Effects of Left Ventricular Assist and Aortic Graft Angle on Aortic Valve: A Hemodynamic Study / 医用生物力学

Objective To investigate the effect of left ventricular assist device (LVAD) and aortic graft angle on hemodynamics of aortic valve. Methods Three models of aorta and aortic valve with 45°, 60° and 90° anastomosis angles between LVAD and aorta were constructed, and an in vitro pulsating table was built for in vitro experiments. Using particle image velocimetry (PIV) system, three moments in the cardiac cycle ( T1 systolic peak, T rapid closure, T3 diastolic peak), were selected to study the hemodynamic state of aortic valve. Results Velocity vector, vorticity and viscous shear stress were used to evaluate the effect of LVAD anastomosis angle on hemodynamics of aortic valve. During the period of rapid valve closure, with the increase of graft angle, the blood flow velocity near the valve wall, the average vorticity and the maximum viscous shear stress all increased. Conclusions When the graft angle is lower, the impact velocity of blood on the valve is smaller, and the shear force on the valve decreases, so that the valve is in a better hemodynamic environment. This study provides references for the selection of anastomotic angles in clinical operations.

GAO Wei-bin's clinical experience in treatment of neurogenic bladder with acupuncture / 中国针灸

The paper introduces GAO Wei-bin's clinical experience in acupuncture treatment for neurogenic bladder. In association with the etiology, the location and types of neurogenic bladder and in accordance with nerve anatomy and meridian differentiation, the acupoints are selected accurately in treatment. Four acupoint prescriptions are allocated. For frequent urination and urinary incontinence, the foot-motor-sensory area of scalp acupuncture, Shenshu (BL 23) and Huiyang (BL 35) are used. For all kinds of urine retention, especially the patients who are not suitable for acupuncture at the lumbar region, Zhongji (CV 3), Qugu (CV 2), Henggu (KI 11) and Dahe (KI 12) are selected. For all kinds of urine retention, Zhongliao (BL 33) and Ciliao (BL 32) are applicable. For the patients with both dysuria and urinary incontinence, Zhongliao (BL 33), Ciliao (BL 32) and Huiyang (BL 35) are chosen. In treatment of neurogenic bladder, both biao (root causes) and ben (primary symptoms) are considered, as well as the accompanying symptoms; and electroacupuncture is combined accordingly. During the delivery of acupuncture, the sites where the acupoints located are detected and palpated so as to rationally control the depth of needle insertion and the operation of reinforcing and reducing needling techniques.

Determination of the ELISA kits for screening convalescence plasma with high potency of SARS-CoV-2 IgG / 中国输血杂志

【Objective】 To determine the ELISA kit for screening convalescence plasma with high potency of SARS-CoV-2 IgG by comparing and analyzing the plasma detection results of convalescent plasma collected in different periods via ELISA kits from two manufacturers and the results of mixed plasma with different potency via pseudovirus neutralization experiments. 【Methods】 Two ELISA kits from different manufacturers(named A, B) were used to detect the plasma of 269 convalescent patients collected from Feb.2020~Jan.2022. The correlation and concordance rate of the two results were analyzed to determine the kit preliminarily. According to the titers of diluted series of standard of the preliminary selected kit, 5 mixed plasma samples (G4-G128) with different potency were prepared. The correlation of ELISA IgG results of product A/B, as well as the pseudovirus neutralization test of the original strain, Omicron mutant BA.1 and BA.2 strains were analyzed. Combined with the outside-well dilution mode of the strongly positive samples, the kit for high potency of SARS-CoV-2 IgG screening was determined. 【Results】 When the internal control reference B2 was used as the standard, the detection sensitivity of product A and B was 1∶32 vs 1∶8; the detection sensitivity of product A was 4 times that of product B. The correlation Pearson r between the results given by two kits was 0.944 1(P<0.000 1). Product B with low sensitivity was primarily selected as an alternative kit. The ELISA IgG results of samples from mixed plasma showed that the order of correlation r between product A and B was 0.988. The correlation r between product A and neutralization antibody potency of the three viruses was original strain (0.978)>BA.2(0.970)>BA.1(0.799); the order of correlation r between ELISA IgG results of product B and neutralization antibody potency of the three viruses was original strain(0.994)>BA.2(0.968)>BA.1(0.804). If twice-diluted B2 was taken as the excellent standard, 55.4% of product B met the criterion, while 47.2% of product A met.For positive plasma with high IgG potency, the product B kit required a lower dilution of the sample, which was more convenient to operate. 【Conclusion】 Both of the ELISA IgG kit from product A and B can be used to screen IgG antibodies of SARS-CoV-2, while product B is more suitable for screening positive plasma with high IgG potency.

Apply ultra-thin lobulated anterolateral thigh perforator flap in repairing of large soft tissue defect in foot: a report of 8 cases / 中华显微外科杂志

Objective:Exploring the clinical efficacy of using ultra-thin lobulated anterolateral thigh perforator flap(ALTPF) with retrograde separation of perforating vessels from the superficial and deep junction layer of the superficial fascia to repair large soft tissue defects in the foot.Methods:From August 2021 to November 2022, 8 patients (5 males and 3 females) were admitted to the Second Department of Hand and Foot Surgery, the Affiliated Central Hospital of Dalian University of Technology. The patients were 28 to 52 years old in age. The soft tissue defects were located in dorsal and plantar foot. At the plantar foot, the wound involved the weight-bearing area with explosion of bone, tendon or internal fixtures. The area of soft tissue defects was 6.0 cm × 5.0 cm - 16.0 cm × 8.0 cm, and the sizes of ALTPF were 8.0 cm ×5.5 cm - 18.0 cm × 8.5 cm. Preoperative high frequency CUD combined with CTA angiography were employed to locate the 2 flap perforator vessels. By keeping the perforator vessels at center and according to the soft tissue defect area and the wound shape, an ALTPF with a proper size and shape was designed in anterolateral thigh. The perforator were separated in the boundary layer between superficial and deep fascia, where it helped to obviously thin the flap. After the flap was harvested, it was further lobulated between the 2 perforators into 2 lobes after having confirmed the effective blood supply. Finally the lobulated ALTPF was transferred to covered the defect in foot. Cautions should be taken to ensure that the flap covered the weight-bearing area of foot. All the donor sites were directly sutured. Postoperative follow-up was conducted to observe the survival of flaps and the functional recovery of the reconstructed site, also to evaluate the clinical effect. Postoperative follow-up included outpatient visits and reviews over WeChat or telephone. Recovery of the ankle motor function was evaluated according to the American Orthopedic Foot and Ankle Societ (AOFAS) ankle-hind foot score scale.Results:All 8 ALTPF survived. Over 6 to 18 months (10.8 months in average) of follow-up, the transferred flaps had good blood supply, soft in texture, with good elasticity and thin in appearance. Appearance and function of donor sites recovered well, except 1 patient who had mild scar hyperplasia. The plantar flap had good abrasion resistance. No flap damage, bleeding or granulation tissue hyperplasia occurred when walking. The mean score of AOFAS ankle-hind foot score achieved 95.6.Conclusion:The application of ultra-thin lobulated ALTPF with retrograde separation of perforating vessels from the superficial fascia at the junction layer for repairing large soft tissue defects in the foot has good clinical efficacy.

Retrospective analysis of treatment experience in 25 cases of lower extremity necrotizing fasciitis / 中国医师进修杂志

Objective:To retrospectively analyze the treatment of 25 cases of lower necrotizing fasciitis.Methods:A total of 25 patients with lower limb necrotizing fasciitis (13 males and 12 females), with mean age 63 years old (48-75 years old) in Dalian Municipal Central Hospital from September 2016 to December 2020. After admission, the patient′s general physical condition was strictly evaluated, the relevant preoperative examination was improved, and the necrotizing fasciitis laboratory risk index (LRINEC) score was performed. In the absence of surgical contraindication, multiple debridement was performed, leaving the necrotic tissue removed for general bacterial culture and drug sensitivity test in parallel. After debridement, eight patients showed a large area of skin necrosis, and amputation was selected. The other 17 patients chose limb protection treatment after debridement, and adopted debridement and free skin grafting. After surgery, patients were encouraged to strengthen rehabilitation exercise to restore limb function to the maximum extent.Results:With followed up 0.6 to 3.0 years, with an average of 1.8 years. Methods include outpatient return visit, WeChat contact or telephone inquiry. The skin survived in 17 patients with mean healing time (27.5 ± 6.9) d. Eighteen patients were multiple bacterial infections and seven patients were single bacterial infections. All patients had no joint dysfunction caused by scar contracture, and reinfection in the skin grafting area.Conclusions:Necrotizing fasciitis requires early diagnosis and early treatment, with correct choice of treatment method is closely related to the patient′s prognosis.

Risk factors and long-term prognosis of early severe complications after radical resection of gastric cancer / 国际外科学杂志

Objective:Clavien-Dindo grading system was used to explore the occurrence and related risk factors of early severe complications after radical resection of gastric cancer, and the effect of severe complications on long-term prognosis was analyzed.Methods:The clinical data of 525 patients who underwent radical resection of gastric cancer, including 387 male and 138 female with average age(62.5±10.7)years old (range from 16 to 89 years), were analyzed retrospectively in Department of Surgical Oncology of Anqing Municipal Hospital from October 2010 to July 2015. The occurrence of postoperative severe complications was analyzed according the Clavien-Dindo grade system.The relationship between 18 variables and severe complications was analyzed by univariate and multivariate analysis in order to explore the risk factors of severe postoperative complications, and the relationship between severe complications and long-term prognosis was analyzed by COX survival model. The software of SPSS 17.0 was used to conduct statistic analysis.Results:Five hundred and twenty-five patients with radical gastrectomy, 114 cases had early postoperative complications, including 20 cases of severe complications, 4 cases were performed second surgery under general anesthesia. The results of univariate analysis showed gender( χ2=4.86, P=0.027), the amount of bleeding( χ2=11.11, P=0.001), opertive time( χ2=4.77, P=0.029), the mode of operation( χ2=9.20, P=0.002) and pTNM stage( χ2=4.86, P=0.027) had significant statistical difference. Multivariate analysis showed that the amount of bleeding ( OR=13.05, P=0.013) and the mode of operation ( OR=7.97, P=0.047) were independent risk factors for early and severe complications after radical resection of gastric cancer. The 5-year survival rates of severe complication and non-severe complication were 35.0% and 61.8% respectively, and the difference was statistically significant ( P=0.004). Severe postoperative complications ( HR=1.595, P=0.107) were not independent risk factors affecting the 5-year survival rate. Conclusions:Early severe complications after radical resection of gastric cancer are closely related to intraoperative blood loss and total gastrectomy. Although the 5-year survival rate in severe complication group is significantly lower than that in non-severe complication group, severe complication is not an independent risk factor for long-term survival.

Research on classification of benign and malignant lung nodules based on three-dimensional multi-view squeeze-and-excitation convolutional neural network / 生物医学工程学杂志

Lung cancer is the most threatening tumor disease to human health. Early detection is crucial to improve the survival rate and recovery rate of lung cancer patients. Existing methods use the two-dimensional multi-view framework to learn lung nodules features and simply integrate multi-view features to achieve the classification of benign and malignant lung nodules. However, these methods suffer from the problems of not capturing the spatial features effectively and ignoring the variability of multi-views. Therefore, this paper proposes a three-dimensional (3D) multi-view convolutional neural network (MVCNN) framework. To further solve the problem of different views in the multi-view model, a 3D multi-view squeeze-and-excitation convolution neural network (MVSECNN) model is constructed by introducing the squeeze-and-excitation (SE) module in the feature fusion stage. Finally, statistical methods are used to analyze model predictions and doctor annotations. In the independent test set, the classification accuracy and sensitivity of the model were 96.04% and 98.59% respectively, which were higher than other state-of-the-art methods. The consistency score between the predictions of the model and the pathological diagnosis results was 0.948, which is significantly higher than that between the doctor annotations and the pathological diagnosis results. The methods presented in this paper can effectively learn the spatial heterogeneity of lung nodules and solve the problem of multi-view differences. At the same time, the classification of benign and malignant lung nodules can be achieved, which is of great significance for assisting doctors in clinical diagnosis.

Association of temperament type and mother's emotional state with acute respiratory infection in children / 南方医科大学学报

OBJECTIVE@#To explore the correlation of temperament type and mother's emotional state with acute respiratory tract infections in children so as to provide evidence for comprehensive treatment of the infections.@*METHODS@#A total of 200 children aged between 3 and 6 were enrolled in this study from two kindergartens of Guangzhou and Hengyang. The mothers were invited to complete a questionnaire of the children's general information followed by assessment using children's temperament scale and the Depression-Anxiety-Stress Scale.@*RESULTS@#The total incidence of acute respiratory infection was significantly higher in children with a hard- to-raise temperament than the easy- to-raise children (P < 0.05); the incidences of acute rhinitis, acute pharyngitis, acute laryngitis and acute bronchitis were all significantly higher in the hard-to-raise children (P < 0.05). A significant positive correlation was identified between the total number of episodes of acute respiratory tract infection in children and their mothers' stress and anxiety levels (P < 0.01). Acute rhinitis and acute tracheitis in the children were both positively correlated with the mothers' stress scores (P < 0.05), while acute pharyngitis and acute laryngitis were positively correlated with the mothers' anxiety scores (P < 0.05), while acute bronchitis was positively correlated with the mothers' stress and anxiety scores (P < 0.05). Multiple linear regression analysis with the factors influencing the types of acute respiratory tract infections in children as the independent variables suggested that the easy-to-raise type of temperament was a protective factor against acute rhinitis in children (P < 0.05), while mothers' anxiety was a risk factor of acute laryngitis in children (P < 0.05); the mothers' stress was a risk factor for acute bronchitis in children (P < 0.05).@*CONCLUSION@#Acute respiratory tract infection in children is closely related to the temperament type of the children and the emotional state of the mothers, which are important therapeutic targets in comprehensive interventions of acute respiratory tract infection in children.

Clinicopathological features and survival prediction after radical resection of gastric cancer / 国际外科学杂志

Objective:To explore the prognostic factors that may affect the postoperative survival of gastric cancer by analyzing patients with radical gastrectomy.Methods:The data of 525 patients with radical gastrectomy, including 387 male and 138 female with average age (62.5±10.7) years old (ranged from 16 to 89 years), were analyzed retrospectively in Anqing Municipal Hospital between October 2010 to July 2015. The relationship between 33 variables and prognosis was analyzed by a Cox proportionalhazards regression model, meanwhile ROC curve was established in order to explore the risk factor of postopertive survival.Results:The over survival(OS) rate of all patients was 89.3% at 1 year, 68.4% at 3 years and 59.6% at 5 years. The 5-year OS rate was 81.9% at stage Ⅰ, 71.4% at stage Ⅱ and 44.1% at stage Ⅲ. In the multivariate analysis that included these factors, preoperative comorbidity ( HR=1.595, P=0.001), hemoglobin( HR=1.377, P=0.017), CA199( HR=1.618, P=0.004), tumor distribution( HR=1.943, P=0.032), pT stage( HR=1.731, P=0.012), pN stage( HR=2.118, P=0.000), signet ring cell( HR=1.642, P=0.038)and intravascular tumor thrombus( HR=1.391, P=0.039) were independent risk factors associating with postopertive survival.According to ROC curve, the following area (AUC value) could predict survival after radical gastrectomy, including CA199 (AUC=0.568), hemoglobin(AUC=0.586), preoperative comorbidity(AUC=0.554), pT stage(AUC=0.636), pN stage(AUC=0.670)and intravascular tumor thrombus(AUC=0.626)( P<0.05). Conclusion:According to ROC curve analysis, preoperative comorbidity, anemia, CA199, pN stage, pT stage and intravascular tumor thrombus played an role in predicting long-term survival after radical resection of gastric cancer.

Application of Superstar mobile learning platform in endocrine teaching / 中华医学教育探索杂志

Our endocrinology teaching group has carried out the application and exploration of mobile APP teaching mode based on Superstar learning. Through the questionnaire survey, students thought there was no significant difference between mobile APP teaching and traditional teaching in knowledge understanding and memory. But the classroom atmosphere of mobile APP teaching was relaxed and active, which helps to improve learning interest and self-learning ability, and the problems after class can be solved by feedback in time. Through the sharing of experience on the whole course management in endocrinology mobile APP teaching, it is expected to provide positive reference for the mobile teaching mode of medical education in the future.

Near-infrared spectroscopy in rapid determination of glycyrrhizic acid and liquiritin in Glycyrrhizae Radix et Rhizoma Yinpian / 第二军医大学学报

Objective To establish a rapid determination model based on near-infrared spectroscopy (NIRS) for glycyrrhizic acid and liquiritin in Glycyrrhizae Radix et Rhizoma Yinpian. Methods The contents of glycyrrhizic acid and liquiritin in Glycyrrhizae Radix et Rhizoma Yinpian from different places of origin were determined by high performance liquid chromatography (HPLC) as reference values. At the same time 2 200-2 049, 1 750-1 450, 1 151-1 001 nm and 1 795-1 475, 1 395-1 293, 1 125-1 030 nm wavelength ranges of near-infrared spectra were selected to establish the rapid determination model by combining partial least squares (PLS) regression analysis with cross validation method. Results The correlation coefficient and root-mean-squares error of cross validation of the established content calibration model were 0.980 and 0.184 for glycyrrhizic acid, and 0.919 and 0.144 for liquiritin, respectively. Conclusion The NIRS-PLS method is convenient, rapid and nondestructive for the content determination of glycyrrhizic acid and liquiritin for large number of Glycyrrhizae Radix et Rhizoma Yinpian, which provides a new and feasible method for the rapid quality evaluation of Glycyrrhizae Radix et Rhizoma Yinpian.

Obesity and binge alcohol intake are deadly combination to induce steatohepatitis: A model of high-fat diet and binge ethanol intake

Obesity and binge drinking often coexist and work synergistically to promote steatohepatitis; however, the underlying mechanisms remain obscure. In this mini-review, we briefly summarize clinical evidence of the synergistical effect of obesity and heavy drinking on steatohepatitis and discuss the underlying mechanisms obtained from the study of several mouse models. High-fat diet (HFD) feeding and binge ethanol synergistically induced steatohepatitis and fibrosis in mice with significant intrahepatic neutrophil infiltration; such HFD-plus-ethanol treatment markedly up-regulated the hepatic expression of many chemokines with the highest fold (approximately 30-fold) induction of chemokine (C-X-C motif) ligand 1 (Cxcl1), which contributes to hepatic neutrophil infiltration and liver injury. Furthermore, HFD feeding activated peroxisome proliferator-activated receptor gamma that subsequently inhibited CXCL1 upregulation in hepatocytes, thereby forming a negative feedback loop to prevent neutrophil overaction; whereas binge ethanol blocked this loop and then exacerbated CXCL1 elevation, neutrophil infiltration, and liver injury. Interestingly, inflamed mouse hepatocytes attracted neutrophils less effectively than inflamed human hepatocytes due to the lower induction of CXCL1 and the lack of the interleukin (IL)-8 gene in the mouse genome, which may be one of the reasons for difficulty in development of mouse models of alcoholic steatohepatitis and nonalcoholic steatohepatitis (NASH). Hepatic overexpression of Cxcl1 and/or IL-8 promoted steatosis-to-NASH progression in HFD-fed mice by inducing neutrophil infiltration, oxidative stress, hepatocyte death, fibrosis, and p38 mitogen-activated protein kinase activation. Collectively, obesity and binge drinking synergistically promote steatohepatitis via the induction of CXCL1 and subsequent hepatic neutrophil infiltration.

Surveillance of Oncomelania hupensis distribution and water levels in Gaoyou sections of the eastern route project of the South-to-North Water Diversion Project following operation of the project / 中国血吸虫病防治杂志

Objective To understand the distribution of Oncomelania hupensis snails and changes of water levels in Gaoyou sections of the Li Canal following the operation of the eastern route project of the South-to-North Water Diversion Project. Methods The Oncomelania snails were monitored in the river banks and water bodies of Gaoyou sections of the Li Canal by means of systematic sampling combined with environmental sampling as well as collection of the floaters from 2014 to 2019, and the water levels were collected in Gaoyou sections of the Li Canal at the typical hydrological year before the operation of the eastern route project of the South-to-North Water Diversion Project and during the period between 2016 and 2019. Results A total area of 235.42 hm2 were investigated and a total of 75.8 kg floaters were collected in Gaoyou sections of the Li Canal from 2014 to 2019; however, no snails were found. The water level in Gaoyou sections of the Li Canal was predominantly high in the flood season and low in the dry season before the operation of the eastern route project of the South-to-North Water Diversion Project, and the water level was elevated in the dry season and relatively low in the flood season after the operation of the project. Conclusion Following the operation of the eastern route project of the South-to-North Water Diversion Project, the original river bank that is characterized by “land in winter and water in summer” has changed in Gaoyou sections of the Li Canal, which is not favorable for snail breeding.

Association between serum levels of osteopontin and systolic pulmonary artery pressure among healthy adults post acute high altitude exposure / 中华心血管病杂志

Objective: To explore the association between serum levels of osteopontin (OPN) and systolic pulmonary artery pressure (sPAP) in healthy men following acute high altitude exposure. Methods: According to the inclusion and exclusion criteria, this observational study included 94 male subjects (aged from 18 to 30 years, dwelling in lowland<500 m) who ascended to Litang (4 100 m) from Chongqing (400 m) by bus with a stair-like journey within 7 days in June 2013. Data including basic information, OPN, superoxide dismutase (SOD), and malondialdehyde (MDA) and echocardiographic derived sPAP were collected within 48 hours before ascent and within 2-7 hours after arrival. Accordingly, subjects were divided into 3 groups based on the tertiles of sPAP after acute high altitude exposure: low sPAP group (26.8-32.3 mmHg (1 mmHg=0.133 kPa)) (n=31), middle sPAP group (32.4-37.4 mmHg) (n=32) and high sPAP group (37.5-55.6 mmHg) (n=31). Associations of serum OPN and SOD levels with sPAP were analysed by univariate and multivariate linear regression analysis. Results: After acute high altitude exposure, the levels of sPAP were significantly increased (P<0.001). There were no differences in age, height, weight, body mass index, percent of Han nationality and smoking among 3 subgroups. However, following acute high altitude exposure, the levels of heart rate, systolic and diastolic blood pressure elevated (all P<0.05), whereas the levels of oxygen saturation were reduced in the total subjects and all subgroups (all P<0.05). Moreover, systolic blood pressure of subjects in the high sPAP group was higher than that in low and middle sPAP groups (both P<0.05), and diastolic blood pressure of subjects in high sPAP group was higher than that in low sPAP group (P<0.05). The serum levels of OPN were increased in total cohort(27.9 (22.5,34.0) μg/L vs. 25.6 (18.4, 33.1) μg/L, P<0.05)， and high sPAP group (P<0.05), whereas no differences were found in serum SOD and MDA levels among groups. Furthermore, the serum level of OPN in high sPAP group was higher than that in low sPAP group at high altitude (P<0.05), and there was a trend for decline in SOD level with increasing sPAP (P>0.05). Results from univariable linear regression analysis showed that the serum levels of OPN (r=0.32, P=0.002) and SOD (r=-0.22，P=0.032) were linearly correlated with sPAP in total cohort after high altitude exposure. Multivariate regression analysis showed that the serum levels of OPN(β=0.310，P=0.002) and SOD (β=-0.199，P=0.043) were independently associated with the levels of sPAP at high altitude. Conclusion: After acute high altitude exposure, the serum level of OPN is positively associated with sPAP, suggesting that OPN may be a novel bio-marker for predicting the increase of pulmonary pressure in response to acute high altitude exposure.

Application of hemodynamic optimization in the design of artificial heart / 生物医学工程学杂志

Heart failure is one kind of cardiovascular disease with high risk and high incidence. As an effective treatment of heart failure, artificial heart is gradually used in clinical treatment. Blood compatibility is an important parameter or index of artificial heart, and how to evaluate it through hemodynamic design and

Efficacy and safety of posterior pedicle screw internal fixation in combination with transpedicular bone grafting for treating thoracolumbar fractures in elderly patients / 中华老年医学杂志

Objective To investigate the efficacy and safety of posterior pedicle screw internal fixation as add-on to transpedicular bone grafting in the treatment of thoracolumbar fractures in elderly patients.Methods The 86 elderly patients with thoracolumbar fracture admitted to our hospital were enrolled in the retrospective study.All patients were divided into a control group(n=40)receiving posterior short-segment pedicle fixation,and a study group(n=46)undergoing transpedicular bone grafting as add-on to posterior short-segment pedicle fixation.The recovery of lumbar function and neurological function were compared between the two groups.Results The Cobb angle of the injured vertebrae was significantly decreased in two groups at one week after operation,and then increased slightly with time-lapse(Ftime =86.34,P＜0.05).The whole Cobb angle of injured vertebrae was lower in the study group than in the control group(F =7.68,P＜0.05).The Cobb angle reduction of injured vertebrae was more in the study group than in the control group (Ftime× groups =4.19,P ＜0.05).The height of the anterior and posterior edges of injured vertebrae was significantly increased in two groups at 1 week after operation,and then decreased slightly with time-lapse(Ftime =75.87 and 66.92,P ＜0.05).The overall level of anterior and posterior edges height of injured vertebrae was higher in the study group than in the control group(Fgroup =9.75 and 6.76,P＜0.05).The increased height of anterior and posterior edges of injured vertebrae was higher in the study group than in the control group(Ftime× groups =7.59 and 5.21,P＜0.05).The bone fusion rate was higher in the study group than in control group (97.8 ％ vs.82.5 ％,P ＜ 0.05).The failure rate of internal fixation was lower in the study group than in the control group (2.2 ％ vs.17.5％,x2 =5.96,P ＜ 0.05).The recovery of neurological function was better in the study group than in the control group(Z =2.12,P ＜0.05).The Oswestry disability index(ODI)in two groups was decreased with time-lapse(Ftime =85.49,P＜0.05).The overall ODI level was lower in the study group than in the control group(Fgroup =47.28,P＜0.05).The decrement of ODI index was larger in the study group than in the control group(Ftime× groups =8.97,P ＜ 0.05).Conclusions Posterior pedicle screw internal fixation in combination with transpedicular bone grafting are safe and effective in the treatment of thoracolumbar fractures in the elderly,which can improve the stability of vertebral compression,and promote the recovery of neurological function and lumbar function.

Evaluation of the auto-segmentation based on self-registration and Atlas in adaptive radiotherapy for cervical cancer / 中华放射肿瘤学杂志

Objective To evaluate the accuracy and validate the feasibility of auto-segmentation based on self-registration and Atlas in adaptive radiotherapy for cervical cancer using MIM-Maestro software.Methods The CT scan images and delineation results of 60 cervical cancer patients were obtained to establish the Atlas template database.The planning CT (pCT) and replanning CT (rCT) images were randomly selected from 15 patients for the contouring of clinical target volume (CTV) and organs at risk (OAR) by an experienced radiation oncologist.The rCT images of 15 patients were auto-contoured using Atlas-based auto-segmentation (Atlas group),and mapping contours from the pCT to the rCT images was performed by rigid and deformable image registration (rigid group and deformable group).The time for the three methods of auto-segmentation was also recorded.The similarity of the auto-contours and reference contours was assessed using dice similarity coefficient (DSC),overlap index (OI),the average hausdorff distance (AHD) and the deviation of centroid (DC),and the results were statistically compared among three groups by using one-way analysis of variance.Results The mean time was 89.2 s,22.4 s and 42.6 s in the Atlas,rigid and deformable groups respectively.The DSC,OI and AHD for the CTV and rectum in the rigid and deformable groups significantly differed from those in the Atlas group (all P＜0.001).In the rigid and deformable groups,the OI for the intestine significantly differed from that in the Atlas group.The mean DSC for CTV was 0.89 in the rigid and deformable groups,and 0.76 in the Atlas group.The optimal delineation of the bladder,pelvis and femoral heads was obtained in the deformable group.Conclusions AIl three methods of auto-segmentation can automatically and rapidly contour the CTV and OARs.The performance in the deformable group is better than that in the rigid and Atlas groups.

The effect of thioredoxin-1 on different layers of skin flap during the early stage of ischemia-reperfusion injury / 中华整形外科杂志

Objective@#Ischemia-reperfusion (IR) injury is a leading cause of flap compromise and organ dysfunction during free-tissue transfer, and remains a great challenge for plastic surgeons. Thioredoxin-1 (Trx-1) was proved to protect the IR flap by mitigating the oxidative stress, and inhibiting the activation of apoptosis signal-regulating kinase-1 (ASK-1) and mitogen-activated protein kinase (MAPK) pathway. The aim of this study is to investigate the distinction of Trx-1 expression, apoptosis indices in different layers of IR flaps, and the feasibility of tissue-layer-specific administration of Trx-1.@*Methods@#Ten patients′ specimens of IR flaps for DIEP breast reconstruction were collected and assessed for apoptosis and Trx-1 expression. Twenty mice were used to establish the IR flap model. The mice were sacrificed twenty-four hours after reperfusion. The flap tissues were harvested and tested by immunohistochemistry staining and TUNEL assay. The tissue-layer-specific dermoprotective effect of Trx-1 and the molecular mechanisms were assessed by an in vitro epithelial skin cell hypoxia-reoxygenation model. The statistics were conducted by t test and ANOVA using SPSS 20.0.@*Results@#Trx-1 expression and apoptotic cells were observed mainly located in the basal layer of epidermis and the papillary layer of dermis in human IR flaps and mice models. Trx-1 depletion was 24.19 %± 2.23% in the basal layer of epidermis and the papillary layer of dermis of patient IR flaps, decreasing significantly compared with 70.71% ± 6.38% in control group (t = 27.54, P< 0.001). Similar tissue-layer-specific down regulation of Trx-1 also displayed in mice IR flap models (19.83% ± 2.34% vs. 76.59% ± 4.88%; t = 34.71, P<0.001). The apoptotic index in human samples significantly increased from 1.32% ± 1.52% in control group to 43.71 %± 3.17% in IR group (t =38.23, P<0.001); while it was proved to be dramatically raised in mice models from 0.86% ± 1.15% in control group to 41.14 %± 4.21% in IR group (t= 36.96, P < 0.001). Western Blot analysis revealed Trx-1 down regulation and a significant increase in ASK-1, p-p38, and c-PARP abundance in the hypoxia-reoxygenation-treated HaCaT cells (P < 0.01). Supplementation of recombinant human Trx-1 significantly reduced the apoptosis-related protein expression.@*Conclusions@#The basal layer of epidermis and the papillary layer of dermis are the main damaged tissue layers in the early stage of skin flap ischemia-reperfusion injury. The IR flap can be protected by precisely replenishing the vulnerable layers with Trx-1.

Integration of Internet of things technology into the experimental teaching reform of biomedical sensor / 中华医学教育探索杂志

In recent years, the rapid development of the Internet of things technology has opened up broad prospects for the integration of the Internet of things technology into medical education to train interdisciplinary talents who master knowledge in both medicine and engineering. The researchers incorporated the Internet of things technology in the experimental teaching of the course "Biomedical sensors", reformed the contents and methods of experimental teaching, and developed and designed a biomedical sensor experimental teaching system based on the Internet of things technology. As a result, the new experimental teaching can help students understand the system design methods of the Internet of things in smart medical devices and cultivate their practical ability and innovative ability, which has obtained preliminary teaching results.

Integration of Internet of things technology into the experimental teaching reform of biomedical sensor / 中华医学教育探索杂志

In recent years,the rapid development of the Internet of things technology has opened up broad prospects for the integration of the Internet of things technology into medical education to train interdisciplinary talents who master knowledge in both medicine and engineering.The researchers incorporated the Internet of things technology in the experimental teaching of the course "Biomedical sensors",reformed the contents and methods of experimental teaching,and developed and designed a biomedical sensor experimental teaching system based on the Internet of things technology.As a result,the new experimental teaching can help students understand the system design methods of the Internet of things in smart medical devices and cultivate their practical ability and innovative ability,which has obtained preliminary teaching results.