Exposure frequency and radiation dose from CT examinations in Huaian.

This study quantified the exposure frequency and established the local diagnostic reference levels (DRLs) for the most common computed tomography (CT) examinations. A combined method census and sampling survey was used to quantify both frequency and radiation dose of CT examinations. Data were acquired through Picture Archiving and Communication System (PACS) or Radiology Information System (RIS). The annual frequency of CT examinations was 239.8 per 1000 inhabitants. The P75 of volume CT dose index (CTDIvol) to adult patients from CT scanning for head, chest, abdomen and lumbar spine examinations were 63.0, 12.4, 20.0 and 24.0 mGy, respectively. The P75 of dose-length product were 858.6, 416.0, 620.7 and 559.2 mGy·cm, respectively. This dose audit of CT practice can act as a starting point for establishing Huaian local DRLs and could be a reference for dose optimisation in China. This study compared DRLs in different countries and analysed some reasons for the rapid growth of CT examination frequency in Huaian.

Dual output feature fusion networks for femoral segmentation and quantitative analysis of the knee joint.

BACKGROUND: Magnetic resonance imaging (MRI) is the preferred imaging modality for diagnosing knee disease. Segmentation of the knee MRI images is essential for subsequent quantification of clinical parameters and treatment planning for knee prosthesis replacement. However, the segmentation remains difficult due to individual differences in anatomy, the difficulty of obtaining accurate edges at lower resolutions, and the presence of speckle noise and artifacts in the images. In addition, radiologists must manually measure the knee's parameters which is a laborious and time-consuming process. PURPOSE: Automatic quantification of femoral morphological parameters can be of fundamental help in the design of prosthetic implants for the repair of the knee and the femur. Knowledge of knee femoral parameters can provide a basis for femoral repair of the knee, the design of fixation materials for femoral prostheses, and the replacement of prostheses. METHODS: This paper proposes a new deep network architecture to comprehensively address these challenges. A dual output model structure is proposed, with a high and low layer fusion extraction feature module designed to extract rich features through the cross-fusion mechanism. A multi-scale edge information extraction spatial feature module is also developed to address the boundary-blurring problem. RESULTS: Based on the precise automated segmentation results, 10 key clinical parameters were automatically measured for a knee femoral prosthesis replacement program. The correlation coefficients of the quantitative results of these parameters compared to manual results all achieved at least 0.92. The proposed method was extensively evaluated with MRIs of 78 patients' knees, and it consistently outperformed other methods used for segmentation. CONCLUSIONS: The automated quantization process produced comparable measurements to those manually obtained by radiologists. This paper demonstrates the viability of automatic knee MRI image segmentation and quantitative analysis with the proposed method. This provides data to support the accuracy of assessing the progression and biomechanical changes of osteoarthritis of the knee using an automated process, thus saving valuable time for the radiologists and surgeons.

DNA Nanomaterial-Empowered Surface Engineering of Extracellular Vesicles.

Extracellular vesicles (EVs) are cell-secreted biological nanoparticles that are critical mediators of intercellular communication. They contain diverse bioactive components, which are promising diagnostic biomarkers and therapeutic agents. Their nanosized membrane-bound structures and innate ability to transport functional cargo across major biological barriers make them promising candidates as drug delivery vehicles. However, the complex biology and heterogeneity of EVs pose significant challenges for their controlled and actionable applications in diagnostics and therapeutics. Recently, DNA molecules with high biocompatibility emerge as excellent functional blocks for surface engineering of EVs. The robust Watson-Crick base pairing of DNA molecules and the resulting programmable DNA nanomaterials provide the EV surface with precise structural customization and adjustable physical and chemical properties, creating unprecedented opportunities for EV biomedical applications. This review focuses on the recent advances in the utilization of programmable DNA to engineer EV surfaces. The biology, function, and biomedical applications of EVs are summarized and the state-of-the-art achievements in EV isolation, analysis, and delivery based on DNA nanomaterials are introduced. Finally, the challenges and new frontiers in EV engineering are discussed.

Recycling of hazardous jarosite residues based on hydrothermal crystal transformation.

Jarosite [MeFe3(SO4)2(OH)6] is a typical non-ferrous smelting slag produced in the process of iron removal from hydrometallurgical solution, which contains a large number of valuable and toxic metal elements. Treating the complex and hazardous jarosite residue in an economically and environmentally sound way has always been an urgent problem. A novel one-step hydrothermal treatment method was proposed in this paper for recycling of jarosite residues. It can be seen from the XRD and TEM results that jarosite residues could be completely transformed into hematite crystal particles under hydrothermal conditions at temperature above 220℃. Meanwhile, other valuable metal components (such as nickel sulfate hexahydrate) entrained in the residue will be dissolved in the aqueous solution, which can be reused in the hydrometallurgical process. Through phase composition analysis of the hydrothermal process, it is concluded that jarosite was firstly pyrolyzed to generate Fe3+. The obtained Fe3+ was then hydrolyzed to Fe (OH)3, which was transformed into Fe2O3 through dehydration condensation and directional arrangement. Further roasting the hematite particles, the obtained product contained 62.57 % of Fe, but only 0.21 % of S and 0.04 % of As, which meets the requirements of raw materials for iron making. In addition, compared with the current international standard ISO 1248:2006 (E), the obtained hematite particles with nanometer size and single crystal structure can be used as iron oxide red pigment. Overall, the one-step hydrothermal treatment of jarosite residues followed by reduction roasting not only realizes the economic recycling of the metal resources, but also solves the stacking problem of those hazardous residues.

A consortium of three-bacteria isolated from human feces inhibits formation of atherosclerotic deposits and lowers lipid levels in a mouse model.

By a survey of metagenome-wide association studies (MWAS), we found a robust depletion of Bacteroides cellulosilyticus, Faecalibacterium prausnitzii, and Roseburia intestinalis in individuals with atherosclerotic cardiovascular disease (ACVD). From an established collection of bacteria isolated from healthy Chinese individuals, we selected B. cellulosilyticus, R. intestinalis, and Faecalibacterium longum, a bacterium related to F. prausnitzii, and tested the effects of these bacteria in an Apoe/- atherosclerosis mouse model. We show that administration of these three bacterial species to Apoe-/- mice robustly improves cardiac function, reduces plasma lipid levels, and attenuates the formation of atherosclerotic plaques. Comprehensive analysis of gut microbiota, plasma metabolome, and liver transcriptome revealed that the beneficial effects are associated with a modulation of the gut microbiota linked to a 7α-dehydroxylation-lithocholic acid (LCA)-farnesoid X receptor (FXR) pathway. Our study provides insights into transcriptional and metabolic impact whereby specific bacteria may hold promises for prevention/treatment of ACVD.

Evaluation of the Impact of BaP Exposure on the Gut Microbiota and Allergic Responses in an OVA-Sensitized Mouse Model.

BACKGROUND: Exposure to environmental pollutants, including benzo[a]pyrene (BaP), has been implicated in allergic diseases and intestinal microbiota homeostasis, but the environment-microbiota-immunity triangular relationship and to what extent BaP-induced remodeling of the gut microbiota contributes to intestinal allergic inflammation remain to be established. OBJECTIVES: We investigated the impact of BaP on intestinal allergic inflammation and examined the relationship between this effect and gut microbiota dysbiosis. We explored the potential ability of intestinal bacteria to degrade BaP and alleviate cytotoxicity as a detoxification strategy to counteract the effects of BaP exposure. METHODS: We combined microbiome shotgun metagenomics with animal histological and intestinal allergic inflammatory responses to assess the effects of BaP (50µg/mouse per day) in a 23-d toxicity test in antigen-induced allergic female mice. In addition, genome annotation, quantitative analysis of BaP, and in vitro cytotoxicity-tests using CaCo-2 cells were conducted to infer the role of intestinal bacteria in BaP detoxification. RESULTS: BaP exposure impacted the taxonomic composition and the functional potential of the gut microbiota and aggravated antigen-induced intestinal allergic inflammatory responses. The level of inflammatory cytokines correlated with the abundance of specific bacterial taxa, including Lachnospiraceae bacterium 28-4 and Alistipes inops. We identified 614 bacteria harboring genes implicated in the degradation of BaP, and 4 of these bacterial strains were shown to significantly reduce the cytotoxicity of BaP to CaCo-2 cells in vitro. DISCUSSION: Using allergic female mice as a model, we investigated the relationship between BaP, microbiota, and host immune reactions, highlighting the role of gut bacteria in BaP-aggravated allergic reactions. Our findings offer novel insight toward establishing the causal relationship between BaP exposure and the occurrence of allergic disorders. Identifying gut bacteria that degrade BaP may provide new strategies for ameliorating BaP cytotoxicity. https://doi.org/10.1289/EHP11874.

Peroxymonosulfate activation by Fe-N-S co-doped tremella-like carbocatalyst for degradation of bisphenol A: Synergistic effect of pyridine N, Fe-Nx, thiophene S.

Bisphenol A (BPA) has received increasing attention due to its long-term industrial application and persistence in environmental pollution. Iron-based carbon catalyst activation of peroxymonosulfate (PMS) shows a good prospect for effective elimination of recalcitrant contaminants in water. Herein, considering the problem about the leaching of iron ions and the optimization of heteroatoms doping, the iron, nitrogen and sulfur co-doped tremella-like carbon catalyst (Fe-NS@C) was rationally designed using very little iron, S-C3N4 and low-cost chitosan (CS) via the impregnation-calcination method. The as-prepared Fe-NS@C exhibited excellent performance for complete removal of BPA (20 mg/L) by activating PMS with the high kinetic constant (1.492 min-1) in 15 min. Besides, the Fe-NS@C/PMS system not only possessed wide pH adaptation and high resistance to environmental interference, but also maintained an excellent degradation efficiency on different pollutants. Impressively, increased S-C3N4 doping amount modulated the contents of different N species in Fe-NS@C, and the catalytic activity of Fe-NS@C-1-x was visibly enhanced with increasing S-C3N4 contents, verifying pyridine N and Fe-Nx as main active sites in the system. Meanwhile, thiophene sulfur (C-S-C) as active sites played an auxiliary role. Furthermore, quenching experiment, EPR analysis and electrochemical test proved that surface-bound radicals (·OH and SO4⋅-) and non-radical pathways worked in the BPA degradation (the former played a dominant role). Finally, possible BPA degradation route were proposed. This work provided a promising way to synthesize the novel Fe, N and S co-doping carbon catalyst for degrading organic pollutants with low metal leaching and high catalytic ability.

An Electrochemical Method for Deborylative Hydroxylation of Arylboronic Acids under Metal-free Conditions.

An electrochemical method for the synthesis of (poly)phenols via deborylative hydroxylation of arylborons has been well established under metal-free conditions, whose practicability and advantage has been highlighted by the preparation of drug molecules and preformation of scalable transformation. Mechanistic studies have demonstrated that superoxide anion radical was involved in the conversion followed by the reaction with arylboronic acid substrate.

[Finite element analysis of the effect of knee movable unicompartmental prosthesis insertion shape and mounting position on stress distribution in the knee joint after replacement].

In unicompartmental replacement surgery, there are a wide variety of commercially available unicompartmental prostheses, and the consistency of the contact surface between the common liner and the femoral prosthesis could impact the stress distribution in the knee after replacement in different ways. Medial tibial plateau fracture and liner dislocation are two common forms of failure after unicompartmental replacement. One of the reasons is the mismatch in the mounting position of the unicompartmental prosthesis in the knee joint, which may lead to failure. Therefore, this paper focuses on the influence of the shape of the contact surface between the liner and the femoral prosthesis and the mounting position of the unicompartmental prosthesis on the stress distribution in the knee joint after replacement. Firstly, a finite element model of the normal human knee joint was established, and the validity of the model was verified by both stress and displacement. Secondly, two different shapes of padded knee prosthesis models (type A and type B) were developed to simulate and analyze the stress distribution in the knee joint under single-leg stance with five internal or external rotation mounting positions of the two pads. The results showed that under a 1 kN axial load, the peak contact pressure of the liner, the peak ACL equivalent force, and the peak contact pressure of the lateral meniscus were smaller for type A than for type B. The liner displacement, peak contact pressure of the liner, peak tibial equivalent force, and peak ACL equivalent force were the smallest for type A at 3° of internal rotation in all five internal or external rotation mounting positions. For unicompartmental replacement, it is recommended that the choice of type A or type B liner for prosthetic internal rotation up to 6° should be combined with other factors of the patient for comprehensive analysis. In conclusion, the results of this paper may reduce the risk of liner dislocation and medial tibial plateau fracture after unicompartmental replacement, providing a biomechanical reference for unicompartmental prosthesis design.

[Intraoperative assisted O-arm navigation imaging for unstable pelvic fractures in INFIX].

OBJECTIVE: To investigate the effect of internal external fixator assisted O-arm navigation imaging in the treatment of unstable pelvic fractures. METHODS: From May 2019 to November 2019, 15 patients with unstable pelvic fractures were treated by intraoperative O-arm navigation imaging using INFIX technology. There were 6 males and 9 females. The age ranged from 24 to 66 years old. The course of disease ranged from 2 to 14 days. According to Tile classification, there were 1 case of B1 type, 8 cases of B2 type, 3 cases of C1 type, and 3 cases of C2 type. According to Young-Burgess classification, there were 8 cases of LC, 1 case of APC, 4 cases of VS, 2 cases of CM. Preoperative routine pelvic anteroposterior film, entrance position, exit position and pelvic CT three-dimensional reconstruction were performed. Intraoperative O-arm navigation system three-dimensional reconstruction and triplane scanning imaging were used to evaluate the effect of intraoperative reduction. The anterior pelvic ring was fixed with internal external fixator, and the posterior ring was fixed with sacroiliac screw, plate screw or lumbar iliac screw. The operation time, intraoperative bleeding and nail placement were observed and recorded. The quality of fracture reduction was evaluated by Matta standard, and the postoperative function was evaluated by Majeed function score. RESULTS: Wound healing was good in all patients without vascular, nerve and local irritation complications. All the 15 patients were followed up for 10 to 16 months. The fracture reduction was evaluated according to the Matta scoring standard, 9 cases were excellent results, 5 cases were good, and 1 case was medium. The Majeed functional score was 0 to 95 points. CONCLUSION: The built-in external fixator assisted O-arm navigation imaging system in the treatment of unstable pelvic fractures. The reduction effect is evaluated in advance, the operation time is shortened, and the accuracy of internal fixation is improved. The operation is simple, safe and less bleeding. The operation is in line with the principles of minimally invasive medical treatment and precision medical treatment in orthopedics, which is conducive to the recovery of patients' postoperative function and rapid recovery.

N, S co-doped magnetic mesoporous carbon nanosheets for activating peroxymonosulfate to rapidly degrade tetracycline: Synergistic effect and mechanism.

Heteroatoms doped carbon materials are widely used in the advanced oxidation process (AOPs) to remove organic pollutants in water due to the synergies effect between different heteroatoms. In this study, a novel kind of N, S co-doped magnetic mesoporous carbon nanosheets (Fe@NS-C) was prepared by simple one-step pyrolysis. Further, the influence of doping amount of S (L-methionine) and N (melamine) on catalytic activity was studied, the optimized sample Fe@NS-C-2-12/PMS showed a satisfying degradation ( 91.07%) for high concentrations of tetracycline (80 mg/L TC) in 10 min, which was attributed to the proper ratio of S content to N content (S(at.%)/ N(at.%)= 0.2097) in the sample could better play its synergistic effect by XPS analysis. The Fe@NS-C-2-12/ PMS system also exhibited satisfactory degradation effects in a wide pH range (3-10) and the existence of inorganic ions and humic acid. Then, the degradation mechanisms were mainly through the non-radical pathway (1O2 and electron transfer) and the major active sites were pyridinic N compared to thiophene S, CO, and Fe-Nx. This study could inspire the design of high-performance active and low-cost heteroatomic doping nano-magnetic catalysts for PMS-based waste treatment.

Facile fabrication of Fe/Fe3C embedded in N-doped carbon nanofiber for efficient degradation of tetracycline via peroxymonosulfate activation: Role of superoxide radical and singlet oxygen.

The toxic metal ions leaching and metal nanoparticles agglomeration were the critical issues for metal-based carbon materials during the peroxymonosulfate (PMS) activation processes. Herein, a facile strategy was first proposed that zero-dimensional Fe/Fe3C nanoparticles were embedded in one-dimensional N-doped carbon nanofiber (Fe/Fe3C@NCNF) to solve the above challenges. The as-obtained Fe/Fe3C@NCNF-800 possessed a low Ea value (11.7 kJ/mol) and exhibited high activity for activating PMS to degrade tetracycline (TC) in a wide range of pH 3-11. As expected, the iron ions leaching concentration of Fe/Fe3C@NCNF-800 was very low (0.082 mg/L). Meanwhile, the Fe/Fe3C@NCNF-800 was easily recovered from the reaction solution due to its magnetic properties. Both superoxide radicals (O2∙-) and non-radical of singlet oxygen (1O2) were the primary reactive oxygen species (ROS) in the Fe/Fe3C@NCNF-800/PMS system via quenching tests and electron spin resonance spectroscopy (ESR). The catalytic mechanism suggested that the Fe/Fe3C and graphitic N were the main active sites in the Fe/Fe3C@NCNF-800 for PMS activation. This work provided a facile method for the preparation of Fe-based carbon materials with high catalytic ability, low metal leaching and easy recycling, showing a broad prospect for environmental applications.

Tetracycline removal via adsorption and metal-free catalysis with 3D macroscopic N-doped porous carbon nanosheets: Non-radical mechanism and degradation pathway.

Recently, metal-based carbon materials have been verified to be an effective persulfate activator, but secondary pollution caused by metal leaching is inevitable. Hence, a green metal-free 3D macroscopic N-doped porous carbon nanosheets (NPCN) was synthesized successfully. The obtained NPCN showed high adsorption capacity of tetracycline (TC) and excellent persulfate (PS) activation ability, especially when calcined at 700 °C (NPCN-700). The maximum adsorption capacity of NPCN-700 was 121.51 mg/g by H-bonds interactions. Moreover, the adsorption process followed pseudo-second-order kinetics model and Langmuir adsorption isotherm. The large specific surface area (365.27 mg/g) and hierarchical porous structure of NPCN-700 reduced the mass transfer resistance and increased the adsorption capacity. About 96.39% of TC was removed after adding PS. The effective adsorption of the catalyst greatly shortened the time for the target organic molecules to migrate to the catalyst. Moreover, the NPCN-700 demonstrated high reusability with the TC removal rate of 80.23% after 4 cycles. Quenching experiment and electron paramagnetic resonance (EPR) test confirmed the non-radical mechanism dominated by 1O2. More importantly, the C = O groups, defects and Graphitic N acted as active sites to generate 1O2. Correspondingly, electrochemical measurement revealed the direct electron transfer pathway of TC degradation. Finally, multiple degradation intermediates were recognized by the LC-MS measurement and three possible degradation pathways were proposed. Overall, the prepared NPCN had excellent application prospects for removal of antibiotics due to its remarkable adsorption and catalytic degradation capabilities.

Integrated All-Fiber Electronic Skin toward Self-Powered Sensing Sports Systems.

The development of wearable electronic skins (E-skins) requires devices with high flexibility, breathability, and antibacterial activity, as in sports sensing technology. Here, we report a flexible, breathable, and antibacterial triboelectric nanogenerator (TENG)-based E-skin for self-powered sensing in volleyball reception statistics and analytics, which is fabricated by sandwiching a silver nanowire (Ag NW) electrode between a thermoplastic polyurethane (TPU) sensing layer and a poly(vinyl alcohol)/chitosan (PVA/CS) substrate. Benefiting from an outstanding breathability of 10.32 kg m-2 day-1 and biocidal properties of CS and Ag NW, the E-skin offers excellent thermal-moisture comfort and a remarkable antibacterial effect on Escherichia coli and Staphylococcus aureus. A pressure sensitivity of 0.3086 V kPa-1 is demonstrated in the sensing range of 6.65-19.21 kPa. Besides, a volleyball reception statistical and analytical system is further developed based on a 2 × 3 E-skin array. According to this work, the integration of wearable electronic devices with self-powered sensors may expand practical applications in sports.

Resource-recycling and energy-saving innovation for iron removal in hydrometallurgy: Crystal transformation of ferric hydroxide precipitates by hydrothermal treatment.

In hydrometallurgy industry, the accumulation of iron removal residues containing heavy metal elements and toxic elements poses great threats to ecological systems. We propose a novel method to prevent the production of hazardous iron removal residues: firstly, neutralization precipitation is used to purify iron ions in solution; after sedimentation of the obtained suspension, only dense underflow is subjected to hydrothermal reaction, in which ferric hydroxide transforms into hematite crystal. Results showed that ferric hydroxide precipitated into a thin sedimentation layer at temperature greater than 60 °C. For hydrothermal treatment of the sedimentation layer, a high hydrothermal reaction temperature was conducive to complete transformation of ferric hydroxide into hematite. The precipitated ferric hydroxide firstly changed from the crystallite of goethite or lepidocrocite to amorphous particles, and then gradually formed spherical α-Fe2O3 monocrystalline with diameter of around 50 nm, as indicated by TEM and XRD results. At 200 °C, hematite precipitates with iron content of about 65% can be obtained. For iron-containing zinc/nickel/cobalt sulfate solution, controlling hydrothermal reaction temperature and acidity of the underflow solution can effectively avoid the generation of zinc/nickel/cobalt hydroxides or subsulfates in the hematite precipitates, thereby significantly reducing the loss of those valuable metals.

Correlation Between Serum Tumor Marker Levels and Connective Tissue Disease-Related Interstitial Lung Disease.

OBJECTIVE: The main aims of this study were to explore the relationships between serum tumor markers and connective tissue disease-related interstitial lung disease (CTD-ILD) and to evaluate the clinical value of tumor markers for investigating interstitial lung disease (ILD) in patients with connective tissue disease (CTD). METHODS: The study included 235 patients with CTD (90 CTD without ILDs, 145 CTD-ILD). Clinical information and the levels of inflammatory and tumor markers, including carbohydrate antigen (CA) 19-9, CA125, carcinoembryonic antigen (CEA), CA153, and cytokeratin 19 fragments (CYFRA21-1), were obtained in all the patients. RESULTS: A significant difference between CTD with or without ILD and higher levels of tumor markers was observed in the CTD-ILD group, including CA19-9 (p<0.001), CEA (p<0.001), CA153 (p<0.001), and CYFRA21-1 (p<0.001). There was no significant difference in serum tumor marker levels in the various types of CTD (rheumatoid arthritis, systemic lupus erythematosus, Sjogren's syndrome, inflammatory myositis, systemic sclerosis, and mixed connective tissue disease). The levels of CA153 [odds ratio (OR)=1.159] and CYFRA21-1 (OR=2.269) were clearly related to the risk of CTD-ILD. The diagnostic value of CA153 [area under receiver operating characteristic curve (AUC)=0.736] and CYFRA21-1 (AUC=0.718) was confirmed for ILDs in CTD patients, at cut-off values of 9.45 U/mL and 2.13 ng/mL, respectively. CONCLUSION: There is a positive correlation between serum tumor marker levels and CTD-ILD. Higher levels of CA153 and CYFRA21-1 suggest an increased risk of developing ILD and may therefore be useful as biomarkers for detecting CTD-ILD in the clinical setting.

Efficient removal of Pb(II) ions from aqueous solution by modified red mud.

In the work, we employed a hydrothermal method for modification of red mud using colloidal silica and sodium hydroxide under mild conditions, and applied it into adsorbing Pb(II) ions in aqueous solutions. In the modification, zeolite structure was formed. The adsorption experiments found that the adsorption capacity of the modified red mud for Pb(II) ions was significantly improved, almost 10 times as much as that of the original red mud. Both the pseudo-first-order and pseudo-second-order kinetic equation can describe the adsorption process, indicating it a more complicated interaction. Langmuir and Dubinin-Radushkevich models well fit the adsorption isotherm, indicating that the modified red mud mainly removes lead ions from aqueous solution by monolayer physical adsorption. According to the fitting results, the saturated adsorption capacity of Pb (II) by the modified red mud is 551.11 mg/g, confirming its high efficiency adsorption performance. XRD, FTIR, XPS and SEM-EDS all detected the formation of PbCO3 and Pb3(CO3)2(OH)2. It was speculated that the adsorption mechanism should be attributed to the joint contribution of ion exchange and precipitation. The excellent performance of the modified red mud on Pb(II) ions adsorption makes it a promising candidate for the treatment of wastewater contaminated by heavy metal ions.

[Deep learning network-based recognition and localization of diatom images against complex background].

ObjectiveWe propose a deep learning network-based method for recognizing and locating diatom targets with interference by complex background in autopsy.MethodThe system consisted of two modules: the preliminary positioning module and the accurate positioning module. In preliminary positioning, ZFNet convolution and pooling were utilized to extract the high-level features, and Regional Proposal Network (RPN) was applied to generate the regions where the diatoms may exist. In accurate positioning, Fast R-CNN was used to modify the position information and identify the types of the diatoms.ResultsWe compared the proposed method with conventional machine learning methods using a self-built database of images with interference by simple, moderate and complex backgrounds. The conventional methods showed a recognition rate of diatoms against partial background interference of about 60%, and failed to recognize or locate the diatom objects in the datasets with complex background interference. The deep learning network-based method effectively recognized and located the diatom targets against complex background interference with an average recognition rate reaching 85%.ConclusionThe proposed method can be applied for recognition and location of diatom targets against complex background interference in autopsy.

The effectiveness of a self-made modular elastic compression device for patients with a fracture of the tibia and fibula.

BACKGROUND: To evaluate the effectiveness of a self-made modular elastic compression device for patients with a fracture of the tibia and fibula. METHODS: Fifty-nine healthy adult patients with a unilateral fracture of the tibia and fibula were randomly divided into an experimental group and a control group. The experimental group was given the self-made combined elastic compression device for the compression treatment of the affected limbs after the operation. The main endpoints included the convenience, safety, and effectiveness of the self-made modular elastic compression device for patients with a fracture of the tibia and fibula. RESULTS: There were 29 cases in the experimental group and 30 cases in the control group. There were no significant differences between the two groups in the general data: age, gender, fracture site, and cause of injury. The preoperative swelling elimination time was 3.3 ± 1.2 days, and the postoperative swelling elimination time was 3.1 ± 1.4 days in the experimental group; the preoperative swelling elimination time was 6.3 ± 1.2 days, and the postoperative swelling elimination time was 7.3 ± 1.2 days in the control group. The preoperative and postoperative swelling degree in the experimental group was shorter than those in the control group. The difference in the postoperative detumescence time between the experimental group (3.1 ± 1.4 days) and the control group (7.3 ± 1.2 days) was significant, and the total hospital stay was 8.1 ± 1.5 days in the experimental group and 13 ± 2.5 days in the control group with a statistical significance of P < 0.05. The change of discharge hemoglobin volume (11.2 ± 6.5 g/L) of the experimental group was lower than that of the control group (3.5 ± 1.2 days), the total drainage volume was 260 ± 50 ml, and the change of admission and discharge hemoglobin volume was 30.3 ± 10.4 g/L. Specifically, although the difference in the average hospital stay between the two groups was statistically significant, the difference was only 1 day, and the clinical difference was not significant. However, in the change of the cumulative drainage volume and hemoglobin volume, the experimental group that was given compression therapy was significantly lower than the control group with a statistical significance (P < 0.05). The pressure injury (4 cases) in the experimental group was significantly lower than that in the control group (8 cases) (P < 0.05). CONCLUSION: A modular combined elastic compression device in patients with a tibial and fibular fracture can significantly accelerate a patient's rehabilitation, shorten the hospital stay, reduce blood loss, relieve the patient's pain, and relieve the patient's social-economic burden during recovery.

Effect of placement of acetabular prosthesis on hip joint function after THA.

The good recovery of hip function after THA depends on reconstruction of acetabular prosthesis accurately. So we investigated the effect of acetabular prosthesis placement on hip joint function after THA and analyzed the clinical data of 432 patients with unilateral THA retrospectively . The patients were followed-up to evaluate the Harris score and hip range of motion (ROM). The hip ROM, the Harris score and the good rate of Harris score were compared between different groups. Comparison of the good rate of Harris score showed that 85%∼100% group of the rotation center horizontal position ratio was higher than >100% group; 80%∼120% group of the rotation center vertical position ratio was higher than >160% group; and the 90%∼110% group and 110%∼130% group of femoral offset ratio were higher than 90% and >130% groups. Comparison of Harris score showed that 85%∼100% and 70%∼85% groups of rotation center horizontal position ratio were higher than 70% and >100% groups; 80%∼120% group of rotation center vertical position ratio was the highest; and 90%∼110% group and 110%∼130% group of femoral offset ratio were higher than >130% and 90% groups. Comparison of hip ROM showed that 85%∼100% and 70%∼85% groups of the rotation center horizontal position ratio were higher than 70% and >100% groups; 80%∼120% group of the rotation center vertical position ratio was the highest; and hip ROM from high to low are 90%∼110%, 110%∼130%, >130% and 90% groups of femoral offset ratio. These findings indicated that during the early follow-up period of THA, if the horizontal position of femoral head rotation center was reconstructed in 0.85 to 1 times of healthy side when compared with reconstruction >1 times of the healthy side and if the vertical position of femoral head rotation center was reconstructed in 0.8 to 1.2 times of the healthy side when compared with reconstruction in >1.6 times of the healthy side, better hip function recovery and optimal hip ROM were obtained. The optimal reconstruction range of femoral offset is 0.9 to 1.3 times of the healthy side.