Skin hemangioma is a tumor originating from skin blood vessels, which often occurs in infants and children. Brachytherapy with the 32P-based radionuclide applicator is an effective non-invasive therapeutic method. However, the inordinance of lesions is still the main challenge for precise local treatment and radiation protection of normal skins. A radionuclide applicator possessing advanced shape adaptability, favorable radionuclide biodistribution, optimized stress feature, and convenient preparation method is highly required for clinical practice. Herein, we present a customizable polyacrylamide (PAAm) hydrogel-based radionuclide applicator, integrating automatic lesion recognition via machine learning and 3D printing technology. The machine learning algorithm achieved a geometric accuracy of 98.78% in automated lesion contour recognition, providing guaranteed data support for 3D printing. The optimized hydrogel exhibited excellent mechanical properties (elastic modulus: 228 kPa, fracture toughness: 4.51 MJ m-3), rapid curing (<10 min), and promising 32P loading efficiency (>85%). Especially, this system greatly shortened the fabrication time while ensuring precise geometric matching for complex lesions. Through in vitro cell and in vivo tumor-bearing mouse models, the hydrogel loaded with 32P (P-HG) demonstrated favorable biocompatibility and effective therapeutic efficacy. It is believed that the synergy of intelligent recognition, 3D printing, and enhanced hydrogel performance can establish a promising treatment method with great practical potential for precise fitting brachytherapy of skin hemangioma.

Inspired by the perception and temperature regulation functionalities of human skin, multifunctional electronic skin (E-skin) for human motion detection and personal thermal management has attracted great attention. Here, we design an E-skin with strain sensing and personal thermal management capabilities based on a PAA-AgPPCM-x eutectogel, which was fabricated by introducing silver nanoparticle-deposited polydopamine-coated phase change microcapsules into an eutectogel matrix. The prepared eutectogel-based E-skin exhibits photothermal conversion, thermal energy storage and temperature regulation capabilities, and can effectively use solar energy for thermal management of the human body. Meanwhile, due the excellent mechanical properties and high conductivity of eutectogels, the eutectogel-based E-skin has the characteristics of a wide working range (0-400% strain), high sensitivity (highest gauge factor value is 5.13), fast response (239 ms) and recovery (337 ms), and excellent fatigue resistance (1000 cycles), and has successfully realized human motion detection, facial micro-expression recognition, and voice recognition. In addition, the eutectogel-based E-skin can be combined with machine learning algorithms to accurately classify 10 types of different complex gesture signals with high precision (97.0%). This multifunctional photothermal phase change microcapsule composite eutectogel-based E-skin shows great potential for application in intelligent wearable devices and personalized healthcare.

Computed tomography attenuation correction (CTAC) is commonly used in cardiac SPECT imaging to reduce soft-tissue attenuation artifacts. However, CTAC is prone to inaccuracies due to CT artifacts and SPECT-CT mismatch, along with additional radiation exposure to patients. Thus, these limitations have led to increasing interest in CT-free AC, with deep learning (DL) offering promising solutions. We proposed a new DL-based CT-free AC methods for cardiac SPECT. We developed a feature alignment attenuation correction network (FA-ACNet) based on the 3D U-Net framework to generate predicted DL-based AC SPECT (Deep AC). The network was trained on 167 cardiac SPECT/CT studies using 5-fold cross validation and tested in an independent testing set (n = 35), with CTAC serving as the reference. During training, multi-scale features from non-attenuation-corrected (NAC) SPECT and CT were processed separately and then aligned with the encoded features from NAC SPECT using adversarial learning and distance metric learning techniques. The performance of FA-ACNet was evaluated using mean square error (MSE), structural similarity index (SSIM) and peak signal-to-noise ratio (PSNR). Additionally, semi-quantitative evaluation of Deep AC images was performed and compared to CTAC using Bland-Altman plots. FA-ACNet achieved an MSE of 16.94 ± 2.03 × 10− 6, SSIM of 0.9955 ± 0.0006 and PSNR of 43.73 ± 0.50 after 5-fold cross validation. Compared to U-Net, MSE and PSNR improved by aligning multi-scale features from NAC SPECT and CT with those from NAC SPECT. In the testing set, FA-ACNet achieved an MSE of 11.98 × 10− 6, SSIM of 0.9976 and PSNR of 45.54. The 95

ABSTRACT:A 57-year-old woman who had persistent symptoms of transthyretin cardiac amyloidosis underwent 99m Tc-pyrophosphate ( 99m Tc-PYP) scintigraphy. The 99m Tc-PYP planar and SPECT/CT fusion image showed diffuse myocardial uptake and multiple fractures of the sternum and ribs. These fractures interfered with semiquantitative scores of 99m Tc-PYP uptake, leading to false positive in 99m Tc-PYP imaging.

Introduction The emergence of electronic cigarettes (e-cigarettes) poses a new challenge to tobacco control efforts. With their increasing popularity, particularly among youth, public concerns have been raised in Mainland China. Further investigation is necessary to fully understand the safety and potential adverse effects of e-cigarettes. Methods The Baidu search index (BSI) was employed using e-cigarette related terms from January 1, 2011, to April 4, 2022. The search volume for each term was recorded and analyzed for the search trend module, geodemographic module, search-demand module, regional preferences, demographic preferences, and user demand. Results According to our analysis, the total BSI for the 18 e-cigarette related search keywords was 39,027,819. The average annual percentage change of BSI indicated an upward trend for each of these categories, including health issues (p < 0.05), definition (p < 0.05), product and promotions (p < 0.05), and policy and regulations. Of all inquiries, 59.38% originated from females and 40.62% from males. The total valid BSI for e-cigarette related words was 165,076,588, and 11.59% of all search inquiries were from individuals aged 19 years and younger. Our analysis also revealed that the public's primary concerns regarding e-cigarettes were related to their quality and potential health issues. Conclusions E-cigarettes enjoy great popularity nationwide, but product quality and safety are major public concerns. Regulation of e-cigarettes for their standard production, quality control, advertisement, and target customers should be implemented promptly, and the public needs to have a clear perception of e-cigarettes, especially adolescents. E-cigarette related health damages or consequences require further investigation, and advertisements and promotions for e-cigarettes should be strictly controlled by the government.

目的 采用计算机深度神经网络技术,构建一款人工智能模型辅助99TcmO4?甲状腺图像诊断.资料与方法 回顾性纳入四川大学华西医院核医学科2013年1月—2020年6月临床已完成甲状腺全切手术、拟进行131I治疗的甲状腺癌患者3515例图像集,按甲状腺残留程度分类标注后,以8:2随机分成训练集2811例和测试集704例.利用3种深度神经网络模型Resnet34、InceptionV3和Densenet161分别对训练集样本进行特征提取和训练后,对测试集样本进行效能验证,并与3名初级医师独立阅片结果进行对比,记录3名医师和模型的阅片时间,采用Kappa检验分析医师阅片的一致性,采用受试者工作特征曲线分析不同模型的诊断效能.结果 在704例甲状腺图像分类测试时,3名医师的判断准确度分别为89.5％、86.5％、86.6％;Resnet34、InceptionV3和Densenet161神经网络模型的判断准确度分别为91.3％、90.4％和91.2％.3名医师两两比较诊断一致性较好(Kappa=0.773、0.746、0.711,P均<0.05),3名医师判断所需总时间分别为170 min、172 min和131 min;Resnet34、InceptionV3和Densenet161神经网络模型诊断总时间分别为4.5 s、2.9 s和17.3 s.结论 人工智能辅助诊断技术可快速、准确地完成甲状腺显像的阅片与甲状腺残留分类工作.

Background and purpose The concept of enhanced recovery after surgery (ERAS) not only reflects rapid perioperative recovery but also focuses on the comfort experience of inpatients. This study intends to establish a clinically applicable general comfort questionnaire (GCQ) for patients with lung cancer after surgery and verify its clinical application effect. Methods The comfort index items for postoperative lung cancer were formed by combining previous research and literature, clinically applied comfort scales, and expert interviews. The Delphi method was used to conduct two rounds of expert consultations to determine the final index and establish a postoperative comfort scale for lung cancer patients. This scale was used to conduct a questionnaire survey on 200 patients to test the reliability and validity of the scale. Results The comfort scale contains 3 dimensions and 10 items and is easy to operate and evaluate in clinical applications. The Cronbach's α coefficient of the comfort scale is 0.801, and the scale content validity index (SCVI/ave) is 0.97. The common factor 1 and 2 characteristic roots of scale structural validity evaluation are 3.257 and 1.352 respectively, both greater than 1, with cumulative variance contribution rates of 32.57% and 13.52%. Pain and getting out of bed are the main factors influencing patient comfort. Conclusion The postoperative comfort scale for lung cancer patients has high clinical application reliability and validity. This study identified pain and mobility (early ambulation or getting out of bed) as the primary factors influencing the postoperative comfort of lung cancer patients.

目的 基于头颈肩最大每秒计数率(CPSmax)及显像剂用量构建全身骨显像扫描速度(SS)回归方程,并验证其价值.方法 回顾性分析385例接受全身骨显像且图像总计数(TC)≥1.50 M的患者资料,采用Person相关性分析及多重线性回归分析基于患者性别、年龄、体质量指数(BMI)、显像剂用量、扫描前等候时间,以及头颈肩CPSmax筛选全身骨显像SS的独立影响因素,构建预测全身骨显像SS回归方程.另将172例患者分为方程拟合组(n=111)和对照组(n=61),采用2台不同SPECT设备行全身骨显像,记录方程拟合组CPSmax,以回归方程设定SS,对照组以固定SS(25 cm/min)进行扫描,比较组间TC合格率(TC≥1.50 M)的差异.结果 头颈肩CPSmax和显像剂用量是全身骨显像SS的独立影响因素(P均＜0.05),以之构建的回归方程为SS=18.98+0.13X显像剂用量+1.06×CPSmax(F=23.22,P＜0.01).方程拟合组TC合格率100％(111/111),高于对照组的88.52％(54/61,P=0.001).结论 基于头颈肩CPSmax及显像剂用量构建的全身骨显像SS回归方程具有一定临床实用性.

ABSTRACT:A 40-year-old woman with a history of papillary thyroid cancer underwent ablative 131I therapy. Postablation whole-body 131I scintigraphy revealed not only increased activity in the thyroid bed but also in the anterior part of the chest. SPECT/CT images localized the activity in the bilateral breast implants.

目的 探讨日归手术模式下小儿血管瘤硬化剂注射术及成人腹股沟疝无张力修补术的安全性及应用效果.方法 回顾性分析2020年11月-2021年10月在四川大学华西医院日间服务中心接受小儿血管瘤硬化剂注射术和成人无张力疝修补术患者,按照患者病情和意愿分为日归组(小儿162例、成人180例)和日间组(小儿68例、成人271例),分析比较两组患者术中出血量、住院时长、住院费用、出院前疼痛以及术后短期并发症等指标.疼痛评估时,成人及6岁后儿童采用视觉模拟评定量表,6岁前儿童采用笑脸评分法.结果 日归手术患者比日间手术患者术中出血量少[小儿:(0.45±0.05) vs.(2.76±1.21) mL,P＜0.05;成人:(1.20±0.05)vs.(6.76±2.30) mL,P＜0.05],住院时长短[小儿:(7.99±1.22) vs.(23.10±1.42)h,P＜0.05;成人:(6.13±1.79)vs.(22.75±1.80)h,P＜0.05],住院费用低[小儿:(5094.00±1320.14) vs.(6263.52±1220.20)元,P＜0.05;成人:(7199.21±1535.84)vs.(7976.82±1967.82)元,P＜0.05],出院前疼痛程度轻[小儿:(0.05±0.02)vs.(0.50±0.01)分,P＜0.05;成人:(1.20±0.01)vs.(2.01±0.20)分,P＜0.05],两种模式患者术后并发症发生率和30 d内非计划再就诊率差异无统计学意义(P＞0.05).结论 日归手术模式在小儿血管硬化剂注射术和成人无张力疝修补术上是安全和可行的,并能缩短住院时长,降低住院成本,建议在临床中推广该模式.

Abstract A 22-year-old man with a history of recurrent papillary thyroid cancer underwent 131I therapy. Posttherapeutic whole-body scintigraphy was performed 5 days after administration of 5.5 GBq of 131I. The scintigraphy revealed increased activity in the left elbow. On physical examination, the patient had posttraumatic superficial scab at the site of the abnormal activity.

Abstract A 24-year-old man with papillary thyroid carcinoma underwent 131I ablation after thyroidectomy. On posttherapy whole-body scintigraphy, only the remnant thyroid was visualized. In view of elevated unstimulated thyroglobulin level 7 months after 131I ablation, 18F-FDG PET/CT scan was ordered for further evaluation. On PET/CT images, a large filling defect from the dilated left brachiocephalic vein to superior vena cava was noted corresponding with high FDG uptake. It was considered as a malignant thrombus.

Myocardial perfusion imaging has been considered the reference standard for detection of myocardial ischemia in coronary heart disease. In clinical practice, doctors typically estimate the individual ischemic scores for 17 myocardial segments and then diagnose myocardial ischemia based on the scores for all segments considered together. However, prior works are generally limited to the diagnosis of myocardial ischemia and ignore the correlation between myocardial ischemia and the myocardial segment showing the defect. In this paper, we explore intra- and inter-granularity relationships between myocardial perfusion imaging tasks of different granularities and construct a multi-task learning framework to jointly learn these tasks. To this end, we propose a cross-granularity multi-task network, namely CGMT-Net. We present a task-specific module based on the attention mechanism to make the feature map task-specific. To explore the intra- and inter-granularity relationships among tasks, we propose a cross-granularity fusion module for the integration and transmission of task-specific information. We present a large dataset containing 1098 myocardial perfusion imaging sets paired with their diagnostic reports. Extensive experiments on the dataset demonstrate the superiority of our CGMT-Net over other methods. Furthermore, we performed ablation experiments that show the rationality and effectiveness of our network architecture.

Large cell lung cancer metastases to the testis are scarce, although it is the most common malignancy and the most common site of metastases for breast, colorectal and kidney cancers. We hereby report a 28‐year‐old male patient admitted to our hospital with a chief complaint of scrotal enlargement, accompanied by chest pain and progressive dyspnea. The definite diagnosis was malignant pleural mesothelioma with the synchronous occurrence of large cell lung cancer with testicular metastasis. Sophisticated clinical manifestation of symptoms led to a time‐consuming diagnosis, while the patient's condition deteriorated rapidly. Herein, we present this case to share our hard‐learnt experience to increase clinician awareness and contribute to the information in the literature.

日归手术通过优化与再造日间手术服务流程、改变我国日间手术传统的过夜模式,融入个体化的加速康复外科(enhanced recovery after surgery,ERAS)理念,将过去需要住院1 d的日间手术缩短为当天住院、当天手术、当天出院.近年来,基于我国在日间手术实践取得的成功经验,四川大学华西医院日间手术中心率先提出"日归手术(same-day surgery)"的定义,选择适宜的术种术式逐步开展日归手术,累积了一定的研究成果和管理经验.规范化的日归手术管理实践围绕"提质增效"的核心理念,促进择期手术诊疗流程的持续优化,推动医疗服务效率的持续提升,契合我国当前对择期手术服务的医疗需求,适合在我国日间手术领域进行深入探索和广泛推广.本文以四川大学华西医院日归手术临床实践经验为例,旨在对日归手术从临床路径管理、手术精细化排程、个性化ERAS管理策略、出院后延续性服务等方面的研究进展进行综述.

普外门诊手术是医院常见的外科手术.为优化患者就医流程,四川大学华西医院日间手术中心联合医务部、门诊部、手术室等医院相关管理部门,实施普外门诊手术患者全流程管理,结合普外门诊手术实际开展情况,从组织构架、管理制度及应急预案等方面进行总结,制定了四川大学华西医院普外门诊手术管理规范,以期为国内普外门诊手术规范化开展提供参考.

态度、价值观和信念,这些具有人文属性的文化,在人类行为和社会进步过程中,无疑发挥着重要作用.社会主义核心价值观视域下,中共中央、国务院提出了"三全育人"的教育理念,为高校学生思想政治教育工作提供了基本遵循.新形势下,作为极具人文属性的医学,其初践者——高校医学生,构建正确的价值观对其自身成长以及整个医疗行业的发展都有着重要意义.

目的:通过对开展日 间手术的医疗机构进行调查,探索日间手术工作管理机制,以期对日间手术的规范化发展及管理提供参考.方法:采用网络问卷对49所医疗机构日间手术质量与安全管理制度建设与实施现状进行调查分析,包括患者、医师和病种/术式等准入管理、麻醉评估管理、日间手术病历管理、临床路径管理、出院后随访管理、医疗质量安全管理等制度建设情况和日间手术的发展困境等问题.结果:49所医疗机构开展日间手术的管理机制和制度建设情况不均匀,需加强科学化和同质化.结论:日间手术快速发展阶段需探讨推动日间手术开展的管理机制,研究制定保障日间手术规范化发展的制度和标准,持续改进日间手术的医疗质量,不断提高日间手术的医疗服务水平.

With the approval of the vaccine in mainland China, concerns over its safety and efficacy emerged. Since the Chinese vaccine has been promoted by the Chinese government for months and got emergency approval from the World Health Organization. The Chinese vaccination program is yet to be identified from the perspective of local populations. The COVID-19 vaccine-related keywords for the period from January 2019 to April 2021 were examined and queried from the Baidu search index. The searching popularity, searching trend, demographic distributions and users' demand were analyzed. The first vaccine enquiry emerged on 25th January 2020, and 17 vaccination keywords were retrieved and with a total BSI value of 13,708,853. The average monthly searching trend growth is 21.05% (p < 0.05) and was led by people aged 20-29 (39.22%) years old. Over 54.93% of the demand term search were pandemic relevant, and the summed vaccine demand ratio was 44.79%. With the rising search population in COVID-19 vaccination, education programs and materials should be designed for teens and people above the 40 s. Also, vaccine-related birth safety should be alerted and further investigated.