Study on anatomical parameters of adult lumbar intervertebral disc and endplate based on CT / 中国骨伤

OBJECTIVE@#To provide basic data for clinical application and individualized design of lumbar disc prostheses by measuring the anatomical parameters of lumbar intervertebral discs and endplates in healthy adults with CT three-dimensional reconstruction technology.@*METHODS@#A retrospective analysis was performed on 200 males and 200 females with normal lumbar spine who were admitted to the imaging center or outpatient department of the Second Affiliated Hospital of Xinjiang Medical University from September 2019 to December 2020. The age ranged from 20 to 60 years old, with an average of (40.61±11.22) years old. The measurement segment was L1-S1 intervertebral disc, and the measurement indicators included the axial anteroposterior diameter and transverse diameter of the intervertebral disc, sagittal anterior, middle and posterior height, coronal left and right height, intervertebral space angle, and transverse and anteroposterior diameters of the upper and lower endplates of each vertebral body.@*RESULTS@#①In terms of gender, the anatomical parameters of L1-S1 disc axial diameter, transverse diameter, sagittal anterior, middle and posterior height, left and right coronal height and intervertebral space angle were all higher in males than in females(P<0.05), and the anatomical parameters of upper and lower endplates of L1-S1 vertebral body were higher in males than in females(P<0.001). ②In comparison of sagittal height of anterior, middle and posterior intervertebral discs, the sagittal height of L1-L5 intervertebral discs was middle-high > anterior-high > posterior-high(P<0.001), while that of L5S1 intervertebral disc was anterior-high > middle-high > posterior-high (P<0.001). ③In the comparison of left and right coronal height, there was no statistical significance in the left and right coronal height of L1-S1 disc between male and female(P>0.05). ④The L1-S1 intervertebral spaces angle between male and female increased with the increase of vertebral body segments. ⑤The anterior and posterior diameters and transverse diameters of upper and lower of L1-S1 vertebral bodies endplates were height in males than in females(P<0.001).@*CONCLUSION@#The results suggest that gender differences should be considered in the design of adult lumbar disc prostheses. The anatomical parameters of the lumbar intervertebral disc varied with the increase of the vertebral body sequence, suggesting that different anatomical parameters of the intervertebral disc should be considered in the design of the artificial intervertebral disc, and the changes in the height of the sagittal position suggest that the design of the intervertebral disc should be wedge-shaped.

Development and validation of a CT-based radiomics model for differentiating pneumonia-like primary pulmonary lymphoma from infectious pneumonia: A multicenter study / 中华医学杂志(英文版)

BACKGROUND@#Pneumonia-like primary pulmonary lymphoma (PPL) was commonly misdiagnosed as infectious pneumonia, leading to delayed treatment. The purpose of this study was to establish a computed tomography (CT)-based radiomics model to differentiate pneumonia-like PPL from infectious pneumonia.@*METHODS@#In this retrospective study, 79 patients with pneumonia-like PPL and 176 patients with infectious pneumonia from 12 medical centers were enrolled. Patients from center 1 to center 7 were assigned to the training or validation cohort, and the remaining patients from other centers were used as the external test cohort. Radiomics features were extracted from CT images. A three-step procedure was applied for radiomics feature selection and radiomics signature building, including the inter- and intra-class correlation coefficients (ICCs), a one-way analysis of variance (ANOVA), and least absolute shrinkage and selection operator (LASSO). Univariate and multivariate analyses were used to identify the significant clinicoradiological variables and construct a clinical factor model. Two radiologists reviewed the CT images for the external test set. Performance of the radiomics model, clinical factor model, and each radiologist were assessed by receiver operating characteristic, and area under the curve (AUC) was compared.@*RESULTS@#A total of 144 patients (44 with pneumonia-like PPL and 100 infectious pneumonia) were in the training cohort, 38 patients (12 with pneumonia-like PPL and 26 infectious pneumonia) were in the validation cohort, and 73 patients (23 with pneumonia-like PPL and 50 infectious pneumonia) were in the external test cohort. Twenty-three radiomics features were selected to build the radiomics model, which yielded AUCs of 0.95 (95% confidence interval [CI]: 0.94-0.99), 0.93 (95% CI: 0.85-0.98), and 0.94 (95% CI: 0.87-0.99) in the training, validation, and external test cohort, respectively. The AUCs for the two readers and clinical factor model were 0.74 (95% CI: 0.63-0.83), 0.72 (95% CI: 0.62-0.82), and 0.73 (95% CI: 0.62-0.84) in the external test cohort, respectively. The radiomics model outperformed both the readers' interpretation and clinical factor model ( P <0.05).@*CONCLUSIONS@#The CT-based radiomics model may provide an effective and non-invasive tool to differentiate pneumonia-like PPL from infectious pneumonia, which might provide assistance for clinicians in tailoring precise therapy.

Discussion on importance of reasonable range of sugar-to-fat ratio in parenteral nutrition prescriptions / 肠外与肠内营养

Objective:To explore the medication safety issues caused by unreasonable sugar-to-fat ratio in clinical practice of parenteral nutrition,providing a basis for the rational use of clinical nutritional drugs.Methods:From the beginning of the database construction until February 28,2023,relevant databases at home and abroad were searched to summarize and analyze the clinical adverse outcomes caused by unreasonable sugar-to-fat ratio prescriptions encountered in the included literature and clinical practice.Results:Eleven articles were included,and 1 case of patient discomfort was improved by adjusting the unreasonable sugar-to-fat ratio.A total of 86 patients were involved,including 51 males and 35 females,with an age range of 18 to 89 years.Among the 86 patients,there were 79 clinical adverse outcomes,including 8 deaths.The incidence rates of clinical adverse outcomes were as follows:abnormal liver function 46.8％(37/79),bile stasis 22.8％(18/79),fat overload syndrome 13.9％(11/79),liver steatosis 11.4％(9/79),platelet reduction 3.8％(3/79),and other 1.3％(1/79).Among the 86 patients,2 cases were clearly recorded to have improved clinical adverse outcomes after adjusting the sugar-to-fat ratio,and the others were not detailed.Conclusions:Inappropriate sugar-to-fat ratio may lead to safety issues related to parenteral nutrition medication and should be given clinical attention.

Application of deep learning in immunofluorescence images recognition of antinuclear antibodies / 中华检验医学杂志

Objective:To develop a prototype artificial intelligence immunofluorescence image recognition system for classification of antinuclear antibodies in order to meet the growing clinical requirements for an automatic readout and classification of immunof luorescence patterns for antinuclear antibody (ANA) images.Methods:Immunofluorescence images with positive results of ANA in Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from April 2020 to December 2021 were collected. Three senior technicians independently and in parallel interpreted the Immunofluorescence images to determine the ANA results. Then the images were labeled according to the ANA International Consensus on Fluorescence Patterns (ICAP) classification criteria. There were 7 labeled groups: Fine speckled, Coarse speckled, Homogeneous, nucleolar, Centromere, Nuclear dots and Nuclear envelope. Each group was randomly divided into training dataset and validation dataset at a ratio of 9∶1 by using random number table. On the deep learning framework PyTORCH 1.7, the convolutional neural network (CNN) training platform was constructed based on ResNet-34 image classification network, and the automatic ANA recognition system was established. After the model was established, the test set was set up separately, the judgment results of the model were output by ranking the prediction probability, with the results of the 2 senior technicians was taken as "golden standard". Parameters such as accuracy, precision, recall and F1-score were used as indicators to evaluate the performance of the model.Results:A total of 23138 immunofluorescence images were obtained after segmentation and annotation. A total of 7 models were trained, and the effects of different algorithms, image processing and enhancement methods on the model were compared. The ResNet-34 model with the highest accuracy andswas selected as the final model, with the classification accuracy of 93.31%, precision rate of 91%, and recall rate of 90% and F1-score of 91% in the test set. The overall coincidence rate between the model and manual interpretation was 90.05%, and the accuracy of recognition of nucleolus was the highest, with the coincidence rate reaching 100% in the test set.Conclusion:The current AI system developed based on deep learning of the ANA immunofluorescence images in the present study showed the ability to recognize ANA pattern, especially in the common, typical, simple pattern.

Morphological observation of broken ends of the mouse tail during wound healing and analysis of cell proliferation active regions / 中国组织工程研究

BACKGROUND: Skin-derived precursor cells play a regenerative role in wound healing, which can restore the physiological and aesthetic features of the skin by mitosis, proliferation and migration to the injury region. OBJECTIVE: To observe the structure of the mouse tail and the healing of the broken end, and then to investigate the correlation of these characteristics with the repair of skin trauma at the tail. METHODS: The tails of 2-day-old Kunming mice were cut off using ophthalmic microsurgical scissors to establish the mouse model of hair follicle regeneration in the tail. Regions in which the cells proliferated actively were determined. Wound healing samples were regularly taken, and embedded using OCT. Wound healing of the broken end was routinely observed by pathological staining. Cell proliferation was observed by immunofluorescence. Expression of AP-1 in the healing site was identified by immunofluorescent staining. RESULTS AND CONCLUSION: The structure of the mouse tail was complex, with rich blood supply. Good healing was observed in the broken end of the mouse tail. The cells in the hair follicles and dermal papillary layer showed active proliferation and mitosis, and thereby participated in wound repair and regeneration. Fluorescence staining results found that the positive expression of AP-1 was mainly concentrated in the epidermis and dermal papilla. These findings indicate that the epidermis and dermal papilla possess a strong ability to regenerate.

Expression of prolyl 4-hydroxylase beta-polypeptide in non-small cell lung cancer treated with Chinese medicines / 中国结合医学杂志

<p><b>OBJECTIVES</b>To investigate the role of prolyl 4-hydroxylase beta polypeptide (P4HB) expressed in lung carcinoma and the intervention effect of Yiqi Chutan Formula (, YQCTF).</p><p><b>METHODS</b>Lung carcinoma model was established by subcutaneously inoculating LEWIS lung carcinoma cells in C57BL/6J mice. The differential expression of P4HB protein between the YQCTF (3.0 g/kg, gavage, once daily, 21 days) group and the control group was acquired by a 2 fluorescence difference gel electrophoresis (2D-DIGE), verified by Western blotting and identified by matrix-assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF/TOF-MS). The expression of P4HB and P4HB mRNA in cultured A549 cells from cisplatin (DDP) 1.5 µg/mL group and 15% serum combined with DDP 1.5 µg/mL group were detected by cellular immunohistochemistry and reverse transcription-polymerase chain reaction, respectively.</p><p><b>RESULTS</b>The proteomics research discovered that one-third of differential proteins including P4HB were decreased in the YQCTF group (P<0.01). Clinical pathology and tissue microarray studies showed that P4HB expression in lung cancer tissue was stronger than adjacent tissues and normal lung epithelial (P<0.01). In the YQCTF and DDP combined groups, the expression of P4HB and P4HB mRNA in A549 cell were decreased significantly (P<0.01).</p><p><b>CONCLUSION</b>YQCTF could inhibit the LEWIS lung carcinoma's growth, decrease the expression of P4HB in LEWIS lung carcinoma and A549 cells. YQCTF might take effect through regulating P4HB in endoplasmic reticulum to inhibit the incidence and growth process of lung carcinoma.</p>

Correlation analysis of efficacy of yiqi chutan recipe in treating NSCLC and P4HB expression / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To study the predicting effect of proly 4-hydroxylase beta polypeptide (P4HB) in treating non-small cell lung cancer (NSCLC) patients by Yiqi Chutan Recipe (YCR).</p><p><b>METHODS</b>Totally 46 stage III and IV NSCLC patients were treated by YCR for 4 therapeutic courses. Effect was assessed by RECIST of solid tumor. P4HB expression was detected in the lung cancer tissue by immunohistochemical assay. Factors affecting disease control rates (DCR) of YCR were analyzed by Logistic regression analysis. The correlation between P4HB expression and the effect of YCR was analyzed.</p><p><b>RESULTS</b>The DCR of advanced NSCLC treated by YCR was 36.96% (17/46 cases). P4HB was high expressed in advanced lung cancer tissue (6/15 cases). Gender, initial treatment, and retreatment are independent factors for affecting DCR of treating lung cancer by YCR.</p><p><b>CONCLUSION</b>P4HB might be taken as a factor for predicting the effect of YCR in treating NSCLC.</p>

Bacterial communities associated with an occurrence of colored water in an urban drinking water distribution system / 生物医学与环境科学（英文）

This study aimed to investigate bacterial community in an urban drinking water distribution system (DWDS) during an occurrence of colored water. Variation in the bacterial community diversity and structure was observed among the different waters, with the predominance of Proteobacteria. While Verrucomicrobia was also a major phylum group in colored water. Limnobacter was the major genus group in colored water, but Undibacterium predominated in normal tap water. The coexistence of Limnobacter as well as Sediminibacterium and Aquabacterium might contribute to the formation of colored water.

Risk factors for the development of vaginal intraepithelial neoplasia / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Vaginal intraepithelial neoplasia (VAIN), as a precursor of vaginal cancer, is a rare disease. Its prevalence has not been well analyzed. This research is to ascertain the risk factors for VAIN in a Chinese population.</p><p><b>METHODS</b>A case-control study was conducted, including 63 VAIN cases and 64 healthy controls. In all subjects Pap smear and HPV tests were performed. A questionnaire survey was distributed, covering information on socio-demographic characteristics, smoking, past history, reproductive and sexual histories. The clinical pathological data were collected from medical records including symptoms, Pap smear results, grade of lesions, and human papillomavirus (HPV) status.</p><p><b>RESULTS</b>Postmenopausal women had a 2.09 times higher risk for VAIN than pre-menopausal women (95%CI: 1.10 - 3.85; P = 0.024). The patients with previous hysterectomy had an increased risk of VAIN (OR = 4.69; P = 0.003). Patients with a history of cervical cancer or CIN were predisposed to VAIN (OR = 78.75; P < 0.0001). The rate of HPV infection in VAIN was significantly higher than in controls, and an increased risk of VAIN was observed in patients with higher viral load (OR = 126.00; P = 0.000). Multivariate analysis showed that HPV infection and a history of CIN or cervical cancer were still found to be significant in patients.</p><p><b>CONCLUSION</b>HPV infection and a history of CIN or cervical cancer are the main risk factors for the development of VAIN.</p>

Effects of yiqi chutan recipe on tumor growth, survival time and expressions of PRDX-1 and PRDX-6 in Lewis lung carcinoma model mice with pi-deficiency syndrome / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To investigate the effects of Yiqi Chutan Recipe (YCR, a Chinese herbal prescription for invigorating qi and removing phlegm) on the growth and metastasis of tumor, survival time, and the expressions of peroxiredoxin (PRDX-1 and PRDX-6) in tumor tissue of C57BL/6J mice bearing Lewis lung carcinoma.</p><p><b>METHODS</b>Lewis lung carcinoma cells were transplanted to 90 C57BL/6J mice receiving preconditioning for inducing Pi-deficiency syndrome and divided into three groups treated respectively with saline, high dose YCR (3.0 g/kg) and low dose YCR (1.0 g/kg) once a day via gastric infusion. Besides, a group of 30 healthy mice simply received tumor cell transplantation was set up for controls. Ten mice selected from each group were sacrificed 21 days later, the size, weight and lung metastasis foci of tumor in mice were measured, and expressions of PRDX-1 and PRDX-6 in tumor tissue were detected using immunohistochemical method. The survival time of the remained 20 mice in each groups was observed.</p><p><b>RESULTS</b>Tumor size, weight and the numbers of lung metastatic foci were (1.14 +/- 0.30) cm3, (0.83 +/- 0.26) g, (6.20 +/- 2.53) foci in the high dose YCR treated group, which were significantly lower than those in the control group [(2.83 +/- 0.35) cm3, (2.08 +/- 0.28) g, and (8.60 +/- 1.84) foci] respectively, also lower than those in the saline treated group [(2.29 +/- 0.49) cm3, (1.67 +/- 0.33) g and (8.70 +/- 2.00) foci]. The median survival time in the three groups, in above order, were 29.00 +/- 0.89 days, 22.00 +/- 0.75 days and 21.00 +/- 0.53 days; the average survival time in them 29.60 +/- 0.53 days, 22.90 +/- 0.50 days and 20.95 +/- 0.44 days; the PRDX-1 expression were 0.15 +/- 0.03, 0.52 +/- 0.07 and 0.61 +/- 0.09; and the PRDX-6 expression were 0.12 +/- 0.02, 0.43 +/- 0.06 and 0.56 +/- 0.07, all showed significant difference in comparing the indices in the high dose treated group with those in the control group and in the saline treated group (P < 0.05 or P < 0.01). The tumor growth inhibition rate was 50.30% in the high dose YCR group with life prolongation rate of 41.29%, all better than those in the low dose YCR treated group (P < 0.05).</p><p><b>CONCLUSIONS</b>YCR can remarkably inhibit the growth and metastasis of Lewis lung carcinoma in mice with Pi-asthenia syndrome, prolong their survival period, and its mechanism is possibly related to the reduction of over expressed PRDX-1 and PRDX-6.</p>

Clinical analysis of combination of (252)Cf neutron intracavitary brachytherapy and external beam radiotherapy for 110 cervical cancer patients / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the curative effect and complication of (252)Cf brachytherapy on cervical cancer.</p><p><b>METHODS</b>From Nov 2002 to Nov 2007, 110 cervical cancer patients were treated by combination of (252)Cf neutron intracavitary brachytherapy and external beam radiotherapy. There were 2 cases of stage Ib, 5 stage IIa, 57 stage IIb, 2 stage IIIa, 41 stage IIIb, 2 stage IVa, and 1 stage IVb. The whole pelvic cavity was irradiated with 8 MV X-ray, 1.8 Gy/fraction, 4 - 5 times per week. The total dose of external beam radiotherapy was 40 - 50 Gy (the center of whole pelvic field was blocked by 4 cm in width after 20 - 30 Gy). (252)Cf neutron intracavitary brachytherapy was delivered at 6 - 8 Gy(i)/fraction, and the total dose of reference point A was 30-51 Gy(i). The median dose was 42 Gy(i).</p><p><b>RESULTS</b>The overall 3-year survival rate of all patients was 79.2%, and the local control rate was 90.0%. In particular, the 3-year survival rate was 1/2 for stage I, 84.3% for stage II, 53.7% for stage III. The difference between stage II and stage III was statistically significant (P < 0.05). The 3-year survival in cervical lesions larger than or equal to 4 cm and those less than 4 cm was 68.1% and 71.2%, respectively (P > 0.05). The 3-year survival rate of patients with and without anemia was 42.4% and 78.2%, respectively (P < 0.05). The 3-year survival rate of patients with squamous cell carcinoma and adenocarcinoma was 78.5% and 76.9%, respectively (P > 0.05). The late radiation complications of rectum and bladder was 11.8% (13/110) and 2.7% (3/110), respectively.</p><p><b>CONCLUSION</b>It is concluded that (252)Cf is a better source for intracavitary brachytherapy. According to our initial experience, (252)Cf has advantages of a high local control rate, especially to bulky tumor and adenocarcinoma.</p>

A comparison of three methods in establishing transplanted model of VX2 tongue carcinoma in rabbits / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To establish transplanted models of VX2 tongue carcinoma in rabbits by three methods and compare these models.</p><p><b>METHODS</b>After establishment of VX2 tumor-bearing rabbits, 72 New-Zealand white rabbits were randomly divided into 3 groups. Intact tumour tissue, modified tumour cell suspension, tumour cell suspension were respectively injected into the middle-third lateral border of the tongues of rabbits in 3 groups to induce transplanted VX2 tongue carcinoma. The histological features, the tumour-take rates and the metastasis rates of the 3 models were observed.</p><p><b>RESULTS</b>The tumour-take rate of 3 models were 83.3%, 91.7% and 33.3% respectively; the lymph node metastasis rates were 71.4%, 100.0% and 37.5% respectively; the lung metastasis rates were 35.7%, 81.3% and 0 respectively. The histological features of the transplanted VX2 tongue carcinoma of 3 models were all consistent with those of moderately differentiated carcinoma.</p><p><b>CONCLUSION</b>The biological properties of the transplanted VX2 tongue carcinoma of 3 models is much alike to tongue carcinoma in humans. The model established with modified tumor cell suspension is considered to be more suitable for tongue cancer study.</p>

Integrative medical strategy for treatment of senile lung cancer / 中国中西医结合杂志

Senile lung cancer has its own characteristics, thus its treatment is also particular. Viewing from the therapeutic angle of integrative medicine, the current status of research and application of various clinical treatment strategies and measures for senile lung cancer were preliminarily reviewed in this paper in items of surgical operation, chemotherapy, radiotherapy, molecular target drugs therapy and Chinese medical therapy.