Effectiveness of Histopathological Examination of Ultrasound-guided Puncture Biopsy Samples for Diagnosis of Extrapulmonary Tuberculosis

Objective To evaluate the diagnostic value of histopathological examination of ultrasound-guided puncture biopsy samples in extrapulmonary tuberculosis(EPTB).Methods This study was conducted at the Shanghai Public Health Clinical Center.A total of 115patients underwent ultrasound-guided puncture biopsy,followed by MGIT 960 culture(culture),smear,Gene Xpert MTB/RIF(Xpert),and histopathological examination.These assays were performed to evaluate their effectiveness in diagnosing EPTB in comparison to two different diagnostic criteria:liquid culture and composite reference standard(CRS).Results When CRS was used as the reference standard,the sensitivity and specificity of culture,smear,Xpert,and histopathological examination were(44.83%,89.29%),(51.72%,89.29%),(70.11%,96.43%),and(85.06%,82.14%),respectively.Based on liquid culture tests,the sensitivity and specificity of smear,Xpert,and pathological examination were(66.67%,72.60%),(83.33%,63.01%),and(92.86%,45.21%),respectively.Histopathological examination showed the highest sensitivity but lowest specificity.Further,we found that the combination of Xpert and histopathological examination showed a sensitivity of 90.80%and a specificity of 89.29%.Conclusion Ultrasound-guided puncture sampling is safe and effective for the diagnosis of EPTB.Compared with culture,smear,and Xpert,histopathological examination showed higher sensitivity but lower specificity.The combination of histopathology with Xpert showed the best performance characteristics.

An Investigation of the Association between Metabolic Syndrome and Osteoporosis Based on Chinese Health Examination Data

Objective Because of the limited number of studies and small sample sizes,whether metabolic syndrome(MS)leads to the occurrence and progression of osteoporosis and the possible underlying mechanisms require further investigation.This study aimed to investigate the association between MS and osteoporosis,along with its influencing factors.Methods This observational cross-sectional study included 139,470 individuals aged≥18 years who underwent health examinations from September 2014 to March 2022.Based on bone mineral density(BMD)screening results,the participants were categorized into a suspected osteoporosis or non-osteoporosis group(control).Participants were further divided into those who met 0 MS criteria,1 MS criterion,2 MS criteria,and≥3 MS criteria(MS group).Participants who had undergone health examinations at least twice formed the follow-up cohort;a self-matched analysis was performed on those with follow-up periods≥5 years and unchanged MS grouping.Results Several examination indicators in the suspected osteoporosis group showed statistically significant differences compared with the control group.The proportion of suspected osteoporosis in the MS group was significantly increased compared with that in the 0 MS criteria group(odds ratio[OR]:1.215,Z=29.11,P<0.001,95%confidence interval:1.199-1.231).After adjusting for age,sex,smoking,and alcohol consumption,the 2 MS criteria group and MS group still had OR values>1(P<0.001).In the follow-up cohort,the proportion of suspected osteoporosis increased gradually with an increase in the number of MS criteria met at baseline and during each follow-up visit(P<0.05),with the highest proportion observed in the MS group.However,the proportion of suspected osteoporosis did not increase significantly over time in the different MS groups(P>0.05).In the follow-up cohort,the proportion of individuals transitioning from normal BMD to suspected osteoporosis was higher in the MS group after≥5 years of follow-up compared with the group meeting 0 MS criteria(0.08%versus 1.15%,χ^(2)=10.76,P=0.001).There was no significant difference in BMD values for the 0 MS criteria group after 5 years(P>0.05),whereas the other three groups experienced a significant decrease in BMD values after 5 years(P<0.05).Conclusion MS is an independent risk factor for osteoporosis,and the effect of risk factors related to MS on osteoporosis may exceed that of aging alone.The specific mechanisms warrant further investigation.

Linear endoscopic ultrasound:Current uses and future perspectives in mediastinal examination

This editorial elaborates on the current and future applications of linear endoscopic ultrasound(EUS),a substantial diagnostic and therapeutic modality for various anatomical regions.The scope of endosonographic assessment is broad and,among other factors,allows for the evaluation of the mediastinal anatomy and related pathologies,such as mediastinal lymphadenopathy and the staging of central malignant lung lesions.Moreover,EUS assessment has proven more accurate in detecting small lesions missed by standard imaging examinations,such as computed tomography or magnetic resonance imaging.We focus on its current uses in the mediastinum,including lung and esophageal cancer staging,as well as evaluating mediastinal lymphadenopathy and submucosal lesions.The editorial also explores future perspectives of EUS in mediastinal examination,including ultrasound-guided therapies,artificial intelligence integration,advancements in mediastinal modalities,and improved diagnostic approaches for various mediastinal lesions.

An Empirical Study of the Socratic Method in Nongraded English Teaching in Senior High School Under the Background of the New National College Entrance Examination

With the reform of the New National College Entrance Examination(Gaokao),the nongraded education will become an inevitable trend.In senior high school,the traditional test-oriented education is popular.The knowledge is mainly taught by the teachers,and the students passively absorb it.This study examines a problem-oriented Socratic experiment in nongraded English teaching in senior high school.The teachers seek output from students,who respond by interpreting questions,fostering critical thinking,and enhancing problem-solving skills.This teaching experiment indicates that the Socratic method has a significant positive effect on cultivating nongraded senior high English students’critical thinking under the New National College Entrance Examination.

Profile of Radiological Examinations in the Radiology and Medical Imaging Department of the Medical Clinic “KALALE” in Mali

Introduction: Radiology and medical imaging examinations bring together the means of acquiring and restoring images of the human body from different physical phenomena such as the absorption of X-rays, nuclear magnetic resonance, reflection of ultrasound waves or radioactivity, with which we sometimes associate optical imaging techniques such as endoscopy. The objective of our study was to study the profile of radiological examinations in the radiology and medical imaging department of the “KALALE” medical clinic. Methodology: This was a descriptive, prospective study that took place over a period of six (6) months in the radiology and medical imaging department of the “KALALE” medical clinic and the centers of health of communes III and IV of Bamako in Mali. Data collection was carried out on a survey form. The parameters studied were sociodemographic data, clinical data, radiological data. Results: We recorded 6030 radiology examinations of which 19% of the examination frequency cases came from the “KALALE” medical clinic and 81% of the cases were referrals from the reference health centers of communes III and IV. There were 1500 X-rays or 24.9% of cases including 54% cases of bone X-rays;5% of cases of skull and face X-rays;5% of cases of Intravenous Urography (IVU);4% of cases of Hysterosalpingography (HSG);3% of cases of Retrograde Ureterocystography (UCR) and 1% of cases of X-ray of the Abdomen without preparation (ASP). We found 4530 ultrasounds or 75.1% of cases. Conclusion: Medical imaging has become essential in the study of the human body and now constitutes an essential tool for the detection and treatment of most pathologies, from simple fractures to the most serious tumors.

Improved Mechanism for Detecting Examinations Impersonations in Public Higher Learning Institutions: Case of the Mwalimu Nyerere Memorial Academy (MNMA)

Currently, most public higher learning institutions in Tanzania rely on traditional in-class examinations, requiring students to register and present identification documents for examinations eligibility verification. This system, however, is prone to impersonations due to security vulnerabilities in current students’ verification system. These vulnerabilities include weak authentication, lack of encryption, and inadequate anti-counterfeiting measures. Additionally, advanced printing technologies and online marketplaces which claim to produce convincing fake identification documents make it easy to create convincing fake identity documents. The Improved Mechanism for Detecting Impersonations (IMDIs) system detects impersonations in in-class exams by integrating QR codes and dynamic question generation based on student profiles. It consists of a mobile verification app, built with Flutter and communicating via RESTful APIs, and a web system, developed with Laravel using HTML, CSS, and JavaScript. The two components communicate through APIs, with MySQL managing the database. The mobile app and web server interact to ensure efficient verification and security during examinations. The implemented IMDIs system was validated by a mobile application which is integrated with a QR codes scanner for capturing codes embedded in student Identity Cards and linking them to a dynamic question generation model. The QG model uses natural language processing (NLP) algorithm and Question Generation (QG) techniques to create dynamic profile questions. Results show that the IMDIs system could generate four challenging profile-based questions within two seconds, allowing the verification of 200 students in 33 minutes by one operator. The IMDIs system also tracks exam-eligible students, aiding in exam attendance and integrates with a Short Message Service (SMS) to report impersonation incidents to a dedicated security officer in real-time. The IMDIs system was tested and found to be 98% secure, 100% convenient, with a 0% false rejection rate and a 2% false acceptance rate, demonstrating its security, reliability, and high performance.

Research on the Evaluation of the Implementation Effect of Curriculum Examination Reform: Taking the Course of “Introduction to Language” as an Example

“Introduction to Language,”as the core course of the English major,mainly reveals the basic laws of language,enabling the students to have the ability to apply linguistic theories to explain language phenomena and solve specific language problems.This course is highly theoretical and has a certain degree of difficulty.The evaluation of student grades has always been based on examination reform,but several problems have been encountered during the implementation process.This article analyzes the current situation of the reform and implementation of the“Introduction to Language”course examination in applied universities and puts forth suggestions and specific measures to improve the assessment of the course,aiming to enhance the teaching effectiveness of the course and scientifically and comprehensively evaluate students’abilities.

Awareness, Practice and Intention to Practice Testicular Self-Examination among Professional Working Males in Ghana

Background: The aetiology of Testicular Cancer (TC) is still unknown to researchers but many of the associated risk factors have been identified. These include family history, age, racial origin, cryptorchidism, urogenital malformations, testicular atrophy, and infertility. Given the lack of scientific data on the causes of the disease, it has been asserted in previous studies that the promotion of awareness and early detection are prerequisites to mitigating risks of metastasis as well as improving survival. This study is to assess the awareness, practice, and intention to practice testicular self-examination among professional working males in Accra. Methods: A quantitative cross-sectional design with a structured research instrument was used to collect data from respondants. The purposive and convenience sampling techniques were used to collect data from 300 men at Accra in Ghana. The study was conducted at two (2) Universities and a Senior High school at Accra in Ghana. The data was then analysed using descriptive statistics, logistic regression, multiple linear regression, and structural equation modeling. Results: From the study findings, 37% of male participants rated their knowledge of testicular self-examination and related symptoms as good, 28% of participants practised testicular self-examination monthly, while 65% of respondents expressed their intention to practice monthly testicular self-examination. The findings from logistic regression demonstrated that level of education, age, and marital status of participants had a significant influence on testicular self-examination. Additionally, the multiple linear regression results revealed knowledge and self-efficacy significantly predict testicular self-examination intention. The path coefficient results from the structural equation model are consistent with results from the regression models. Conclusion: This research is the first to investigate testicular self-examination among men in Ghana. The findings revealed awareness and practice of TSE are low among participants. Therefore, the research findings would improve the expertise of physicians and nurses in providing counsel, intervention, and support for patients at risk of testicular cancer.

试析科举考试的题型结构及其功能

历史上随着科举考试科目和场次的不断变化,考试题型也在不断发展和改进。从题型总体结构来看,以主观题型为主。曾经使用和经常出现过的科举考试题型包括:帖经;墨义、口义、经义、经问、经疑;诗赋、词赋、试帖诗、律赋;杂文、诏、诰、箴、表、赞、判;四书文、五经文、八股文;策、论、对策、策问、时务策等。另外,武举、童子举等也各有题型。不同的题型显示不同的人才考选作用,进而发挥不同的功能。科举考试借助确立衡文标准,力图把知识和能力的测评相结合,共同为科学选才和巩固儒学本位的命题立意服务。

考教融合:英国GCSE中文科目考试与教学关系探析

GCSE中文科目是英国中等教育阶段外语类重要科目之一,其考试旨在测试学生的中文听、说、读、写基本技能。GCSE中文科目没有统一的教学大纲,因此在教学上具有较大的自由度,而考试内容由考试大纲规定。英国GCSE中文科目考试与教学的关系呈现出一致性、分层性和矛盾性等特点,其育人功能通过考试与教学在目标与形式上的相互融合得到有效发挥。这为我国语言考试评价改革提供了有益启示。

A Physical Examination Method for Artificial Rainfall Effect Based on Radar Data

[Objective] This study aimed to establish a physical examination method for artificial rainfall effect based on radar data. [Method] The radar base data of Shenyang was processed with interpolation by using the nearest neighbor in radial and oriental direction to establish corresponding response variables, and the effect of a precipitation enhancement case was analyzed. [Result] The trends of response variables showed that there was certain positive effect of the precipitation enhancement operation. [Conclusion] The analysis on a case was not sufficient enough, and statistical test should be the future direction of the study on the physical effect.

Development of Standard Examination System of Special Course for Remote Education

Standard examination is an effective approach to promote the teaching quality of modern education. On terms of the analysis of main target, function and constitution of special course examination system for remote education, the internet scheme of the examination system is given according to the students and teachers' requirements. The implementation method for the communication and dynamic production of tests on home page of the exam system are elaborated by using programming technology of Active Server Pages (ASP)3.0. The query of exam information and automatic marking of test questions can be easily realized by the developed exam system under World Wide Web enviromment according to users' requirements.

“以本经中式”的真正含义是什么?

在明清时期有关人物传记的文献中,常有“以本经中式”(如“以《诗》中式”“以《春秋》中式”)的记述方式。这种记述方式长期以来被理解为“因本经文优秀而中式”,以致有人把“首艺”误解为第一篇本经文。事实上,这一记述方式还有另一层更重要的含义,即它是“以某经为本经参加科举而中式”的简化表述。从这个意义上说,“以本经中式”与这样一种选拔制度相关:考生占经应试,以该经为参试的个人标识;考官按经分房阅卷、按五经配额录取。

Pancreatic cancer:Future challenges and new perspectives for an early diagnosis

This editorial is a commentary on the case report by Furuya et al focusing on the challenging diagnosis of early pancreatic adenocarcinoma and new tools for an earlier diagnosis.Currently,pancreatic cancer still has a poor prognosis,mainly due to late diagnosis in an advanced stage.Two main precancerous routes have been identified as pathways to pancreatic adenocarcinoma:The first encompasses a large group of mucinous cystic lesions:intraductal papillary mucinous neoplasm and mucinous cystic neoplasm,and the second is pancreatic intraepithelial neoplasia.In the last decade the focus of research has been to identify high-risk patients,using advanced imaging techniques(magnetic resonance cholangiopancreatography or endoscopic ultrasonography)which could be helpful in finding“indirect signs”of early stage pancreatic lesions.Nevertheless,the survival rate still remains poor,and alternative screening methods are under investigation.Endoscopic retrograde cholangiopancreatography followed by serial pancreatic juice aspiration cytology could be a promising tool for identifying precursor lesions such as intraductal papillary mucinous neoplasm,but confirming data are still needed to validate its role.Probably a combination of cross-sectional imaging,endoscopic techniques(old and new ones)and genetic and biological biomarkers also in pancreatic juice)could be the best solution to reach an early diagnosis.Biomarkers could help to predict and follow the progression of early pancreatic lesions.However,further studies are needed to validate their diagnostic reliability and to establish diagnostic algorithms to improve prognosis and survival in patients with pancreatic cancer.

A cross-sectional study of the association between dietary inflammatory index and glaucoma prevalence in a US population

AIM:To assess the relationship between dietary inflammatory index(DII)and prevalence of glaucoma among individuals aged 40y and above in the United States.METHODS:Participants were drawn from 2 cycles of the National Health and Nutrition Examination Survey(NHANES,2005-2008)for a cross-sectional study.DII was calculated from 24-hour dietary recall questionnaire conducted by experienced researchers and data analyzed in R according to the NHANES user guide,“Stratified Multi-stage Probability Sampling”.The relationship between DII and glaucoma was evaluated by multi-factor logistic regression analysis and the existence of a non-linear association examined by restricted cubic spline(RCS)analysis.RESULTS:A total of 5359 subjects were included and the cross-sectional analysis weighted to represent the US population of 109 million.DII was elevated in glaucoma patients(P<0.001)and smoking and alcohol use contributed to significant differences(P<0.001).DII correlated negatively with Healthy Eating Index(HEI)-2015(Spearman rank correlation coefficient,r=-0.49).RCS analysis showed a linear relationship between DII and glaucoma risk(P of non-linear relationship=0.575).CONCLUSION:An increased DII is strongly associated with high risk of glaucoma and diet-induced inflammation should be controlled to delay glaucoma progression.

谈谈与examination搭配的词语

本文结合相关辞书,概述与examination相关的表达。1.用prepare/revise/studyfor等表示“为考试而准备”“复习迎考”“温习备考”。例如:We are preparing for the examination next week.我们正在为下周的考试做准备。I do not have much time to revise for examinations.我没有很多时间复习迎考。Ineed time to study for tomorrow's exami nation.我需要时间学习,准备明天的考试。

Analysis on the results of graduate examination for standardized medical residency training in general hospital---- Takes The First Affiliated Hospital of Kunming Medical University as an example

[ 目的] 对昆明医科大学第一附属医院（ 以下简称昆医附一院）2016 -2017年住院医师规范化培训结 业综合考核结果进行分析和总结,查找培训过程中存在的问题,提出提高住院医师规范化培训质量的建议. [方法] 将云南省住院医师规范化培训管理平台中公布的昆医附-院2016 - 2017年住院医师规范化培训结业综 合考核的结果录入Excel, 按照考试站点各专业考核情况进行分类统计,并对数据进行分析.[结果] 各站点考 试的合格率分别为综合知识部分95.26%,辅助检查部分88.23%,病史采集部分97.64%,体格检查部分 96. 14% ,病例分析部分97.21%,临床操作部分94.21%,门诊病例书写部分97.42%,医患沟通部分98.07%. 各专业综合考核第-阶段的不合格率：最高的为泌尿外科63. 64 %,最低的为内科学6.25%.各专业综合考核 第二阶段的不合格率：最高的为神经内科33.33%,最低的为超声科6. 67 %.[结论] 结业考核结果中,除辅助 检查部分外,其余七站均达到90 %以上的合格率,说明辅助检查判读的部分是该院参培住院医师的薄弱环节, 应加强检查结果判读培训,以确保提高住院医师规范化培训的综合质量.

职业伦理素养测评融入专业学位硕士研究生招生考试:学理基础与路径探索

党的十八大以来,国家对专业学位人才的职业伦理素养提出更为明确的培养要求。在硕士研究生招生考试中适当增加职业伦理素养方面的测评,有助于形成教考育人合力,全面落实立德树人根本任务。本文阐释了职业伦理素养测评有机融入专硕招生考试的学理基础,通过借鉴职业资格类考试中职业伦理素养的评价方式,探讨当前职业伦理素养测评融入专硕招生考试面临的挑战,并针对性提出考试内容改革的实施路径。建议以专硕招生考试评价指标体系为理论支撑,将职业伦理素养考查要求有机融入考试大纲,建构结构化命题任务模块,加大测评的技术供给与革新,加强研考复试对职业伦理素养的测评。

肺动脉栓塞行低对比剂肺动脉CTA成像检查的可行性评价及应用剂量对检查结果的影响

目的 分析为肺动脉栓塞患者实施低剂量肺动脉CTA成像检查的临床可行性以及辐射剂量高低对临床检查结果的影响。方法 选取我院2019.10至2023.4月期间收治的156例肺动脉栓塞患者为研究对象,对所有患者实施CTA成像检查,根据随机数表法将所有患者分为对照组(常规剂量)及观察组(低剂量),对两组患者的MSCT图像结果进行观察对比,评估两组血管的强化情况及图像质量。结果 经对比后发现两组所应用的剂量均符合临床评价工作标准,对比结果无统计学差异(P>0.05);对照组强化后的肺动脉主干CT数值均高于观察组(P<0.05);对照组图像质量优化率与观察组对比无统计学差异(P>0.05)。结论 针对肺动脉栓塞患者,可为其实施低对比剂肺动脉CTA检查,低剂量CTA检查仍能获取较为理想的图像质量,为临床诊断工作提供客观可靠的肺动脉影像数据。

A nomogram based on age, prostate-specific antigen level, prostate volume and digital rectal examination for predicting risk of prostate cancer

Nomograms for predicting the risk of prostate cancer developed using other populations may introduce sizable bias when applied to a Chinese cohort. In the present study, we sought to develop a nomogram for predicting the probability of a positive initial prostate biopsy in a Chinese population. A total of 535 Chinese men who underwent a prostatic biopsy for the detection of prostate cancer in the past decade with complete biopsy data were included. Stepwise logistic regression was used to determine the independent predictors of a positive initial biopsy. Age, prostate-specific antigen （PSA）, prostate volume （PV）, digital rectal examination （DRE） status, % free PSA and transrectal ultrasound （TRUS） findings were included in the analysis. A nomogram model was developed that was based on these independent predictors to calculate the probability of a positive initial prostate biopsy. A receiver-operating characteristic curve was used to assess the accuracy of using the nomogram and PSA levels alone for predicting positive prostate biopsy. The rate for positive initial prostate biopsy was 41.7% （223/535）. The independent variables used to predict a positive initial prostate biopsy were age, PSA, PV and DRE status. The areas under the receiver-operating characteristic curve for a positive initial prostate biopsy for PSA alone and the nomogram were 79.7% and 84.8%, respectively. Our results indicate that the risk of a positive initial prostate biopsy can be predicted to a satisfactory level in a Chinese population using our nomogram. The nomogram can be used to identify and counsel patients who should consider a prostate biopsy, ultimately enhancing accuracy in diagnosing prostate cancer.