Recognition pest by image-based transfer learning.

BACKGROUND: Plant pests mainly refers to insects and mites that harm crops and products. There are a wide variety of plant pests, with wide distribution, fast reproduction and large quantity, which directly causes serious losses to crops. Therefore, pest recognition is very important for crops to grow healthily, and this in turn affects crop yields and quality. At present, it is a great challenge to realize accurate and reliable pest identification. RESULTS: In this study, we put forward a diagnostic system based on transfer learning for pest detection and recognition. This method is able to train and test ten types of pests and achieves an accuracy of 93.84%. We compared this transfer learning method with human experts and a traditional neural network model. Experimental results show that the performance of the proposed method is comparable to human experts and the traditional neural network. To verify the general adaptability of this model, we used our model to recognize two types of weeds: Sisymbrium sophia and Procumbent Speedwell, and achieved an accuracy of 98.92%. CONCLUSION: The proposed method can provide evidence for the control of pests and weeds and the precise spraying of pesticides. Thus, it provides reliable technical support for precision agriculture. © 2019 Society of Chemical Industry.

Genome-wide characterization and expression analyses of the MYB superfamily genes during developmental stages in Chinese jujube.

The MYB transcription factor (TF) superfamily, one of the largest gene superfamilies, regulates a variety of physiological processes in plants. Although many MYB superfamily genes have been identified in plants, the MYB TFs in Chinese jujube (Ziziphus jujuba Mill.) have not been fully identified and characterized. Additionally, the functions of these genes remain unclear. In total, we identified 171 MYB superfamily genes in jujube and divided them into five subfamilies containing 99 genes of the R2R3-MYB subfamily, 58 genes of the MYB-related subfamily, four genes of the R1R2R3-MYB subfamily, one gene of the 4R-MYB subfamily, and nine genes of the atypical MYB subfamily. The 99 R2R3-MYB genes of jujube were divided into 35 groups, C1-C35, and the 58 MYB-related genes were divided into the following groups: the R-R-type, CCA1-like, I-box-binding-like, TBP-like, CPC-like, and Chinese jujube-specific groups. ZjMYB genes in jujube were well supported by additional highly conserved motifs and exon/intron structures. Most R1 repeats of MYB-related proteins comprised the R2 repeat and had highly conserved EED and EEE residue groups in jujube. Three tandem duplicated gene pairs were found on 12 chromosomes in jujube. According to an expression analysis of 126 ZjMYB genes, MYB-related genes played important roles in jujube development and fruit-related biological processes. The total flavonoid content of jujube fruit decreased as ripening progressed. A total of 93 expressed genes were identified in the RNA-sequencing data from jujube fruit, and 56 ZjMYB members presented significant correlations with total flavonoid contents by correlation analysis. Five pairs of paralogous MYB genes within jujube were composed of nine jujube MYB genes. A total of 14 ZjMYB genes had the same homology to the MYB genes of Arabidopsis and peach, indicating that these 14 MYB genes and their orthologs probably existed before the ancestral divergence of the MYB superfamily. We used a synteny analysis of MYB genes between jujube and Arabidopsis to predict that the functions of the ZjMYBs involve flavonoid/phenylpropanoid metabolism, the light signaling pathway, auxin signal transduction, and responses to various abiotic stresses (cold, drought, and salt stresses). Additionally, we speculate that ZjMYB108 is an important TF involved in the flavonoid metabolic pathway. This comprehensive analysis of MYB superfamily genes in jujube lay a solid foundation for future comprehensive analyses of ZjMYB gene functions.

Expression of Serum Vaspin and SFRP5 in Children with Idiopathic Nanosomia and Their Diagnostic Value / 现代检验医学杂志

Objective To explore the expression level of visceral adipose tissue-derived serine protease inhibitor(Vaspin)and secreted frizzled-related protein5(SFRP5)in the serum of children with idiopathic short stature(ISS)and its diagnostic value.Methods 70 children with ISS diagnosed in the First Hospital of Zhangjiakou from December 2021 to February 2023 were selected as the disease group,while 72 healthy volunteer children who underwent physical examination were collected as the control group.Immunoluminescence was applied to detect the expression level of VASPIN,Enzyme-linked immunosorbent assay(ELISA)was applied to detect the expression level of SFRP5 the clinical data of children in two groups were analyzed.Receiver operating characteristic(ROC)curve was applied to analyze the diagnostic value of serum Vaspin and SFRP5 for ISS,multivariate Logistic regression was used to analyze the influencing factors of ISS.Results Compared with the control group,the serum Vaspin level in the disease group was obviously increased(2.89±0.92 ng/ml vs 1.81±0.42 ng/ml),while the SFRP5 level was obviously reduced(10.22±2.84 pg/ml vs 13.21±3.53 pg/ml),the differences were statistically significant(t=9.040,5.552,all P＜0.05).The weight,height,body mass index(BMI)and proportion of sexual development stage II～V of children in the disease group were obviously lower than those in the control group,and the differences were statistically significant(t=7.687,6.330,5.559,7.024,all P＜0.05).The area under ROC curve showed that the AUC of Vaspin and SFRP5 and their combined detection in the diagnosis of ISS were 0.768,0.849 and 0.925,respectively,the combined diagnosis efficacy of Vaspin and SFRP5 was better than that of serum Vaspin and SFRP5 alone(Z =3.829,P＜0.001;Z =2.141,P=0.032).Multivariate Logistic regression analysis showed that BMI(OR=0.508,95%CI:0.260～0.991),Vaspin(OR=3.458,95%CI:1.125～10.631)and SFRP5(OR=0.378,95%CI:0.153～0.935)were the influencing factors for ISS(all P＜0.05).Conclusion The expression level of Vaspin in the serum of children with ISS is obviously increased,while the expression level of SFRP5 is obviously reduced.The two are influencing factors of ISS,and the combined detection of their expression levels has certain value in the diagnosis of ISS.

Expression of MutS homolog 3 in oral squamous cell carcinoma and its significance / 中国现代医生

Objective To investigate the expression of MutS homolog 3(MSH3)in oral squamous cell carcinoma and its significance.Methods The MSH3 protein expression was examined by immunohistochemistry in 20 normal oral mucosa and 60 oral squamous cell carcinoma tissues.Results Our results showed that MSH3 expression in oral squamous cell carcinoma tissues was lower than normal oral mucosa.The MSH3 expression in oral squamous cell carcinoma tissues with better differentiation was higher than that with worse differentiation.The positive MSH3 expression decreased from oral squamous cell carcinoma patients without lymph nodal metastasis to that with metastasis.MSH3 expression was not related to the patients'gender,age,tumour location or size.Conclusion Downregulation of MSH3 is consistent with poorly differentiation and nodal metastasis in oral squamous cell carcinoma.MSH3 may play a significant role in the malignant progression of oral squamous cell carcinoma.

Identification and expression analysis of MADS-box gene family in Docynia delavayi (Franch.) Schneid / 生物工程学报

MADS-box gene family is a significant transcription factor family that plays a crucial role in regulating plant growth, development, signal transduction, and other processes. In order to study the characteristics of MADS-box gene family in Docynia delavayi (Franch.) Schneid. and its expression during different stages of seed germination, this study used seedlings at different stages of germination as materials and screened MADS-box transcription factors from the transcriptome database of D. delavayi using bioinformatics methods based on transcriptome sequencing. The physical and chemical properties, protein conservative motifs, phylogenetic evolution, and expression patterns of the MADS-box transcription factors were analyzed. Quantitative real-time PCR (qRT-PCR) was used to verify the expression of MADS-box gene family members during different stages of seed germination in D. delavayi. The results showed that 81 genes of MADS-box gene family were identified from the transcriptome data of D. delavayi, with the molecular weight distribution ranged of 6 211.34-173 512.77 Da and the theoretical isoelectric point ranged from 5.21 to 10.97. Phylogenetic analysis showed that the 81 genes could be divided into 15 subgroups, among which DdMADS27, DdMADS42, DdMADS45, DdMADS46, DdMADS53, DdMADS61, DdMADS76, DdMADS77 and DdMADS79 might be involved in the regulation of ovule development in D. delavayi. The combination of the transcriptome data and the qRT-PCR analysis results of D. delavayi seeds indicated that DdMADS25 and DdMADS42 might be involved in the regulation of seed development, and that DdMADS37 and DdMADS38 might have negative regulation effects on seed dormancy. Previous studies have reported that the MIKC* subgroup is mainly involved in regulating flower organ development. For the first time, we found that the transcription factors of the MIKC* subgroup exhibited a high expression level at the early stage of seed germination, so we speculated that the MIKC* subgroup played a regulatory role in the process of seed germination. To verify the accuracy of this speculation, we selected DdMADS60 and DdMADS75 from the MIKC* subgroup for qRT-PCR experiments, and the experimental results were consistent with the expression trend of transcriptome sequencing. This study provides a reference for further research on the biological function of D. delavayi MADS-box gene family from the perspective of molecular evolution.

Comparison of the efficacy of open reduction Kirschner wire internal fixation and closed reduction Herbert screw internal fixation in the treatment of fresh unstable scaphoid fracture / 临床外科杂志

Objective To explore and compare the efficacy of open reduction Kirschner-wire internal fixation and closed reduction Herbert screw internal fixation in the treatment of fresh unstable scaphoid lumbar fracture.Methods 72 patients with fresh unstable scaphoid lumbar fracture admitted to our hospital from January 2020 to January 2022 were selected and randomly divided into the experimental group(36 cases,open reduction Kirschberg wire internal fixation)and the control group(36 cases,closed reduction Herbert screw internal fixation).The operation time,fracture healing time,healing rate at 12 weeks,complication rate,scaphoid osteonecrosis rate,wrist functional recovery 6 months and 1 year after surgery were observed and compared within 2 groups,including wrist range of motion,improved Mayo wrist function score,pain index using visual analog scale(VAS).Results There were no significant differences in operation time,fracture healing time,healing rate and complication rate in 2 groups(P＞0.05).6 months after surgery,the wrist motion of ulnar deviation,radial deviation,dorsalis extension and palmaris flexion in 2 groups were significantly improved compared with before surgery(P＜0.05).There was no significant difference in wrist motion in 2 groups after surgery(P＞0.05).Compared with 6 months after surgery,Mayo score of experimental group was significantly improved at 12 months after surgery(95.36± 3.34)vs.(78.52±5.62)(P＜0.05),and VAS was significantly decreased(1.04±2.24)vs.(3.25± 1.62)(P＜0.05),but there was no significant difference in Mayo score and VAS between 2 groups(P＞0.05).Conclusions Compared with closed reduction and Herbert screw internal fixation,open reduction and Kirschner wire internal fixation can also achieve satisfactory results.However,the operation cost and difficulty of Kirschner wire internal fixation are relatively low.

Minimally invasive technique for tibial plateau bicondylar fracture repair using the double reverse traction repositor / 中华骨科杂志

Objective:To assess the efficacy of a minimally invasive technique for repairing tibial plateau bicondylar fractures utilizing the double reverse traction repositor.Methods:A retrospective analysis was performed of the data of 31 patients (Schatzker V 17 cases, Schatzker VI 14 cases) who had been admitted to trauma center of Shandong provincial hospital affiliated to Shandong first medical university for tibial plateau bicondylar fractures from January 2017 to January 2022. There were 21 males and 10 females, aged from 18 to 67 years (average, 32.4±6.5 years). The intervention strategy comprised the use of a double reverse traction repositor and was augmented by precise screw fixation. A comprehensive set of parameters were measured, including time interval between injury and operation, operation time, blood loss, hospital stay, fracture healing time, incision complications. Postoperative assessments were made immediately and at the 12-month mark, including the evaluation of articular step-off height, medial tibial plateau angle, and posterior tibial slope angle. The evaluation also included thTime interval between injury and operation ranged from 5 to 11 days, with an average of 6.1±1.3 days. The surgical procedures varied in length from 70 to 160 minutes, averaging at 109.2±15.6 minutes. The volume of blood loss was noted to be between 90 to 380 ml, averaging at 176.5±20.8 ml. Hospitalization spanned from 10 to 15 days, with an average stay of 12.2 ±0.8 days. Over a follow-up duration of 12 to 20 months, averaging at 13.5±1.1 months, all patients achieved fracture union within a period of 11 to 20 weeks, with an average time of 14.6±1.5 weeks. The postoperative articular step-off was recorded at 0.45±0.13 mm immediately after surgery and 0.58±0.21 mm at the one-year follow-up. Similarly, the medial tibial plateau angle and posterior tibial slope angle showed marginal changes from the immediate postoperative period to the 12-month evaluation. Knee joint mobility at the one-year mark ranged impressively from 0° to 135°, with an average of 125.6°±2.1°. Functional outcomes as reflected by Rasmussen scores ranged from 18 to 28 points, with an average of 25.4±1.7 points. Pain, as assessed by the VAS, had a low score range of 0 to 2 points, averaging at 0.7±0.2 points. Notably, there were no postoperative complications associated with the incisions, such as fat liquefaction, infection, skin necrosis, or exposure of internal fixations. Additionally, no cases of delayed union or fixation failure were observed. Six patients had traumatic arthritis 1 year after operation.Conclusion:The minimally invasive double reverse traction repositor technique for tibial plateau bicondylar fracture repair is effective, warranting its broader application in orthopedic surgery.

Right-to-Left Displacement of an Airgun Lead Bullet after Transorbital Entry into the Skull Complicated by Posttraumatic Epilepsy : A Case Report

Penetrating head injury is a serious open cranial injury. In civilians, it is often caused by non-missile, low velocity flying objects that penetrate the skull through a weak cranial structure, forming intracranial foreign bodies. The intracranial foreign body can be displaced due to its special quality, shape, and location. In this paper, we report a rare case of right-to-left displacement of an airgun lead bullet after transorbital entry into the skull complicated by posttraumatic epilepsy, as a reminder to colleagues that intracranial metal foreign bodies maybe displaced intraoperatively. In addition, we have found that the presence of intracranial metallic foreign bodies may be a factor for the posttraumatic epilepsy, and their timely removal appears to be beneficial for epilepsy control.

Reproducible Abnormalities and Diagnostic Generalizability of White Matter in Alzheimer's Disease / 神经科学通报·英文版

Alzheimer's disease (AD) is associated with the impairment of white matter (WM) tracts. The current study aimed to verify the utility of WM as the neuroimaging marker of AD with multisite diffusion tensor imaging datasets [321 patients with AD, 265 patients with mild cognitive impairment (MCI), 279 normal controls (NC)], a unified pipeline, and independent site cross-validation. Automated fiber quantification was used to extract diffusion profiles along tracts. Random-effects meta-analyses showed a reproducible degeneration pattern in which fractional anisotropy significantly decreased in the AD and MCI groups compared with NC. Machine learning models using tract-based features showed good generalizability among independent site cross-validation. The diffusion metrics of the altered regions and the AD probability predicted by the models were highly correlated with cognitive ability in the AD and MCI groups. We highlighted the reproducibility and generalizability of the degeneration pattern of WM tracts in AD.

Chloroplast genome phylogeny and codon preference of Docynia longiunguis / 生物工程学报

Docynia longiunguis is a plant uniquely present in China and is of high edible and medicinal value. The analysis of its chloroplast genome will help clarify the phylogenetic relationship among Docynia and facilitate the development and utilization of D. longiunguis resources. Based on the alignment of chloroplast genome sequences of related species, the phylogeny and codon preference were analyzed. The total length of D. longiunguis chloroplast genome sequence was 158 914 bp (GenBank accession number is MW367027), with an average GC content of 36.7%. The length of the large single-copy (LSC), the small single-copy (SSC), and inverted repeats (IRs) are 87 020 bp, 19 156 bp, and 26 369 bp, respectively. A total of 102 functional genes were annotated, including 72 protein-coding genes, 26 tRNA genes, and 4 rRNA genes. The best model for constructing phylogenetic tree was TVM+F+R2. D. longiunguis and Docynia indica were clustered into a single group, while Docynia and Malus were clustered into a single group. Comparison of the chloroplast genome sequences of D. longiunguis and its five related species revealed that trnY (GUA)-psbD, ndhC-trnV (UAC), accD-psaI, psbZ-trnfM (CAU), ndhF-trnL gene regions varied greatly. The nucleic acid diversity analysis showed that there were 11 high variation areas with nucleotide variability > 0.01, all were located in the LSC and SSC regions. Except for D. longiunguis, the trnH genes in other sequences were located at the IRs/LSC junction and did not cross the boundary. Codon preference analysis showed that D. longiunguis chloroplast genome has the largest number of isoleucine (Ile) codons, up to 1 205. D. longiunguis has the closest genetic relationship with Malus baccata, Malus sieboldii, Malus hupehensis and Chaenomeles sinensis. Its chloroplast genome codon prefers to end with A/T. The chloroplast genome of D. longiunguis and other Rosaceae chloroplast genomes showed great differences in gene distribution in four boundary regions, while relatively small differences from the chloroplast genomes of Docynia delavayi and D. indica of the same genus were observed. The genome annotation, phylogenetic analysis and sequence alignment of chloroplast genome of D. longiunguis may facilitate the identification, development and utilization of this species.

Evaluation of integrated teaching model based on chronic disease care clinic in general practice department of general hospital / 中华全科医师杂志

Twenty general practice residents who received training in Tongren Hospital from 2018 to 2020 were enrolled. The residents undertook rotation in chronic disease care clinic of the general medicine department, and a multi-disciplinary integrated teaching mode was applied. The theoretical knowledge test, skill assessment and self-evaluation were performed before and after rotation. The 360-degree evaluation was carried out when leaving the department (study group), the results were compared with that of internal medicine (control group) in the same period. The teaching effect was comprehensively evaluated. The scores of theoretical knowledge and skill assessment after rotation were significantly higher than those before rotation ( P<0.01). The self-evaluated ability was significantly higher than that at admission, especially in general practice thinking (7.85±0.88), doctor-patient communication (7.95±0.69), health education (7.80±0.70) and disease management (8.20±0.62) ( P<0.01). The 360-degree evaluation showed that the study group was better than the control group in interpersonal communication skills [(4.75±0.44) vs. (4.41±0.50)], system-based work ability[(4.75±0.44) vs. (4.31±0.47)], practice-based learning and improvement [(4.80±0.41) vs. (4.33±0.48)], patient care [(4.75±0.44) vs. (4.28±0.46)] and training mode satisfaction [(4.85±0.37) vs. (4.38±0.49)] (all P<0.05). The study indicates that the multi-disciplinary integrated teaching mode applied for rotation in the chronic disease care clinic of the general medicine department can improve the teaching effect and raise the teaching quality for general practice residency training.

Effects of Dynesys dynamic fixation versus fusion fixation on sagittal alignment of lumbar degenerative diseases involving 2 to 4 segments / 中华骨科杂志

Objective:To compare the effects of Dynesys dynamic fixation and fusion fixation on the sagittal parameters of lumbar degenerative diseases of 2-4 segments.Methods:A total of 45 patients with 2-4 segments lumbar degenerative diseases, who underwent decompression and internal fixation in our hospital from March 2014 to July 2019, were retrospectively analyzed. There were 23 males and 22 females with an average age of 55±18 years (range 15-86 years). Dynesys dynamic fixation was performed in 22 cases and fusion fixation in 23 cases. Lumbar anteroposterior, flexion and extension lateral and standing full-length spine radiographs were taken before surgery, 2 weeks postoperatively, 3 months postoperatively and at the last follow-up. Sagittal alignment parameters were measured on those radiographs and compared between two groups. Lumbar parameters included lumbar lordosis (LL), lordosis of the fixed segments (LFx), lordosis of the adjacent level to fixed segment (LAdj) and lumbar range of motion (ROM). Pelvic parameters included pelvic incidence (PI), pelvic tilt (PT) and sacral slope (SS).Results:All cases were followed up for 12-50 months with an average of 18.5 months. There was no significant intra- and inter-group difference of LL value between Dynesys dynamic fixation and fusion fixation group before and after surgery ( P>0.05). The overall difference of LFx between groups was not statistically significant ( F=0.700, P=0.406). There was statistically significant variance between time points ( F=7.960, P<0.001) and an interaction effect between group and time ( F=3.940, P=0.006). The LFx of the fusion fixation group was more than that of the dynamic fixation group at 3 months postoperatively and at the last follow-up ( P<0.05). The difference of LAdj value between the two groups was not statistically significant ( F=0.520, P=0.476), while the difference between time points was significant ( F=4.810, P=0.002) with interaction effect between group and time ( F=3.560, P=0.010). Postoperative ROM values of the two groups showed statistically significant differences in group effect, time effect and interaction effect, respectively ( F=4.770, P=0.034; F=18.510, P<0.001; F=5.940, P=0.002). Dynamic fixation group's ROM was more than that of the fusion fixation group at 3 months postoperatively and at the last follow-up ( P<0.05). There was no significant difference of PI between groups and between different time points ( F=0.580, P=0.451; F=0.750; P=0.477). There was no interaction effect in PI between group and time ( F=0.120, P=0.886). There was no significant difference of PT and SS between two groups ( F=0.320, P=0.576; F=0.020, P=0.901). Both time effect and interaction effect were statistically significant ( P<0.05). One complication of unilateral S 1 screw loosening happened in one patient with dynamic fixed at 2 years after surgery. There was no complication in the fusion fixation group during the follow-up. Conclusion:Both Dynesys dynamic fixation and fusion fixation can effectively reconstruct the lumbar lordosis. The fixed segments' lordosis of Dynesys was less than that of fusion fixation from 3 months after operation. Theoretically, the similar increasing trends of LAdj after fixation implied that the degeneration of adjacent segments may occur in both fixation systems. The dynamic fixation can retain more ROM than the fusion fixation. Both two fixation systems have similar influence on the pelvic parameters.

Clinical effect of rhinoplasty with ear cartilage and silicone prosthesis: a three-dimensional scanning study / 中华医学美学美容杂志

Objective:To use three-dimensional (3D) scanning to measure the preoperative and postoperative nasal parameters of the patients received rhinoplasty with ear cartilage and silicone prosthesis, and to evaluate the clinical effect of the surgery.Methods:Sixteen female patients with an average age of 28.3 years, ranged from 21 to 35 years, received rhinoplasty with ear cartilage and silicone prosthesis in Wuhan Tongji Hospital from June 2018 to February 2019. Preoperative and postoperative 3D scanning was performed to measure nasal parameters, including linear length, angle, and proportional index.Results:All patients were satisfied with the postoperative outcomes. The postoperative nasal length, nasal height, and nasal depth increased significantly, and the postoperative nasal width and nasal tip width decreased. The postoperative nasolabial angle and nasofrontal angle were statistically improved, while the preoperative and postoperative data of columellar facial angle, nasal tip angle, and nasal column-lobular angle were not significantly different. The ratios of nasal depth and nasal width, nasal index and nasal tip protrusion were improved after surgery, while the postoperative ratios of nasal columella and nasal lobules length were not statistically improved.Conclusions:The 3D scanning allows for comprehensive and accurate measurement of the nasal parameters. The rhinoplasty with ear cartilage and silicone prosthesis is more effective in improving the overall contour of the nose, but less effective in improving the aesthetics of the nasal tip.

Application of magnetic resonance neurography in the treatment of pelvic fracture with lumbosacral plexus injury / 中华骨科杂志

Objective:To investigate the application value of magnetic resonance neurography (MRN) in pelvic fractures with lumbosacral plexus injury.Methods:From January 2014 to June 2020, data of 9 patients with pelvic fractures combined with lumbosacral plexus injury who were diagnosed with MRN and were performed surgical treatment were analyzed retrospectively. Among them, there were 8 males and 1 female, aged from 18 to 54 years, with an average age of 40.6±11.0 years. There were 2 fresh fractures within 3 weeks and 7 old pelvic fractures in 9 patients. According to AO classification, there were 6 cases of C1.3 type, 3 cases of C3 type. According to Denis classification of sacral fracture, there were 8 cases of Denis II type, 1 case of Denis III. Gibbons classification of nerve injury: 2 cases of grade II, 4 cases of grade III, 3 cases of grade IV; According to the criteria by the Nervous Injury Committee of British Medical Research Council (BMRC): 2 cases of M1, 3 cases of M2, 2 cases of M3, 2 cases of M4. Before the operation, the MRN technology was used to accurately locate the location and extent of the lumbosacral nerve injury, and nerve exploration release or internal fixation combined with nerve exploration release was employed for treatment.Results:All 9 patients underwent surgery successfully. The operation time ranged from 150 to 360 min, with an average of 217.8±63.8 min; intraoperative blood loss ranged from 200 to 1 100 ml, with an average of 388.9±293.4 ml. All patients were followed up for 21.6±19.3 months. All the fractures were healed, and the healing time was 12.7±2.2 months (range, 10-18 months). At the last follow-up, Gibbons classification of nerve injury: 3 cases of grade I, 5 cases of grade II, and 1 case of grade III. According to the criteria of BMRC: the muscle strength achieved M5 in 6 cases, M4 in 2 cases, M3 in 1 case. One patient developed a urinary system infection 2 months after discharge and recovered after treatment.Conclusion:MRN technique can assist the surgeon to fully understand the compression and traction damage of the lumbosacral nerve by the fracture before the operation, and make clear qualitative and localized diagnosis of the nerve damage, making the operation more precise and minimally invasive, which is a supplement to the traditional diagnosis method of lumbosacral plexus injury.

Clinical treatment of pelvic fracture complicated with anterior sacroiliac joint dislocation / 中华骨科杂志

Objective:To explore the clinical diagnosis and treatment experience of pelvic fracture complicated with anterior sacroiliac joint dislocation.Methods:The data of 19 patients with pelvic fracture and anterior sacroiliac joint dislocation admitted from June 2013 to September 2019 were retrospectively analyzed. There were 12 males and 7 females; aged 9-67 years, with an average of 28.0 years. There were 11 cases of traffic accident injury, 6 of falling injury and 2 of crashing injury caused by machine extrusion. According to the Tile classification, there were 8 cases of type C1, 2 of type C2, and 9 of type C3; 6 cases of modified mangled extremity severity score (MESS) were greater than or equal to 7, of which 2 cases underwent hip amputation, 4 cases underwent king-steelquis semipelvectomy. 13 cases underwent limb-salvage surgery, of which 3 cases underwent external fixation surgery, and the remaining 10 cases underwent open reduction and internal fixation with steel plate. The reduction quality was evaluated according to the Matta imaging criteria of pelvis, the pain was evaluated according to the visual analogue scale (VAS), and the pelvic function was evaluated according to the Majeed score.Results:The operation time was 2 to 4 hours, with an average of 3.2 hours; the intraoperative blood loss was 400 to 1 200 ml, with an average of 768.4 ml. The 18 surviving patients were followed up for 6 to 24 months, with an average of 11.6 months. One of the 6 amputation patients died one week after the operation due to septic shock and multiple organ failure. The overall survival rate of the patients was 94.7% (18/19), and the amputation rate was 31.6% (6/19). The pelvic fractures of the 18 surviving patients were all healed, and the fracture healing time was 3 to 6 months, with an average of 4.2 months. No delayed union or nonunion occurred. At the last follow-up of the 18 surviving patients, the VAS was 2.4±1.9 points (range, 0-6 points). Among them, there were no pain in 3 cases, mild pain in 9 cases and moderate pain in 6 cases. At the last follow-up, 13 patients undergoing limb salvage treatment evaluated the quality of reduction according to Matta imaging criteria. Among them, 6 cases were excellent, 4 were good, 2 were fair, and 1 was poor. The excellent and good rate was 76.9% (10/13). The Majeed functional score was 81.8±11.9 points (range, 53-95 points). Among them, 6 cases were excellent, 5 were good, 1 was fair, and 1 was poor. The excellent and good rate was 84.6% (11/13). In the limb salvage treatment group, 4 patients with lumbosacral nerve injury caused limited hip joint movement function, and unilateral lower limb sensation and movement were weakened. After neurolysis and nutritional support treatment, the patient's sensorimotor function was significantly improved.Conclusion:The mortality and disability rate of pelvic fractures combined with anterior sacroiliac joint dislocation is high. In order to save the patient's life, early diagnosis of limb injury and early surgical intervention should be performed. If necessary, hip disarticulation or king-steelquis should be selected.

Effect and mechanism of interleukin 37 on the immune function of regulatory T cells in septic mice / 中华急诊医学杂志

Objective:To investigate the effect of interleukin (IL)-37 on the immune function of regulatory T cells (Treg) in sepsis.Methods:TTregs were isolated and purified from the spleen of C57BL/6J mice and cultured in vitro. The cells were divided into the control group, lipopolysaccharide (LPS) group, IL-37 group, LPS+IL-37 group, LPS+3-Methyladenine (3-MA) group, LPS+3-MA+IL-37 group, LPS+Rapamaycin group, and LPS+Rapamaycin+IL-37 group. Culture supernatants and cells were collected, respectively, after cell culture for 24, 48, and 72 h. The secretion of IL-10 and TGF-β by Tregs was detected by ELISA, expressions of forkhead wing-link transcription factor (Foxp3) and cytotoxic T lymphocytes antigen 4 (CTLA-4) were measured by flow cytometry. Formation and number of autophagosomes were observed by transmission electron microscope. Western blot was used to determine expressions of autophagy associated proteins, including LC3I/II and Beclin1. Cecal ligation and puncture (CLP) was used to construct septic mice model, and the differences in survival rates between the groups were recorded and compared.Results:IL-37 was given to Tregs at 24, 48, and 72 h after LPS stimulation. The function of Treg was significantly enhanced after 72 h of synergistically stimulation by both LPS and IL-37. After stimulation with LPS and IL-37, the formation of autophagosomes in Tregs was obviously increased under observation of transmission electron microscopy. Pretreatment with autophagy agonist Rapamycin and autophagy inhibitor 3-MA was applied for altering the activity of cell autophagy. It was noticed that immune function of Treg was significantly decreased in the 3-MA group compared with the control group, while it was enhanced in the Rapamycin group. Secretion of TGF-β in the 3-MA group presented with significant reduction, which showed a marked increase in the Rapamycin group. However, no significant differences were found in IL-10 levels among various groups. Administration of IL-37 improved the survival rates of septic mice, which was much more efficient by treatment prior to the onset of sepsis.Conclusions:IL-37 appears to be capable of augmenting immune function of Tregs in an autophagy-dependent pathway, which might contribute to maintaining homeostasis of immune response in the setting of sepsis, and further improves the survival and prognosis of septic mice.

False-Negative Results of Real-Time Reverse-Transcriptase Polymerase Chain Reaction for Severe Acute Respiratory Syndrome Coronavirus 2: Role of Deep-Learning-Based CT Diagnosis and Insights from Two Cases

The epidemic of 2019 novel coronavirus, later named as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is still gradually spreading worldwide. The nucleic acid test or genetic sequencing serves as the gold standard method for confirmation of infection, yet several recent studies have reported false-negative results of real-time reverse-transcriptase polymerase chain reaction (rRT-PCR). Here, we report two representative false-negative cases and discuss the supplementary role of clinical data with rRT-PCR, including laboratory examination results and computed tomography features. Coinfection with SARS-COV-2 and other viruses has been discussed as well.

Clinical application of ultrasound modified gynecology imaging reporting and data system(mGI-RADS) in the diagnosis of ovarian tumors / 中华超声影像学杂志

Objective:To classify the ultrasound features of ovarian tumors by modified gynecology imaging reporting and data system(mGI-RADS), and explore the clinical value of mGI-RADS in differentiating of benign and malignant tumors.Methods:The 242 ultrasound images of the adnexal mass from 221 patients with ovarian tumor who underwent ultrasound scan and proceeded surgeries in the Second Affiliated Hospital of Harbin Medical University from September 2017 and December 2019 were involved in the retrospective analysis and compared with the pathological results. According to the latest ultrasound terminology for adnexal masses proposed by the International Ovarian Tumor Analysis (IOTA), the adnexal masses were classified. The suspeted malignant sings were screened for mGI-RADS. Using GI-RADS and mGI-RADS classification systems, all the adnexal masses were double-blindly classified by two senior doctors and their diagnostic efficiencies were evaluated.Results:Among the suspected malignant signs proposed by IOTA, resistance index (RI)<0.5, central blood flow signal, ascites, irregular cystic wall with uneven thickness separation, mass composition (solid component ≥30% and silent shadow attenuation), and papillary structure≥7 mm, showed retatively higher OR values(14.282, 10.372, 9.653, 8.832, 5.851, 4.506, respectively. Using GI-RADS and mGI-RADS classification systems, the diagnostic consistency by the two senior doctors in differentiating benign and malignant ovarian neoplasms was good(Kappa=0.767, P<0.05). Grade Ⅳ was divided into three subtypes (Ⅳa, Ⅳb, Ⅳc) by the mGI-RADS, and their positive predictive values for malignant ovarian masses were 69.0%, 90.4% and 92.9% respectively. When a cut-off value >mGRⅣ was used to distinguish the benign and malignant adnexal tumors, the AUC was the largest, and its sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 93.4%, 93.1%, 90.4%, 95.2% and 93.2%, respectively. Conclusions:The mGI-RADS has a high clinical value in the differential diagnosis of ovarian tumors.

Effect of Shouwu Jiangzhi decoction on hyperlipidemia Golden Syrian hamsters based on TNF-α/MAPK/apoB-48 pat / 中国药科大学学报

@#To investigate the mechanism of Shouwu Jiangzhi decoction in treatment of hyperlipidemia by suppress apoB-48 in small intestines, Golden Syrian hamsters were randomly devided into blank group, model group, fenobrate treatment group and Shouwu Jiangzhi decoction treatment group based on weight. The hyperlipidemia models of golden Syrian hamsters were induced by high fat diet(HFD)treatment for 4 weeks, then administered orally with drugs for 4 weeks. The serum indexes of HDL-C, LDL-C, TG and TC were determined by microplate methods, ELISA kits were used to evaluate the contents of serum TNF-α, apoB-48 and FFA. The protein expression levels of p38, ERK, JNK, SREBP, TNF-α and apoB-48 in small intestines were determined by Western blots. The results showed that Shouwu Jiangzhi decoction can effectively increase the serum HDL-C level and reduce the serum level of TG, LDL-C, TNF-α and apoB-48 in HFD-induced hamsters. Furthermore, Shouwu Jiangzhi decoction can significantly downregulate the protein expressions of p38, JNK, ERK, SREBP, TNF-α and apoB-48 in small intestines. Results above indicate that Shouwu Jiangzhi decoction may downregulate the protein expression of apoB-48 to treat hyperlipidemia via partially downregulating TNF-α/MAPK signal pathway.

Application of three-dimensional SPACE magnetic resonance imaging in accurate measurement of implant volume in breast surgery / 中华整形外科杂志

Objective@#The study is to assess the accuracy and reliability of three-dimensional simulated magnetic resonance imaging with silicone-excitation SPACE (sampling perfection with application optimized contrast using different flip angle evolutions) sequence for estimating implant volume.@*Methods@#(1) MRI examinations of 10 silicone implants (Wuhan Tongji Hospital from October 2018 to December 2018) were performed with T2, H2O-excitation SPACE sequence (T2-spc-H2O) and silicone-excitation SPACE sequence (T2-spc-Silicone) to find the most accurate method to estimate implant volume by ITK-SNAP. The effect of implant deformation and slice thickness of T2-spc-Silicone on volume measurement were investigated. (2) 13 normal patients and 6 patients with implant complications (Wuhan Tongji Hospital from March 2017 to May 2019) were enrolled for testing the accuracy and reliability of T2-spc-Silicone for volume measurement in vivo. The data were analyzed using Prism 8.0 software. The paired student t-test was used to compare the difference of two groups. One-way ANOVA was used to compare the difference of multiple groups. P<0.05 was considered statistically significant.@*Results@#The absolute volume differences of T2, T2-spc-H2O, T2-spc-Silicone were (42.19±2.31) ml, (23.27±1.55) ml and (6.28±1.22) ml. The absolute volume differences of T2-spc-Silicone group was significantly less than T2-spc-H2O and T2 group in vitro(F=195.3, P<0.001). No significant difference(F=1.36, P=0.22)was shown between the normality group and the deformation group for estimating the volume of implants with the slice thickness of SPACE increased from 0.5 mm×0.5 mm×0.5 mm to 5.0 mm×5.0 mm×5.0 mm. Besides, the slices thickness of SPACE from 0.5 mm×0.5 mm×0.5 mm to 5.0 mm×5.0 mm×5.0 mm did not significantly affect the accuracy of volume measurement of the implants in deformation state(F=1.22, P=0.29). The measurement error of SPACE was (8.82±0.99) ml in normal patients. Moreover, there was no significant difference between measured volume[(226.4±12.76)ml] and actual volume of implants[(225.9±11.94) ml](t=0.31, P=0.76)in patients with implant complications. The result showed excellent intraobserver reliability (ICC=0.997) and internal consistency ranged from 0.986 to 0.997 (P<0.001).@*Conclusions@#The method to measure implant volume by silicone-excitation SPACE sequence had desirable accuracy and reliability. The deformation of the implant and the slice thickness of the SPACE sequence did not exhibit a significant effect on the accuracy of volume measurement.