[Development and Application of Deep Learning-Based Model for Quality Control of Children Pelvic X-Ray Images].

Objective: A deep learning-based method for evaluating the quality of pediatric pelvic X-ray images is proposed to construct a diagnostic model and verify its clinical feasibility. Methods: Three thousand two hundred and forty-seven children with anteroposteric pelvic radiographs are retrospectively collected and randomly divided into training datasets, validation datasets and test datasets. Artificial intelligence model is conducted to evaluate the reliability of quality control model. Results: The diagnostic accuracy, area under ROC curve, sensitivity and specificity of the model are 99.4%, 0.993, 98.6% and 100.0%, respectively. The 95% consistency limit of the pelvic tilt index of the model is -0.052-0.072. The 95% consistency threshold of pelvic rotation index is -0.088-0.055. Conclusion: This is the first attempt to apply AI algorithm to the quality assessment of children's pelvic radiographs, and has significantly improved the diagnosis and treatment status of DDH in children.

Adenylate kinase 2 is a biomarker related to the prognosis of glioma and the immune microenvironment.

BACKGROUND: Among the brain and the other central nervous system, gliomas are the most prevalent malignant primary tumors. Adenylate kinase 2 (AK2) is generally thought to be crucial for energy metabolism and signal transduction. Several disorders are correlated with its aberrant expression. However, it is unclear what functions AK2 might have in gliomas. METHODS: We investigated the relationship between AK2 expression and clinicopathological features of glioma patients using information obtained from public databases and patient tissue microarrays. AK2 knockdown glioma cell lines were constructed to explore how AK2 affects glioma progress. The association between AK2 and the immune microenvironment in gliomas was evaluated by multiple methods. RESULTS: AK2 expression was higher in glioma samples than in normal brain tissues. Older patients and those with higher-grade, IDH-wildtype, 1p/19q codeletion-free, and MGMT-unmethylated tumors had higher levels of AK2 expression, linking to poor outcomes. Thus, gliomas with high AK2 expression have a worse prognosis. GO and KEGG analyses demonstrated that AK2 was relevant to cell division and DNA replication. Downregulation of AK2 suppresses cell proliferation, migration, and colony formation of glioma cell lines in vitro. AK2 expression was positively connected to the inhibitory immune checkpoints, also correlating with immune infiltration degree. CONCLUSIONS: In this study, AK2 may be a potential biological target for more precise molecular therapy of gliomas, since its high expression is associated with worse outcomes and a more malignant immune microenvironment.

Role of stem cell-like memory T cells in autoimmune diseases. / å¹²ç»†èƒžæ ·è®°å¿†Tç»†èƒžåœ¨è‡ªèº«å ç–«æ€§ç–¾ç— ä¸­çš„ä½œç”¨.

Stem cell-like memory T (TSCM) cell is a memory T cell subset with characteristics of long life span, consistent self-renewing, and the multipotent capacity to reconstitute the memory and effector T cell subsets. TSCM cell is the least differentiated cell in the memory T lymphocyte system, endowed with the stem cell-like ability, and it is essential for maintaining functional immunity. In addition, owing to its robust potential for immune reconstitution, it is central player in many physiological and pathological human processes. TSCM cell plays an important role in the occurrence and development of various autoimmune diseases. The specific role of TSCM cell in autoimmune diseases may make it a potential target for the treatment of multiple autoimmune diseases, driving effective immune reconstitution in therapy.

Numerically modelling the reflectance of a rough surface covered with diesel fuel based on bidirectional reflectance distribution function.

Oil spills have become a problem that negatively affects the oceanic environment and maritime transportation. Optical remote sensing technology is a potential method to monitor oil spills by analyzing the reflectance spectra of oil-polluted and clean water surface. In this paper, a numerical model for the reflectance of a rough oil surface is constructed by combining Fresnel reflection and bidirectional reflectance distribution function (BRDF). The way that visible light is reflected from the rough diesel fuel surface is quantitatively described and discussed based on the reflection theory of electromagnetic waves. The simulation result of the proposed model shows reasonable agreement with experimental measurements. With reliable prediction and a low computational complexity, the proposed model is expected to provide a theorical basis for rapid detection of oil spills on rough sea surfaces using optical remote sensing technology.

Effects of a 4-week Omaha System transitional care programme on rheumatoid arthritis patients' self-efficacy, health status, and readmission in mainland China: A randomized controlled trial.

BACKGROUND AND AIM: To our knowledge, the practice of transitional care was not common in mainland China. This study was designed to test the intervention effects of a specific dose (4 weeks) of an Omaha-based system transitional care programme for Chinese patients suffering from rheumatoid arthritis. METHODS: The intervention group adopted a 4-week nurse-led transitional care intervention based on the Omaha System. The control group used a comparable length of routine care. The outcome indexes were a Chinese version of the Arthritis Self-Efficacy Scale-8, Health Assessment Questionnaire-Disability Index, and hospital readmission rates. Data were collected from June 2018 to December 2018. RESULTS: Finally, 88 patients (44 in the intervention group and 44 in the control group) entered the data analysis. Baseline sociodemographic data for both groups were not found to be statistically significant. The self-efficacy and HAQ-DI of the intervention group were significantly different from the control group. Although the readmission rates of the intervention group were lower than that of the control group, it was not statistically significant. CONCLUSIONS: This 4-week transitional care intervention dose is sufficient to provide evidence for improving self-efficacy to implement disease management and enhancing physical function of patients diagnosed with rheumatoid arthritis.

Is meat consumption associated with depression? A meta-analysis of observational studies.

BACKGROUND: A number of epidemiological studies have examined the effect of meat consumption on depression. However, no conclusion has been reached. The aim of this study was to examine the relationship between meat consumption and depression. METHODS: The electronic databases of PUBMED and EMBASE were searched up to March 2017, for observational studies that examined the relationship between meat consumption and depression. The pooled odds ratio (OR) for the prevalence of depression and the relative risk (RR) for the incidence of depression, as well as their corresponding 95% confidence interval (CI), were calculated respectively (the highest versus the lowest category of meat consumption). RESULTS: A total of eight observational studies (three cross-sectional, three cohort and two case-control studies) were included in this meta-analysis. Specifically, six studies were related to the prevalence of depression, and the overall multi-variable adjusted OR suggested no significant association between meat consumption and the prevalence of depression (OR = 0.89, 95% CI: 0.65 to 1.22; P = 0.469). In contrast, for the three studies related to the incidence of depression, the overall multi-variable adjusted RR evidenced an association between meat consumption and a moderately higher incidence of depression (RR = 1.13, 95% CI: 1.03 to 1.24; P = 0.013). CONCLUSIONS: Meat consumption may be associated with a moderately higher risk of depression. However, it still warrants further studies to confirm such findings due to the limited number of prospective studies.

Biosorption and biodegradation of pyrene by Brevibacillus brevis and cellular responses to pyrene treatment.

Biodegradation has been proposed as an effective approach to remove pyrene, however, the information regarding cellular responses to pyrene treatment is limited thus far. In this study, the biodegradation and biosorption of pyrene by Brevibacillus brevis, along with cellular responses caused by pollutant were investigated by means of flow cytometry assay and scanning electron microscopy. The experimental results showed that pyrene was initially adsorbed by B. brevis and subsequently transported and intracellularly degraded. During this process, pyrene removal was primarily dependent on biodegradation. Cell invagination and cell surface corrugation occurred due to pyrene exposure. Nevertheless, cell regrowth after 96h treatment was observed, and the proportion of necrotic cell was only 2.8% after pyrene exposure for 120h, confirming that B. brevis could utilize pyrene as a sole carbon source for growth. The removal and biodegradation amount of pyrene (1mg/L) at 168h were 0.75 and 0.69mg/L, respectively, and the biosorption amount by inactivated cells was 0.41mg/L at this time.

Mapping the intellectual structure of the research of omalizumab in chronic spontaneous urticaria: A bibliometric analysis.

Background: The guidelines for treating chronic spontaneous urticaria (CSU) recommend using the IgE-targeted biologic omalizumab in patients with antihistamine-refractory disease. Objective: Our aim was to present a bibliometric review of publications related to omalizumab and CSU over the past 2 decades. Methods: Relevant publications from 2003 to 2022 were extracted from the Science Citation Index-Expanded (SCI-EXPANDED) database in the Web of Science Core Collection database as of January 8, 2023. We utilized CiteSpace (version 6.1.R3), VOSviewer (version 1.6.18), and the R package (version 4.2.1) to analyze and visualize the data. The R package bibliometrix (version 4.2.1) was also used. Results: Between 2003 and 2022, a total of 566 articles on omalizumab and CSU were published. Since 2014, there has been a rapid increase in publication output. According to the collaboration network, the most influential country, institute, and scholar were the United States, Charité Universitätsmedizin Berlin, and Marcus Maurer, respectively. The study identified the Journal of Allergy and Clinical Immunology: In Practice as the most productive journal and the Journal of Allergy and Clinical Immunology as the most cocited journal. The analysis of key words revealed the presence of high-frequency terms such as angioedema, IgE, treatment, anti-IgE, asthma, and atopic dermatitis. Moreover, recent studies in this area have concentrated mainly on biomarkers, dupilumab, and coronavirus 2019 (COVID-19). Conclusion: There has been a growing interest in the use of omalizumab in CSU in recent years. The current trending topics in this research are the identification of biomarkers and the development of new mAbs for the treatment of CSU.

Assessment of serum soluble CD40 ligand levels in patients with chronic rhinosinusitis.

Chronic rhinosinusitis (CRS) is a disease highly associated with abnormal regulation of T and B cells. The underlying pathophysiology of inflammatory pathways has critical implications for the diagnosis and management of CRS. Soluble CD40-ligand (sCD40L) is a cleaved form of CD40L present in plasma which functions the same way as CD40L, which has been observed as an inflammatory biomarker in many diseases. CD40L-positive cells control B-cell maturation, proliferation, apoptosis, and antibody production by binding to its receptor CD40 on B-cells. And our results show for the first time that patients with CRS have lower serum sCD40L levels compared to healthy subjects and that decreased sCD40L levels in patients correlate with increased CD40L-positive cell counts in the sinonasal mucosa. In addition, eosinophilic chronic rhinosinusitis (eCRS) patients tend to exhibit more CD40L-positive cells in the sinonasal mucosa compared to non-eCRS patients. This supports the notion that local blockade of CD40/CD40L may suppress pathogenic T/B cell responses and reduce tissue inflammation. Significantly, sCD40L and CD40L may be involved in the development and progression of CRS by impairing peripheral blood B-cell function and enhancing the local inflammatory response in the sinonasal mucosa.

CXCR5+TIM-3-PD-1+ stem-like cytotoxic CD8+ T cells: elevated in chronic rhinosinusitis and associated with disease severity.

Background: Chronic rhinosinusitis (CRS) is a chronic inflammatory disease with an autoimmune background. Altered expression levels of T cell immunoglobulin and mucin-domain containing-3 (TIM-3), C-X-C chemokine receptor type 5 (CXCR5), and programmed cell death protein 1 (PD-1) are implicated in the progression of inflammatory and autoimmune diseases. Moreover, CXCR5+TIM-3-PD-1+ stem-like cytotoxic T cells function as memory stem cells during chronic disease processes and retain cytotoxicity-related gene networks. Objectives: To explore the expressions of CXCR5, TIM-3, and PD-1 on T cells and their correlation with clinical parameters in CRS. Methods: Flow cytometry was used to assess the expressions and co-expressions of CXCR5, TIM-3, and PD-1 on T cells in the tissues of the paranasal sinus and peripheral blood of patients with CRS as well as healthy controls. Immunofluorescence was used to assess the co-localization of TIM-3, CXCR5, and PD-1 with T cells. The disease severity of our patients with CRS was evaluated using the Lund-Mackay score. A complete blood count was also performed for the patients with CRS. Results: Expression levels of CXCR5 and PD-1 on T cells were significantly increased in the nasal tissues of patients with CRS. Compared with those in healthy controls, patients with CRS had high percentages of CXCR5+TIM-3-PD-1+ CD8+ and CD4+ T cells in nasal tissues, while no significant difference was observed in peripheral blood levels. Patients with CRS had a higher density of nasal CXCR5+TIM-3-PD-1+ T cells than that in healthy controls. CXCR5+TIM-3-PD-1+ CD8+ T cell levels in the nasal polyps of patients with CRS were negatively correlated with the patients' Lund-Mackay scores. The levels of CXCR5+TIM-3-PD-1+ T cells in nasal tissues were also negatively associated with disease duration and positively associated with the chronic inflammatory state of CRS. Conclusions: The level of CXCR5+TIM-3-PD-1+ stem cell-like T cells, especially CXCR5+TIM-3-PD-1+ CD8+ T cells, is increased in CRS. Therefore, inducing CXCR5+TIM-3-PD-1+ T cell exhaustion may be an effective immunotherapy for CRS.

Bifunctional Cu-incorporated carbon nanospheres via in-situ complexation strategy as efficient toluene adsorbents and antibacterial agents.

Carbon adsorbents have been widely used to remove indoor volatile organic compounds (VOCs), however, the proliferation of bacteria on the carbon adsorbents may deteriorate the indoor air quality and thus pose a serious threat to human health. Herein, we report the synthesis of antibacterial porous carbon spheres (carbonized aminophenol-formaldehyde resin, CAF) with well-dispersed Cu species via an in situ incorporation of Cu2+ during the polymerization of 3-aminophenol-formaldehyde resin followed by a thermal carbonization and reduction process. Compared with CAF, the Cu/CAF-x nanocomposites with Cu loading show a much higher specific surface area (>700 m2 g-1vs. 569 m2 g-1 for CAF). In addition, the pore size of Cu/CAF-x is ranging from 0.7 to 1.68 nm, which is exactly conducive to adsorb the toluene molecules. As a result, the toluene adsorption capacity is improved from 123.50 mg g-1 for CAF to >170 mg g-1 for Cu/CAF-x. More importantly, such adsorbents possess excellent antibacterial performance, the Cu/CAF-10 (10 wt% of Cu loading) with a concentration of 50 µg mL-1 can completely kill the E. coli within 30 min. Our work paves the way to the development of bifunctional adsorbents with both efficient VOCs adsorption and excellent antibacterial performance.

Nano molybdenum trioxide-mediated enhancement of soybean yield through improvement of rhizosphere soil molybdenum bioavailability for nitrogen-fixing microbial recruitment.

Molybdenum (Mo) plays a pivotal role in the growth and nitrogen-fixing process of plants mediated by rhizobia. However, the influence of nano­molybdenum trioxide (MoO3NPs) on soybean growth, rhizosphere bioavailable Mo, and nitrogen-fixing microorganisms remains underexplored. Here, we report that compared with that of ionic Mo and bulk MoO3, the utilization of MoO3NPs (specifically NPs0.05 and NPs0.15) significantly boosted the available Mo content in the rhizosphere soil throughout the seedling (by 21.64 %-101.38 %), podding (by 54.44 %-68.89 %), and mature stage (by 34.41 %-to 45.71 %) of soybean growth. Furthermore, both NPs0.05 and NPs0.15 treatments maintained consistently higher levels of acid-extractable Mo, reducible Mo, and oxidizable Mo across these stages, which facilitated stable conversion and supply of bioavailable Mo. Within the rhizosphere soil, NPs0.05 and NPs0.15 treatments resulted in the highest relative abundance of Rhizobiales and Bradyrhizobium genera, and significantly promoted the colonization of nitrogen-fixing microorganisms, thereby increasing the content of nitrate nitrogen (NO3--N) by 8.69 % and 7.72 % and ammonium nitrogen (NH4+-N) by 44.75 % and 17.55 %, respectively. Ultimately, these effects together contributed to 107.17 % and 84.00 % increment in soybean yield by NPs0.05 and NPs0.15 treatments, respectively. In summary, our findings underscore the potential of employing MoO3NPs to promote plant growth and maintain soil nitrogen cycling, indicating distinct advantages of MoO3NPs over ionic Mo and bulk MoO3.

Visual and bibliometric analysis of chronic rhinosinusitis and nasal polyps.

Background: Chronic rhinosinusitis (CRS) is a heterogeneous disease characterized by persistent sinonasal inflammation and sinus microbiome dysbiosis. Nasal polyps (NPs) are one of the main manifestations that cause diverse clinical symptoms of CRS. Objective: We sought to conduct a bibliometric and visual analysis of articles on CRS and NPs published between 2003 and 2022 to provide researchers with the current state of research and potential directions. Methods: We searched relevant articles from 2003 to 2022 in the Web of Science database. VOSviewer and the Bibliometrix R package were used to perform the bibliometric analysis. Results: A total of 3907 publications were retrieved. The United States made the highest contributions to global research, followed by China. Northwestern University had the most publications. The most published author was C. Bachert, followed by R. P. Schleimer and R. J. Schlosser. The authors with the most co-citations were C. Bachert, W. J. Fokkens, and P. Gevaert. Moreover, the journal with the most publications was the International Forum of Allergy & Rhinology, and the Journal of Allergy and Clinical Immunology was the most cited. "Covid-19," "biologics," and "type 2 inflammation" were the top current research hotspots. Conclusions: The United States and Northwestern University were the leading country and institution in researching CRS and NPs. C. Bachert was the most influential expert. The International Forum of Allergy & Rhinology and the Journal of Allergy and Clinical Immunology were leading journals. "Covid-19," "biologics," and "type 2 inflammation" were the trending topics.

Effects of nonsynonymous single nucleotide polymorphisms of the KIAA1217, SNTA1 and LTBP1 genes on the growth traits of Ujumqin sheep.

Sheep body size can directly reflect the growth rates and fattening rates of sheep and is also an important index for measuring the growth performance of meat sheep. In this study, high-resolution resequencing data from four sheep breeds (Dorper sheep, Suffolk sheep, Ouessant sheep, and Shetland sheep) were analyzed. The nonsynonymous single nucleotide polymorphisms of three candidate genes (KIAA1217, SNTA1, and LTBP1) were also genotyped in 642 healthy Ujumqin sheep using MALDI-TOFMS and the genotyping results were associated with growth traits. The results showed that different genotypes of the KIAA1217 g.24429511T>C locus had significant effects on the chest circumferences of Ujumqin sheep. The SNTA1 g.62222626C>A locus had different effects on the chest depths, shoulder widths and rump widths of Ujumqin sheep. This study showed that these two sites can be used for marker-assisted selection, which will be beneficial for future precision molecular breeding.

In vivo study of pedicle screw augmentation using bioactive glass in osteoporosis sheep.

STUDY DESIGN: Augmentation of pedicle screws with bioactive glass (BG) was performed in osteoporotic ovine spine in vivo. Biomechanical tests, micro-computed tomography (CT) analysis, and histologic observation were performed. OBJECTIVE: To investigate the biomechanical stability of pedicle screws augmented by BG in osteoporotic sheep and observe the bone-screw interface histologically. SUMMARY OF BACKGROUND DATA: There is little information on the long-term biomechanical performance and screw-bone interfacial bonding of pedicle screws augmented with BG in osteoporotic spine in vivo. METHODS: Twelve months after ovariectomy combined with methylprednisolone injection, 8 adult female sheep were randomly divided into 2 groups (3- and 6-mo time point groups). In each time point group, pedicles were randomly selected from the lumbar spine (L1-L6) and implanted with (1) pedicle screw alone; (2) pedicle screw augmented by polymethylmethacrylate; or (3) pedicle screw augmented by BG. Three and 6 months after implantation, animals were labeled with tetracycline and calcein before being killed. Then vertebrae with pedicle screws were obtained, and a micro-CT scan, histologic analysis, and biomechanical tests were performed. RESULTS: Three months after implantation, micro-CT reconstruction showed that microstructural parameters of the BG group were significantly better compared with those in the other 2 groups (P<0.05). Histologic observation revealed that bone trabeculae around the screws in the BG group were more in number and denser than those in the control group. The average mineral apposition rate of the bone in the BG group was also higher than that in the other 2 groups (P<0.05). The mechanical properties in the BG group were also significantly higher than that in the control group. Six months after implantation, similar results except mineral apposition rate can be obtained among different groups. CONCLUSIONS: BG can significantly improve bone microstructure of the interface in osteoporosis condition and increase the hold strength of the pedicle screw.

Clinical assessment of a CMC/PEO gel to inhibit postoperative epidural adhesion formation after lumbar discectomy: a randomized, control study.

PURPOSE: To evaluate effectiveness of carboxymethylcellulose/polyethylene oxide (CMC/PEO) gel in improving clinical outcomes after the first-time lumbar discectomy. METHOD: Ninety-three patients with herniated lumbar disc at L4-L5 or L5-S1 were enrolled and randomized into two groups: CMC/PEO gel treatment group and control group. All the patients underwent laminotomy and discectomy by posterior approach. The preoperative and postoperative Oswestry Disability Index (ODI) and Visual Analogue Scale (VAS) scores for lower-back pain and leg pain were analyzed and compared between two groups at 30- and 60-day time points. RESULTS: No patient presented with any clinically measurable adverse event during surgery. There were no significant differences between the treated group and the control group on the preoperative ODI and VAS scores. In general, the ODI and VAS scores decreased in both groups at all the time points. At the 30-day time point, the VAS scores for back pain and leg pain and the ODI scores in treatment group were lower by 9.9 % (P = 0.0302), 27.0 % (P = 0.0002) and 16.3 % (P = 0.0007) than those in control group. And at the 60-day time point, the ODI and VAS scores further decreased in both groups. The VAS scores for leg pain in treatment group were lower by 4.5 % than that in the control group (P = 0.0149). However, no significant difference was detected between two groups on the ODI and VAS scores for back pain. CONCLUSIONS: The results demonstrated that CMC/PEO gel is effective in reducing posterior dural adhesions in the spine with no apparent safety issues. It can improve patients' postoperative clinical outcome.

Effect of regulating the different proportions of Zr to Mn elements on the hydrogen storage properties of titanium-iron-manganese-hydrogen storage alloys.

The effect of regulating the different proportions (0, 1 : 3, 1 : 2 and 1 : 1) of Zr to Mn elements on the hydrogen storage properties of TiFe0.85-x Mn0.15Zr x (x = 0, 0.05, 0.075 and 0.15) alloys was systematically studied in this work. The results showed that all alloys mainly showed TiFe and MgZn2 type phases. The MgZn2 type phase went up with the proportion of Zr to Mn elements. At the same time, increasing the proportion of Zr to Mn elements enhanced the first hydrogenation properties. In addition, the x = 0.15 alloy showed the highest hydrogen storage capacity during the first hydrogenation process. This was because the MgZn2 type phase could improve the penetration of hydrogen atoms and enhance the diffusion of hydrogen atoms. During the test of prolonged air exposure, it was clear that the oxidation resistance also increased with the proportion of Zr to Mn elements. In addition to this, the effect of the starting particle size was also studied. When the length of the starting particle size was around 0.5 cm, the x = 0.05 alloy did not absorb any hydrogen within 1500 seconds. However, the x = 0.15 alloy could be activated in only around 100 seconds. Finally, the rate limiting step of the first hydrogenation and PCT properties were also investigated.

Alkaline phosphatase combined with γ-glutamyl transferase is an independent predictor of prognosis of hepatocellular carcinoma patients receiving programmed death-1 inhibitors.

Background: Immunotherapy plays an increasingly critical role in the systemic treatment of HCC. This current study aimed to establish a novel prognostic predictor of Programmed death 1 (PD-1) inhibitor therapy in hepatocellular carcinoma (HCC) independent of Child-Pugh grade. Methods: Our study screened patients with HCC who received PD-1 inhibitors at Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from January 2018 to December 2020. ALG grade was determined by the patient's serum ALP and GGT levels before the initiation of PD-1 inhibitors. The endpoints of our study were overall survival (OS) and progression free survival (PFS). Follow-up ended at May 31, 2022. Results: Eighty- five patients (77 with Child-Pugh grade A, 8 with Child-Pugh grade B at baseline) were enrolled according to the inclusion criteria. Patients with Child-Pugh grade A achieved longer PFS and OS than those with Child-Pugh grade B. Patients with ALG grade 3 at baseline showed worse tumor response and poorer survival, and ALG grade could stratify patients with Child-Pugh grade A into subgroups with significantly different prognosis. Conclusions: ALG grade, combining ALP and GGT, is a novel and readily available prognostic marker and the predictive effect of ALG grade on patient prognosis is independent of Child-Pugh grade.

Quantification of femoral position on radiographic acetabular coverage in children.

An accurate assessment of the radiographic acetabular coverage is essential for clinical diagnosis or surgical decision-making in hip disorders. This study aimed to evaluate the effect of femoral position on acetabular coverage and to predict the actual acetabular coverage from nonstandard radiographs. A total of 21 children (34 hips) with normative acetabular coverage were screened in this retrospective study. The Mimics-based local-rotation fluoroscopy simulation method was used to tilt, incline, and rotate the femur in 4° increments within the range of femoral motion. The acetabular coverage, namely acetabular-head index (AHI) and center-edge angle (CEA), increased with femoral abduction but decreased with other motions. Compared to the femoral neutral position, no significant differences were identified in AHI with the rotation (range: 0°-16°) and in CEA with the tilt (range: -20°-4°), inclination (range: 0°-4°), or rotation (range: -8°-40°). The linear regression analysis showed that the CEA increased by about 0.20° for each 1° increase in femoral inclination and decreased by about 0.01°, 0.07°, 0.06°, or 0.07° for each 1° increase in internal rotation, external rotation, flexion, or extension, respectively. And a more significant change in AHI was observed. All femoral malpositions, especially the inclination, affected radiographic acetabular coverage in children. Therefore, each pelvic radiograph should assess potential femoral malpositioning before diagnosing hip disorders. This study will assist surgeons in predicting the acetabular coverage on nonstandard radiographs.

Risk factors for misdiagnosis in children with developmental dysplasia of the hip: a retrospective single centre study.

OBJECTIVE: To investigate risk factors of misdiagnosis at the first visit of children with developmental dysplasia of the hip (DDH) who did not participate in hip ultrasound screening. METHODS: A retrospective review was conducted on children with DDH admitted to a tertiary hospital in northwestern China between January 2010 and June 2021. We divided the patients into the diagnosis and misdiagnosis groups according to whether they were diagnosed at the first visit. The basic information, treatment process and medical information of the children were investigated. We made a line chart of the annual misdiagnosis rate to observe the trend in the annual misdiagnosis rate. Univariate and multivariate logistic regression analyses were used to identify significant risk factors for missed diagnosis. RESULTS: A total of 351 patients met the inclusion criteria, including 256 (72.9%) patients in the diagnosis group and 95 (27.1%) patients in the misdiagnosis group. The line chart of the annual rate of misdiagnoses among children with DDH from 2010 to 2020 showed no significant change trend. Multiple logistic regression analysis showed that the paediatrics department (v the paediatric orthopaedics department: OR 0.21, p<0.001), the general orthopaedics department (v the paediatric orthopaedics department: OR 0.39, p=0.006) and the senior physician (v the junior physician: OR 2.47, p=0.006) on the misdiagnosis at the first visit of children were statistically significant. CONCLUSION: Children with DDH without hip ultrasound screening are prone to be misdiagnosed at their first visit. The annual misdiagnosis rate has not been significantly reduced in recent years. The department and title of the physician are independent risk factors for misdiagnosis.