.05). In the observation group, BALP and N-MID OC in the high-dose group were significantly higher than those in the medium-dose group and low-dose group after treatment (all P<0.01). Multiple linear regression analysis showed that metformin dose was positively correlated with BALP (β=0.266, P=0.035) and N-MID OC (β=0.355, P=0.008), and negatively correlated with urinary calcium to creatinine ratio (β=-0.296, P=0.026). Conclusion Metformin used for controling glucose in patients with type 1 diabetes mellitus has a protective effect on bone tissue, and may inhibit the occurrence of osteoporosis.

Abstract:Objective To investigate the dynamic ultrasonographic characteristics of the ablation areas of solid thyroid nodules after microwave ablation. Methods A total of 434 nodules of 364 patients treated with ultrasound-guided percutaneous microwave ablation in The Second Affiliated Hospital of Naval Medical University (Second Military Medical University) and Shanghai International Medical Center from Jan. 2015 to Dec. 2018 were selected, including 329 in benign nodule ablation group and 105 in malignant nodule (thyroid papillary carcinoma) ablation group. All nodules were completely ablated. The ultrasonographic features (including the echo, peripheral acoustic halo, needle tract, calcification, aspect ratio, boundary and the change of the color Doppler flow) of the ablation areas of the 2 groups at 1, 3, 6 and 12 months after ablation were analyzed retrospectively, and the similarities and differences between the 2 groups were summarized. At the same time, the ultrasonic images of the 105 nodules in the malignant nodule ablation group were collected before ablation. The ultrasonic characteristics of the nodule ablation areas in the 2 groups were compared with those of malignant nodules before ablation, so as to explore their similar characteristics and key points for differentiation. Results The ablation areas of the benign and malignant thyroid nodules showed hypoechoic echo with needle tract and hypoechoic acoustic halo after ablation, with no internal blood flow signal. The ablation needle tracts of 20 nodules were absorbed 12 months after operation, and the other needle tracts showed an absorption trend over time. The acoustic halo was incomplete at 1 month after operation, was complete and clear at 3 months, and was gradually blurred at 6 and 12 months. The clearest boundary was found at 3 and 6 months after operation, but blurred at 1 and 12 months. There was no blood flow signal in the ablation areas from 1 to 12 months after operation. The ablation areas with calcification generally aggregated at 3 months after operation, and the aggregation became more obvious over time. Before the ablation, papillary thyroid carcinoma showed solid hypoecho, unclear boundary, coarse margin, incomplete acoustic halo and scattered microcalcification, with internal and peripheral blood supply, which were similar to the characteristics of ablation areas in the benign and malignant nodule ablation groups at all time points. Conclusion The ultrasonographic features of benign and malignant thyroid nodules in the ablation areas are consistent, and some of the ultrasonographic features are similar to those of papillary thyroid carcinoma without ablation, but they can be identified by needle tract, acoustic halo, calcification distribution and blood supply in the ablation areas.

Abstract:Objective To evaluate the safety and antimicrobial efficacy of low concentration hypochlorous acid (HClO) irrigation for the prevention of open fracture infection in vitro. Methods Mouse epithelioid fibroblast cell line L929 and osteoblast MC3T3-E1 cells were used in this study, and blank control group and HClO groups with different concentrations (10%, 30%, 50% and 100%) were set up. The safety of different concentrations of HClO was evaluated by cell colony formation test, cell proliferation test and apoptosis test in vitro. The red blood cells of mice were taken, and normal saline group, phosphate buffered saline (PBS) group and HClO groups with different concentrations (10%, 30%, 50% and 100%) were set up. The hemolysis risk of different concentrations of HClO was evaluated by hemolysis test. To evaluate the antibacterial effect of low concentration HClO, Staphylococcus aureus and Escherichia coli were cultured in the blank control group, 10% HClO group and antibiotic positive control group to observe the growth of bacteria; and the blank control group, 10% HClO group, antibiotic positive control group, iodophor group and hydrogen peroxide group were set up for the bacteriostatic circle experiment. Results In vitro experiments showed that L929 and MC3T3-E1 cells had colony formation and lower proliferation inhibition and apoptosis rates in the 10% HClO group, while they had no colony formation but higher proliferation inhibition and apoptosis rates in the 30%, 50% and 100% HClO groups (all P<0.01). The erythrocyte hemolysis test was negative at all concentrations in HClO group. Low concentration (10%) HClO could significantly inhibit bacterial growth and had the same antibacterial effect as iodophor and hydrogen peroxide. Conclusion Low concentration (10%) HClO is safe and has good inhibitory effect on both Gram-positive and Gram-negative bacteria. It is a potential irrigation for clinical treatment of open fractures, osteomyelitis and infected bone defects.

Abstract:Objective To construct v-maf musculoaponeurotic fibrosarcoma oncogene homolog B (Mafb) knockout mice by clustered regularly interspaced short palindromic repeats (CRISPR) and CRISPR-associated protein 9 (Cas9), and explore the impact brought by this gene deletion on the urethral development. Methods The F0 Mafb knockout C57BL/6J mice were constructed according to the principle of CRISPR/Cas9 technology. F0 mice identified by polymerase chain reaction and gene sequencing were mated with wild-type C57BL/6J mice to obtain F1 Mafb knockout heterozygous (Mafb^+/-) mice. Mafb knockout homozygous (Mafb^-/-) fetal mice were obtained by mating between Mafb^+/- mice. The penile tissues of male Mafb^-/- fetal mice were collected. The expression of Mafb protein in the penile tissues and the expression of epithelial cadherin (E-cadherin) and α-smooth muscle actin (α-SMA) in the urethral seam were detected by immunofluorescence. The histological morphology of the penile tissues was observed by scanning electron microscopy and paraffin section hematoxylin-eosin (H-E) staining. Results The Mafb^+/- mice were successfully constructed and bred, and male Mafb^-/- fetal mice were obtained. Immunofluorescence showed scarce expression of Mafb protein in the penises of the male Mafb^-/- fetal mice; compared with wide type mice, the expression of E-cadherin was downregulated and α-SMA was upregulated in the urethral seam. Scanning electron microscopy and H-E staining showed that the phenotype of male Mafb^-/- fetal mice was hypospadias. Conclusion The Mafb knockout mouse model is successfully constructed. The knockout of Mafb can lead to the hypospadias phenotype and change the expression levels of E-cadherin and α-SMA on the urethral seam. This model lays a foundation for further study on the role of Mafb in the pathogenesis of hypospadias.

Abstract:Objective To preliminarily explore the neuroprotective effect of acetate (Ace) on 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced Parkinson disease mice and its mechanism. Methods Twenty-four mice were randomly divided into control group, MPTP group and MPTP+Ace group (8 mice in each group). The mice in the control group and MPTP group drank normal drinking water, and those in the MPTP+Ace group drank water containing 1 mol/L Ace. After 7 d, 30 mg/kg MPTP was injected intraperitoneally into the mice in the MPTP group and MPTP+Ace group to induce Parkinson disease model for 7 d. The motor function and cognitive function of mice were detected by tremor paralysis score, pole climbing test and Morris water maze, the activation of microglia in mouse hippocampus was detected by immunohistochemistry, the expression of proinflammatory cytokines in the peripheral blood and hippocampus was detected by enzyme-linked immunosorbent assay (ELISA), and the protein expression of p38 and p65 of nuclear factor κB (NF-κB)/mitogen-activated protein kinase (MAPK) pathway in the hippocampus was detected by Western blotting. Results Compared with the control group, the tremor paralysis score of the MPTP group was higher (P<0.05), the pole climbing time was longer (P<0.01), and the percentage of stay time in the target quadrant, the percentage of distance and the times of crossing the platform were decreased (all P<0.01). Compared with the MPTP group, the tremor paralysis score of the MPTP+ace group was lower (P<0.05), the pole climbing time was shorter (P<0.01), and the percentage of stay time in the target quadrant, the percentage of distance and the times of crossing the platform were increased (all P<0.01). Compared with the control group, the activated microglia in hippocampus of mice in the MPTP group were increased, the expression levels of tumor necrosis factor α (TNF-α) and interleukin 6 (IL-6) in the serum and hippocampus were increased (all P<0.01), and the expression levels of phosphorylated p38 and phosphorylated p65 proteins in the hippocampus were increased (both P<0.01). Compared with the MPTP group, the activated microglia in the hippocampus of mice in the MPTP+Ace group were decreased, the expression levels of TNF-α and IL-6 in the serum and hippocampus were decreased (all P<0.05), and the expression levels of phosphorylated p38 and phosphorylated p65 in hippocampus were decreased (both P<0.01). Conclusion Ace can reduce microglia activation in the hippocampus by inhibiting NF-κB/MAPK inflammatory signaling pathway, inhibit the inflammatory response of central nervous system, and improve motor function and cognitive function of MPTP-induced Parkinson disease mice.

Abstract:Objective To search for the hub genes for the prognosis of ovarian cancer and provide new targets for the treatment of ovarian cancer. Methods Ovarian cancer related data were downloaded from Gene Expression Omnibus (GEO) database (GSE18520 and GSE14407 datasets), The Cancer Genome Atlas (TCGA) database and the Genotype-Tissue Expression (GTEx) database. Differentially expressed genes were analyzed with limma package of R 3.6.2 software, and then clusterProfiler package was used for Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses of these genes. Meanwhile, STRING was used to establish the protein-protein interaction network, and cytoHubba package of Cytoscape software was used to screen the hub genes. Gene Expression Profile Interaction Analysis (GEPIA) database was used to verify the expression of hub genes in ovarian cancer tissues. Then, Kaplan-Meier Plotter database was used to perform survival analysis on the hub genes. Results A total of 69 differentially expressed genes were screened by GEO (GSE18520 and GSE14407), TCGA and GTEx databases, and they were mainly enriched in the ABC transporter, retinol metabolism and Wnt signaling pathways. Protein-protein interaction network analysis showed that there were 9 hub genes, which were verified in GEPIA. Kaplan-Meier Plotter database analysis showed that the overall survival was shorter in the ovarian cancer patients with high expression of centrosomal protein 55 (CEP55), family with sequence similarity 83, member D (FAM83D), kinesin family member 20A (KIF20A), cyclin dependent-kinase subunit protein 2 (CKS2) and NIMA related kinase 2 (NEK2) genes; and the progression-free survival was shorter in patients with high expression of CEP55, FAM83D, KIF20A, forkhead box protein M1 (FOXM1) and TTK protein kinase (TTK) than those with low expression. Conclusion The expression of CEP55, FAM83D, KIF20A, CKS2, NEK2, FOXM1 and TTK are closely related to the prognosis of ovarian cancer patients.

Abstract:Hypoxia is one of the important features of tumor microenvironment, and it is mainly caused by the imbalance between oxygen supply and oxygen consumption of tumor tissues. Hypoxia has an extremely important effect on tumor growth and metastasis, such as triggering drug resistance and radiation resistance, so it has always been regarded as a major obstacle to tumor treatment. Meanwhile, hypoxic microenvironment is becoming a favorable target for tumor therapy because of its uniqueness in tumor site. Nanotechnology has high targeting ability and good histocompatibility, and has been widely applied in tumor therapy. This review summarizes recent advances in new nano-delivery systems based on hypoxic microenvironment in tumor chemotherapy, radiotherapy, photodynamic therapy and immunotherapy.

Abstract:Bone turnover involves 2 processes:bone resorption and bone formation, and it can be evaluated by bone turnover markers (BTM). In menopausal women, estrogen level decreases, the number of bone remodeling units increases, bone resorption is greater than bone formation, and the level of BTM changes, resulting in bone mass and bone density decrease, and even osteoporosis. Changes in BTM may contribute to the diagnosis of osteoporosis and the evaluation of responses and adherence to treatments promoting synthesis and inhibiting absorption. This article reviews the research progresses of BTM in the process of osteoporosis in menopausal women, the diagnosis of osteoporosis, the prediction of fracture risk and the response to drug treatments.

Abstract:In recent years, several studies have demonstrated that the left atrial appendage is closely related to the induction and maintenance of atrial fibrillation, and the left atrial appendage electrical isolation (LAAEI) has been confirmed to effectively improve the success rate of atrial fibrillation ablation and reduce the recurrence of atrial fibrillation. Currently, LAAEI is mainly achieved through radiofrequency or cryoballoon ablation, surgical intervention, LARIAT ligation, etc. However, it is necessary to promote the understanding of its complications, especially the postoperative thrombus events and stroke. This paper reviews the anatomical characteristics of left atrial appendage, as well as the clinical treatment progress and related complications of LAAEI.

Abstract:G-induced loss of consciousness (G-LOC) means that when the pilot is exposed to positive acceleration (+Gz), the blood is rapidly transferred to the lower body due to inertial forces, results in acute cerebral ischemic and hypoxia and loss of consciousness. G-LOC is highly likely to cause catastrophic consequences. Currently, there is no effective method to avoid G-LOC. The fundamental strategy to solve this problem is to warn pilots of the potential danger of G-LOC by real-time physiological monitoring and to alert them to take timely measures. Advances in technologies of wireless sensing and artificial intelligence have made dynamic and accurate measurement possible. By reviewing the progress of sensitive physiological indexes during high +GZ exposure, this paper analyzes the characteristics and significance of head level hemodynamics, electroencephalogram, cerebral oxygen metabolism, electrocardiogram and electromyogram before and after the occurrence of G-LOC, summarizing the existing alerting technologies and their deficiencies. It is concluded that multi-index physiological monitoring combined with pilot physical signs and aircraft maneuvering status for a comprehensive judgment is a future way for solving G-LOC early warning issues.

Abstract:Objective To evaluate the incidence of autoimmune thyroid diseases in naval soldiers under different environments, so as to take early prevention and control measures. Methods The data of 2 198 naval officers and soldiers who underwent physical examination in the Physical Examination Center, The First Affiliated Hospital of Naval Medical University (Second Military Medical University) from Jun. to Sep. 2020 were retrospectively analyzed. The officers and soldiers were divided into urban groups (stationed in coastal cities) and ship groups (stationed in ships) according to their stations. The levels of serum triiodothyronine (T₃), thyroxine (T₄), thyroid-stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb) and thyroid ultrasound results were compared. Multivariate logistic regression was used to analyze the influencing factors of thyroid function, thyroid antibody level and thyroid ultrasound results. Results There were 1 095 cases in the urban group, with a median age of 34 (29, 41) years, including 663 males (60.55%) and 432 females (39.45%), and 1 103 cases in the ship group, with a median age of 33 (28, 38) years, including 1 014 males (91.93%) and 89 females (8.07%). There were significant differences in gender and age between the 2 groups (P<0.01). In the urban group, there were 111 cases (10.14%, 111/1 095) of abnormal thyroid antibodies, 9 cases (0.82%, 9/1 095) of subclinical hyperthyroidism, 85 cases (7.76%, 85/1 095) of subclinical hypothyroidism and 363 cases (45.72%, 363/794) of thyroid nodules. In the ship group, there were 84 cases (7.62%, 84/1 103) of abnormal thyroid antibodies, 5 cases (0.45%, 5/1 103) of subclinical hyperthyroidism, 38 cases (3.45%, 38/1 103) of subclinical hypothyroidism and 258 cases (33.64%, 258/767) of thyroid nodules. Multivariate logistic regression analysis showed that the gender was correlated with abnormal thyroid antibody level (P<0.01), station and thyroid antibody level were the influencing factors of TSH (both P<0.01), and gender, age and thyroid antibody level were related to the incidence of thyroid nodules (all P<0.01). Conclusion The naval officers and soldiers stationed in coastal cities have higher incidence of abnormal thyroid antibody, subclinical hypothyroidism and thyroid nodules. For female naval officers and soldiers, prevention and control measures should be taken earlier, and the benign or malignant of the nodules in female naval officers and soldiers with elevated thyroid antibodies need to be further evaluated with the increase of age.

Abstract:This article introduces the ABCs of stress during prolonged submergence proposed by Benjamin B. Weybrew, a senior researcher in the U.S. Naval Submarine Medical Research Laboratory, summarizes the research and practice of the submarine psychology of U.S. based on the ABCs, and analyzes the defects of this model in the practical application, hoping to provide a reference for our submarine medicine and psychology research in the future.

Abstract:With the development of China's marine defense and the increased depth of the underwater exploration, the diving-related decompression sicknesses are increasing, and they can be divided into type Ⅰ (mild) and type Ⅱ (severe) decompression sicknesses. Type Ⅱ decompression sickness can damage the function of multiple organs, leading to more serious condition. The lung injuries induced by type Ⅱ decompression sickness may eventually progress to respiratory failure, which is not only an important cause of death, but also the key of the treatment. Based on the pathophysiological process of lung injuries induced by type Ⅱ decompression sickness, this paper summarizes the current clinical treatments and research progress at home and abroad.

Abstract:Objective To verify the safety and efficacy of a dry-sealed thoracic drainage device. Methods This study was a prospective, single-center, randomized, parallel controlled, non-blind and non-inferiority clinical trial. Block randomization was used. A total of 72 patients who received lobotomy and postoperative thoracic drainage in Shanghai Chest Hospital of Shanghai Jiao Tong University from Jan. 2017 to Jun. 2019 were selected and randomly assigned to experimental group and control group, with 36 patients in each group. The experimental group used a disposable dry-sealed thoracic drainage device, and the control group used a disposable thoracic drainage bottle for gas and/or fluid drainage in the pleural cavity. Full analysis set (FAS), per-protocol set (PPS) and safety set (SS) were set up to evaluate the effect of fluid drainage (recovery rate of pleural effusion), ventilation effect (good recovery rate of lung inflation) and safety in the 2 groups. Results Among the 72 cases, 3 patients were excluded because their hospitalization age exceeded the inclusion criteria, and the exclusion rate was 4.17% (3/72). FAS included all 72 subjects, 36 in the control group and 36 in the experimental group; 69 subjects in PPS, 36 in the control group and 33 in the experimental group; and 72 subjects in the SS, 36 in the control group and 36 in the experimental group. The results of FAS analysis showed that the good recovery rate of pleural effusion was 100.00% (36/36) in the control group, and that in the experimental group was 100.00% (36/36); the non-inferiority margin was 7.00%, the difference between the 2 groups was 0.00% (95% confidence interval[CI] 0.00%-0.00%), and its lower limit absolute value was lower than the non-inferiority margin. The good recovery rate of lung inflation was 69.44% (25/36) in the control group and 77.22% (26/36) in the experimental group, and the difference between the 2 groups was 2.78% (95% CI -18.21%-23.77%), showing no significant difference (P>0.05). The results of PPS analysis showed that the good recovery rate of pleural effusion was 100.00% (36/36) in the control group, and that in the experimental group was 100.00% (33/33), with the difference between the 2 groups being 0.00% (95% CI 0.00%-0.00%) and the lower limit absolute value being lower than the non-inferiority margin; the good recovery rate of lung inflation was 69.44% (25/36) in the control group and 69.70% (23/33) in the experimental group, and the difference between the 2 groups was 0.25% (95% CI -21.48%-21.98%), showing no significant difference (P>0.05). SS analysis results showed that the dry-sealed thoracic drainage device and the closed thoracic drainage bottle both had good sealing performance during the whole experiment, the connecting port did not fall off, and there were no clinical adverse events. Conclusion The application of dry-sealed thoracic drainage device in postoperative patients plays positive roles in fluid and/or gas drainage with good safety. It is a good supplement to the drainage method of water-sealed thoracic bottle and worthy popularizing.

Abstract:Objective To analyze the safety and efficacy of low-profile visualized intraluminal support (LVIS) stent-assisted embolization for the anterior choroidal artery aneurysms. Methods The clinical and follow-up data of 31 patients with wide-necked anterior choroidal artery aneurysms who received LVIS stent-assisted embolization therapy in The Second Affiliated Hospital of Nanchang University from Jan. 2015 to Jan. 2019 were retrospectively analyzed. Cerebral digital subtraction angiography (DSA) and Raymond classification were used to evaluate the embolization effect, and modified Rankin scale (mRS) score was used to evaluate the prognosis. Results All the 31 patients with wide-necked anterior choroidal artery aneurysms (including 22 cases of ruptured aneurysms and 9 cases of non-ruptured aneurysms) were successfully treated with LVIS stent-assisted embolization. The results of DSA immediately after embolization showed that 25 aneurysms were presented with Raymond grade Ⅰ (complete occlusion), 4 with grade Ⅱ (subtotal occlusion) and 2 with grade Ⅲ (partial occlusion), parent arteries were unobstructed, and ischemic complications occurred in 4 cases. The results of DSA 6-9 months after embolization showed that 27 aneurysms were Raymond grade Ⅰ, 3 grade Ⅱ and 1 grade Ⅲ, 1 case had a mild stenosis of anterior choroidal artery, and no significant stenosis or occlusion was found in the remaining parent arteries. Twenty-nine patients had a good prognosis (mRS score ≤ 2), and 2 patients had a poor prognosis (mRS score was 3). There was no significant difference in postoperative ischemic complication incidence, complete occlusion rate or good prognosis rate 6-9 months after embolization between ruptured and non-ruptured groups (all P>0.05). No rebleeding or retreatment occured during follow-up. Conclusion LVIS stent-assisted embolization of wide-necked anterior choroidal artery aneurysms is safe and effective, showing no significant difference between ruptured and non-ruptured groups, however, it still needs to be further verified by multicenter trials with large samples and long-term follow-up.

Abstract:Objective To analyze the radiation doses to surroundings and medical staffs during positron emission tomography-computed tomography (PET-CT) examination of malignant tumor patients. Methods Sixty-two patients with malignant tumors who underwent PET-CT examination in Hongkou Branch of The First Affiliated Hospital of Naval Medical University (Second Military Medical University) from Jan. 2019 to Aug. 2020 were enrolled. The radiation doses to the surroundings of patients, medical staffs and the workplaces were detected, including the equivalent dose rates at 1, 2 and 3 m away from the subjects and each monitoring point in the waiting room, PET-CT room, doctor's office and injection room, and the annual effective doses of medical staffs. Results The equivalent dose rates at 1, 2 and 3 m away from the subjects were (4.40±0.64), (1.82±0.61) and (0.87±0.35) μSv/h, respectively, and the equivalent dose rate at 1 m away from the subject was higher than that at 2 and 3 m (both P<0.01). The equivalent dose rates at outer surface of protective door of waiting room, fume hood hand hole of injection room, hand hole of injection table, and positions of injection table staff were higher than those at other monitoring sites, such as outer surface of the protective wall and surface outside the protective door of the injection room (all P<0.05). The annual effective radiation dose of operation technicians was 0.82 mSv, which was higher than that of other involved staffs, such as waiting personnels and auxiliary operators. Conclusion The equivalent dose rate at 1 m away from PET-CT subjects is higher than that at a longer distance. The equivalent dose rates at outer surface of protective door of waiting room and fume hood hand hole, hand hole of injection table, and positions of injection table staff of injection room are higher than those of other workplaces.