Partial cellular reprogramming stably restores the stemness of senescent epidermal stem cells.

OBJECTIVE: Adult stem cell senescence and exhaustion are important drivers of organismal age. Restored stem cell self-renewal has revealed novel therapeutic targets for decreasing the incidence of age-associated diseases (AADs) and prolonging the human health span. Transient ectopic expression of the reprogramming factors Oct3/4, Sox2, Klf4 and c-Myc (collectively known as OSKM) in somatic cells can induce partial cellular reprogramming and effectively ameliorate their age-associated hallmarks. However, how this form of rejuvenation is applied to senescent stem cells remains unknown. MATERIALS AND METHODS: The Integrin-α6highCD71high epidermal stem cells (ESCs) with low self-renewal ability were sorted by flow cytometry and then treated by the interrupted reprogramming induced by transient expression of OSKM. The ability of secondary clones' generation and self-proliferation in vitro, as well as stem cell marker p63, were detected to determine their self-renewal ability. Besides, gene and protein of epidermal cell markers were detected to determine whether their cell identities were retained. Finally, DNA methylation age (eAge) and DNA dehydroxymethylase/methyltransferase were analyzed to explore the alternation of their global DNA methylation pattern during this rejuvenation. RESULTS: The partial reprogramming restored the youthful self-renewal and proliferation in senescent ESCs, including larger secondary clone generation, higher expression of stem cell marker p63 and proliferation marker Ki67, and faster proliferation speed, in each case without abolishing epithelial cellular identity. Moreover, the rejuvenation of adult stem cells could be maintained for 2 weeks after reprogramming factor withdrawal, which was more stable than that of differentiated somatic cells. Additionally, we found that partial reprogramming counteracted the acceleration of eAge in senescent epidermal stem cells and DNA methyltransferase 1 (DNMT1) may play a crucial role in this process. CONCLUSIONS: Partial reprogramming has high therapeutic potential for reversing adult stem cell age, providing an advanced way to treat AADs.

Retraction Note: LINC01296 promotes the proliferation and invasion by regulating microRNA-760 expression and predicts poor prognosis of hepatocellular carcinoma.

The article "LINC01296 promotes the proliferation and invasion by regulating microRNA-760 expression and predicts poor prognosis of hepatocellular carcinoma", by Z.-C. Wang, S. Yang, M.-Q. Chen, S.-S. Wu, H.-H. Lv, W.-X. Jin, published in Eur Rev Med Pharmacol Sci 2019; 23 (22): 9848-9856-DOI: 10.26355/eurrev_201911_19548- PMID: 31799652 has been retracted by the author for the following reasons: After the publication of this article, the authors reviewed the process of the experiment and found there were mistakes in the methodology search. Not all the carcinoma specimens used in the experiment were from hepatocellular carcinoma. The prognosis and clinical features the rate of lymph node metastasis and the treatment and prognosis between these types of cancers are different. For example, intrahepatic cholangiocarcinoma tends to involve a high frequency of lymph node metastasis, and the prognosis is worse than hepatocellular carcinoma; hepatocellular carcinoma seldom involves lymph node metastasis but often involves intrahepatic metastasis; colorectal cancer liver metastasis is far more sensitive to chemotherapy and has a relatively long survival, and neuroendocrine carcinoma is sometimes sensitive to hormone therapy and generally has better survival than hepatocellular carcinoma. As a result, the clinical results and gene test results mentioned in this article were incorrect. After that the authors found that there was a mistake, they subsequently carried out supplementary experiments and found that they could not confirm that there was an increase in the expression of the LICO01296 gene in hepatocellular carcinoma, so they could not link some clinical results with the results of the basic research results mentioned in this article. Therefore, from the perspective of academic rigor, they requested to withdraw the article. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/19548.

[To highlight the evidence-based medical imaging clinical appropriateness (EB-MICA􀳏)].

The appropriate application of medical imaging is a major concern of our nation in recent years. In the year of 2020, we proposed the concept of Evidence-based Medical Imaging Clinical Appropriateness (EB-MICA®). We preliminary evaluated the value of different kinds of medical imaging in clinical practice. A series of work had be applied in the stage of medical imaging application. It has decreased the cost of patients and medical insurance and improved the medical efficiency, providing key clues for medical policy makers objectively. It is also an important opportunity for the transformation of medical model towards the "value-based model". In the concern of appropriate medical imaging for patients with tinnitus, hearing loss and (or) vertigo, IgG4-related disease in clinical practice, experts in related academic group wrote and published three EB-MICA consensuses as reference. This work keeps promoting rational utilization of medical resource and improving the quality of clinical decision-making.

iTRAQ-based quantitative proteomics reveals biomarkers/pathways in psoriasis that can predict the efficacy of methotrexate.

BACKGROUND: Methotrexate (MTX) is the first-line medicine to treat psoriasis. So far, there has been less research on protein biomarkers to predict its efficacy by the proteomic technique. OBJECTIVES: To evaluate differentially expressed proteins in peripheral mononuclear cells (PBMCs) between good responders (GRs) and non-responders (NRs) after MTX treatment, compared with normal controls (NCs). METHODS: We quantified protein expression of PBMCs with four GRs and four NRs to MTX and four NCs by isobaric tags for relative and absolute quantification (iTRAQ), analysing and identifying proteins related to efficacy of MTX in 18 psoriatic patients. RESULTS: A total of 3177 proteins had quantitative information, and 403 differentially expressed proteins (fold change ≥1.2, P < 0.05) were identified. Compared to NCs, upregulated proteins (ANXA6, RPS27A, EZR, XRCC6), participating in the activation of NF-κB, the JAK-STAT pathway and neutrophil degranulation were detected in GRs. The proteins (GPV, FN1, STOM), involving platelet activation, signalling and aggregation as well as neutrophil degranulation were significantly downregulated in GRs. These proteins returned to normal levels after MTX treatment. Furthermore, Western blotting identified the expression of ANXA6 and STAT1 in PBMCs, which were significantly downregulated in GRs, but not in NRs. CONCLUSIONS: We identified seven differentially expressed and regulated proteins (ANXA6, GPV, FN1, XRCC6, STOM, RPS27A and EZR) as biomarkers to predict MTX efficacy in NF-κB signalling, JAK-STAT pathways, neutrophil degranulation, platelet activation, signalling and aggregation.

[Analysis of the associations of chemokine receptors expression on circulating Tfh2 and Th2 cells with sIgE level and disease severity in patients with AR].

Objective: To clarify the chemotactic characteristics of type 2 helper T cells (Th2 cells) and type 2 follicular helper T cells (Tfh2 cells) in peripheral blood of patients with allergic rhinitis (AR), and to explore the associations between the chemokine receptors expression and the levels of antigen-specific IgE (sIgE) and the severity of the disease. Methods: The peripheral blood mononuclear cells of 41 patients with AR (20 males and 21 females, aged 35.0 (24.5, 47.0) years) and 42 healthy controls (24 males and 18 females, aged 35.0 (24.8, 46.5) years) treated in Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from April 2017 to February 2018 were isolated. The expressions of chemokine receptor (CCR)2, CCR3, CCR4, CCR5, CCR7, CCR8, chemokine C-X3-C-motif receptor 1 (CX3CR1) and C-X-C motif receptor 4 (CXCR4) in Th2 and Tfh2 cells were explored by fluorescence activated cell sorting (FACs). The relationship between the expression of these chemokine receptors in Th2 cells and Tfh2 cells and the levels of serum sIgE and the scores of visual analogue scale (VAS) was analyzed. Graphpad prism 7.0 software was used for statistical analysis. Results: The significant differences in chemotactic characteristics between Th2 cells and Tfh2 cells in the control group were found: Th2 cells highly expressed chemokine receptors CCR2, CCR3, CCR5, CCR8 and CX3CR1, while Tfh2 cells highly expressed immune cell homing chemokine receptors CCR7 and CXCR4. AR patients, compared to the control, expressed higher levels of CCR2, CCR5 and CX3CR1 on peripheral Th2 cells(all P<0.01). At the same time, the proportion of CCR2+and CCR5+Th2 cells was positively correlated with VAS score (r value was 0.58 and 0.61, respectively, both P<0.01). In AR patients, higher expression levels of CCR7 on Tfh2 cells were detected (P<0.01), and the proportion of CCR7+Tfh2 cells was positively correlated with the level of serum sIgE (r=0.51, P<0.01). Conclusion: The percentage of CCR2+ and CCR5+ Th2 cells in peripheral of AR patients can reflect the severity of AR to some extent, while the percentage of CCR7+ Tfh2 cells is positively correlated with the level of serum sIgE.

Risk factors for progression of Urolith Associated with Obstructive Urosepsis to severe sepsis or septic shock.

INTRODUCTION: To analyze the risk factors for progression of urolith associated with obstructive urosepsis to severe sepsis or septic shock, we had done the retrospective cross-sectional study, which would facilitate the early identification of high-risk patients. MATERIALS AND METHODS: Datas were retrospectively reviewed from 160 patients, suffering from obstructive urosepsis associated with urolith between December 2013 and December 2019. There were 49 patients complicating by severe sepsis (severe sepsis group), 12 patients complicating by septic shock (septic shock group), and 99 patients without progressing to severe sepsis or septic shock (sepsis group). The data covered age, gender, BMI (body mass index), time interval from ED (emergency department) to admission, WBC count (white blood cell count), NLR (neutrophil/lymphocyte ratio), HGB (hemoglobin), etc. Datas were analyzed by univariate analyses and multivariate logistic regression analysis. The corresponding nomogram prediction model was drawn according to the regression coefficients. RESULTS: Univariate analysis showed that the differences of age, the time interval from ED to admission, history of diabetes mellitus, history of CKI (chronic kidney disease), NLR, HGB, platelet count, TBil (total bilirubin), SCr (serum creatinine), ALB (albumin), PT (prothrombin time), APTT (activated partial thromboplastin time), INR (international normalized ratio), PCT (procalcitonin), and positive rate of pathogens in blood culture were statistically significant (P < 0.05). Multivariatelogistic regression analysis showed that age, SCr, and history of CKI were independent risk factors for progression to severe sepsis, or septic shock (P < 0.05). CONCLUSIONS: Aged ≥ 65 years, SCr ≥ 248 mol/L, and history of CKI were independent risk factors for progression of urolith associated with obstructive urosepsis to severe sepsis or septic shock. We need to pay more attention to these aspects, when coming across the patients with urolithic sepsis.

[Promote the construction of multi-factor associated diagnosis system, improve the clinical efficiency of medical imaging].

Medical imaging is playing a more and more important role in the new diagnosis and treatment service mode, which is being optimized under the promotion of multiple factors. Based on the concept of promoting the reconstruction of medical imaging with the theories and methods of system science, this paper proposes a new paradigm of systematic diagnosis called multi-factor associated diagnosis system, explains the background, key techniques, and inherent logic of the proposed system, and prospects the application scenarios of the system in the future.

[Improvement of CT spatial resolution brings about enormous changes in the diagnosis and treatment of otological diseases].

CT examination of temporal bone is of great value in the diagnosis and treatment of otological diseases, and improvement in spatial resolution is an inevitable demand to enhance diagnostic efficiency. In the past 40 years, the spatial resolution of temporal bone CT has been continuously improved, making great contribution to improving the diagnosis and treatment level of otological diseases. The newly reported 10 µm otology CT device has greatly improved the ability to visualize fine structures and occult lesions of temporal bone key area and effectively reduced radiation dose, therefore it is expected to bring new changes to diagnosis and treatment of otological diseases.

[Analysis of the anatomical features of vestibular nerve canal based on 10 µm otology CT].

Objective: To analysis the anatomical features of normal vestibular nerve canal based on 10 µm otology CT. Methods: Sixty-seven patients (103 ears) underwent 10 µm otology CT examinations in Department of Radiology, Beijing Friendship Hospital, Capital Medical University from September 2020 to March 2021 were retrospectively recruited. There were 24 males and 43 females, aged from 18 to 70 (40±17) years. According to the morphology of the inferior vestibular nerve canal, it can be divided into four types as follows: uniform straight type, curved type, ampullary type and direct connection. The anatomical variables of the superior vestibular nerve canal (external orifice, isthmus and internal orifice widths, canal length, angle with labyrinthine segment of the facial nerve) and inferior vestibular nerve canal (widths of the externaland internal orifice, canal length, angles with long axis of the vestibule and the modiolus) between the different sides, genders and canal morphologies were analyzed and compared, respectively. Results: 100% superior vestibular nerve canals and 75.7% (78/103) inferior vestibular nerve canals are clearly depicted by otology CT. The left-side ear presented with larger internal orifice diameter of the superior vestibular neve canal [(1.46±0.47) mm vs (1.31±0.41) mm], and a smaller angle between the inferior vestibular neve canal and the modiolus [(41.6±16.9)° vs (51.6±21.0)°] than the right-side ear (all P<0.05, respectively), respectively. Compared to females, males demonstrated larger internal orifice of the superior vestibular nerve canal [(1.55±0.37) mm vs (1.28±0.36) mm, P<0.05]. The uniform straight type of the inferior vestibular nerve canal was the most common type (62.1%, 64/103), followed by the direct connection (19.4%, 20/103), and the ampullary type was the least common type (4.9%, 5/103). There were significant differences in external diameter and angles with the long axis of the vestibule and the modiolus between the four morphologies of the superior vestibular nerve canal (all P<0.05, respectively). Conclusion: Ten µm otology CT is capable of depicting normal vestibular nerve canal clearly. Quantitative measurement of the normal vestibular nerve canal can provide references for the imaging diagnosis and preoperative evaluation of lesions in this area.

[Analysis of spatial location of the malleus in patients with chronic otitis media based on 10 µm otology CT].

Objective: To assess the changes of the spatial location of the malleus in patients with chronic otitis media (COM) using 10 µm otology CT. Methods: Forty-five patients with COM (COM group, 45 ears) and 55 patients without external and middle ear disease (control group, 89 ears), who underwent 10 µm otology CT examination in Department of Radiology, Beijing Friendship Hospital, Capital Medical University from October 2020 to March 2021, were retrospectively collected during the same period. In the COM group, there are 20 males and 25 females, aged from 20 to 78 (40±14) years. In the control group, 29 were males and 26 were females, with age of 19 to 57 (32±11) years. The shortest distance between the malleus head and the upper wall, the distance between the outer edge of the malleus neck and the scutum, the distance between the outer edge of the malleus neck and the pars flaccida of the tympanic membrane, the shortest distance between the malleus head and the anterior wall, the shortest distance between the anterior process and the anterolateral wall, the shortest distance between the tip of the malleus handle and the promontory, and the shortest distance between the malleus head and the tympanic segment of the facial nerve were measured and compared between the two groups. Results: Compared with the control group, the head-upper wall distance (M (Q1, Q3)) (0.81 (0.48, 1.21) mm vs 0.57 (0.33, 0.90) mm) and the neck-scutum distance (1.79 (1.54, 2.13) mm vs 1.65 (1.48, 1.83) mm) were larger in the COM group (all P<0.05), and the neck-tympanic membrane distance (1.32 (1.15, 1.49) mm vs 1.45 (1.31, 1.59) mm) and the handle-promontory distance (1.56 (1.33, 2.09) mm vs 2.10 (1.74, 2.43) mm) were reduced in the COM group (all P<0.05, respectively). The neck-tympanic membrane distance on the left was larger than those on the right in the COM group (1.39 (1.19, 1.51) mm vs 1.21 (0.87, 1.31) mm, P<0.05). Conclusion: There are changes in the relative position of the malleus in patients with COM, which are helpful for further understanding the imaging manifestations in patients with COM.

[Application of 10 µm otology CT on evaluation of isolated malleus fixation in patients with conductive hearing loss].

Objective: To evaluate the application of 10 µm otology CT on evaluation of isolated malleus fixation (IMF) in patients with conductive hearing loss. Methods: A total of 19 patients (25 sides) with idiopathic hearing loss, including 8 males and 11 females, aged between 4 to 50 years, who underwent 10 µm otology CT examination in Department of Radiology, Beijing Friendship Hospital, Capital Medical University from October 2020 to July 2021, were retrospectively collected. For those patients with idiopathic hearing loss, there were 5 cases (6 sides), including 2 males and 3 females, with an average age of 18-70 [65(20,68)] years, with bony connection between malleus and tympanum wall. Eighteen sex-and age-matched cases with normal hearing group, including 6 males and 12 females, with an average age of 20-68 (39±14) years, as the ratio of 1∶3, were included as the controls. The distances of the tegmen tympani between malleus head and horizontal semicircular canal, as well the distances between malleus head and horizontal semicircular canal were retrospectively measured and further compared between the two groups. Results: The incidence of IMF in patients with idiopathic conductive hearing loss without other etiologies was 24.0% (6/25). The specificity of 10 µm otology CT in diagnosing IMF was 100%. The distances of tegmen tympani between horizontal semicircular canal and malleus head in IMF patients were significantly smaller compared with the controls [-0.65(-1.21, -0.35) mm vs 1.34(0.04, 1.68) mm;0.92(0.51, 1.49) mm vs 2.82(1.76, 3.53) mm](both P<0.05, respectively). There was no significant difference in distances between malleus head and horizontal semicircular canal [-1.30 (-1.90, -0.46)mm vs -0.42 (-1.15, 0.05),P=0.057]. Conclusions: IMF is not uncommon in conductive hearing loss without other causes, which can be clearly shown by 10 µm otology CT. Its occurrence is related to the local downward shift of tegmen tympani above the malleus, without upwards displacement of the malleus.

[Study on the relationship between the morphology of the isthmus of the vestibular aqueduct and Meniere's disease based on 10 µm otology CT].

Objective: To evaluate the morphology of isthmus of the vestibular aqueduct (VA) and its relationship with the occurrence, course of Meniere's disease (MD) and the degree of hearing loss based on 10 µm otology CT. Methods: A total of 13 patients with MD in Beijing Friendship Hospital, Capital Medical University from October 2020 to July 2021, including 4 males and 9 females, age from 16 to 77 (56±16) years, were prospectively enrolled. All patients underwent 10 µm otology CT examination. The included lesion side was the MD affected group (14 sides), and the non-lesion side was the MD healthy group (12 sides). According to the 1∶2 side, 16 sex-and side matched cases (28 sides) without external and middle ear disease were included in the control group, including 4 males and 12 females, age from 16 to 77 (56±14) years. The horizontal semicircular canal showed on the largest plane was considered as the standard cross-section, and continuous observation was made on this image. According to the display type of isthmus of the VA, it was divided into Ⅰ to Ⅳ grades. Kruskal Wallis test was used to compare the morphological differences of VA isthmus among the affected group, the healthy group and the control group. The degree of hearing impairment was assessed by pure tone audiometry (PTA) results, which were divided into normal/mild/moderate/moderately severe/severe/extremely severe hearing impairment. Spearman correlation analysis was used to compare the correlation between the morphological rating of VA isthmus on the affected side and age, course of disease and the results of pure tone audiometry (PTA). Results: The proportions of VA isthmic morphology GRADE Ⅰ,Ⅱ,Ⅲ,Ⅳ in the MD affected group were 28.6% (4/14), 42.9% (6/14), 21.4% (3/14), 7.1% (1/14), those in the MD healthy group were 0 (0/12), 33.3% (4/12), 33.3% (4/12), 33.3% (4/12), and those in the control group were 0 (0/28), 7.1% (2/28), 64.2% (18/28), 28.6% (8/28). The VA isthmus scores [M (Q1, Q3)] of MD affected group was lower than that of MD healthy group [2 (1, 3) vs 3 (2, 4)] and control group [2 (1, 3) vs 3 (3, 4)] (all P<0.05, respectively). The morphology of the VA isthmus on the affected side of MD was negatively correlated with age (r=-0.81, P=0.002), and there was no correlation with the course of disease and degree of hearing impairment (r=-0.40, r=-0.26; all P>0.05, respectively). Conclusion: The stenosis of the VA isthmus in MD was a possible anatomical factor for the occurrence of MD.

[Analysis of the imaging characteristics of otosclerosis based on 10 µm otology CT].

Objective: To evaluate the imaging features of otosclerosis based on10 µm otology CT. Methods: Data of 27 patients with otosclerosis (51 sides) in Beijing Friendship Hospital, Capital Medical University from October 2020 to July 2021 were retrospectively collected, including 9 males and 18 females age ffrom 22 to 70 (42±12) years. All patients underwent 10 µm otology CT examination and surgical treatment. The types, amounts and involved sites of otosclerosis were analyzed and the sensitivity of 10 µm otology CT in diagnosing otosclerosis were evaluated. Results: Fenestral type accounted for 49.0% (25/51 sides), and diffuse type accounted for 51.0% (26/51 sides),and he retrofenestral type without fenestral lesion was not seen. Single lesions accounted for 45.1% (23/51 sides) and multiple lesions accounted for 54.9% (28/51 sides). The incidence of involvement of the fissula ante fenestram and annular ligaments were both 100%. The incidence of involvement of stapes footplate, vestibule, cochlea, round window, inner auditory canal wall, facial nerve canal, stapes muscle and semicircular canal was 60.8% (31 sides), 33.3% (17/51 sides), 21.6% (11/51 sides), 17.6% (9/51 sides), 13.7% (7/51 sides), 9.8% (5/51 sides), 7.8% (4/51 sides) and 5.9% (3/51 sides), respectively. The sensitivity of 10 µm otology CT in diagnosis of otosclerosis was 100%. Conclusion: 10 µm otology CT can fully display the imaging features of otosclerosis, and has the potential to be an effective routine method for otosclerosis.

[Experimental comparison of temporal bone imaging protocol optimization between 10 µm otology CT and multi-slice CT].

Objective: To evaluate different protocol optimization strategies for temporal bone between10 µm otology CT and multi-slice CT (MSCT). Methods: Ten adult skull specimens (20-sides temporal bones) were prospectively enrolled. From October to November 2020, the temporal bones were scanned under four different imaging conditions using 10 µm otology CT (90 kV, 120 mAs; 90 kV, 140 mAs; 100 kV, 120 mAs; 100 kV, 140 mAs) and MSCT (120 kV, 220 mAs; 120 kV, 310 mAs; 140 kV, 160 mAs; 140 kV, 220 mAs), respectively. The image quality was subjectively scored using 5-grade scores, and the contrast noise ratio (CNR) of the image was measured. The absorbed dose of tissues and organs under different imaging conditions was measured by thermoluminescence dosimeter, and the effective dose was calculated. The figure of merit (FOM) is defined as the ratio of the square of the mean CNR to the effective dose. χ2 test was used to compare the difference of subjective scores of different scanning parameter groups, and paired t test was used to analyze and compare the difference of image CNR of different scanning parameter groups. The image quality, radiation dose and FOM of the combination of recommended parameters of the two devices were analyzed and compared. Results: For 10 µm otology CT, under 100 kV condition, the CNR of 140 mAs group was better than that of 120 mAs group (11.27±1.85 vs 10.26±1.38, P<0.001). There was no significant difference in subjective scores between the two groups [5.00 (4.00, 5.00) vs 5.00 (4.25, 5.00), P=0.264]. For MSCT, under 120 kV condition, the subjective scores and CNR of 310 mAs group were better than those of 220 mAs at 120 kV [4.00(3.00, 4.00) vs 3.00(3.00, 3.00),P=0.002;5.24±0.62 vs 4.60±0.62,P<0.001]. According to the principle of image quality-radiation dose optimization, the combination of 100 kV with 120 mAs and 120 kV with 310 mAs are recommended for 10 µm otology CT and MSCT, respectively. The subjective scores and CNR of 10 µm otology CT images were better than those of MSCT (5.00 (4.25, 5.00) vs 4.00 (3.00, 4.00), 10.26±1.38 vs 5.48±0.22, P<0.001). The effective dose was 1/3 of that of MSCT (82.99 µSv vs 252.56 µSv), and the FOM was 11.16 times of that of MSCT (1 268.44 mSv-1 vs 113.71 mSv-1). Conclusion: The temporal bone image quality of newly developed 10 µm otology CT is significantly better than that of MSCT, and its effective dose is lower than that of MSCT, which has more accurate and safer application potential.

[Analysis of the performance of a multi-view fusion and active contour constraint based deep learning algorithm for ossicles segmentation on 10 µm otology CT].

Objective: To explore the performance of a deep learning algorithm that combined multi-view fusion with active contour constrained for ossicles segmentation on the 10 µm otology CT images. Methods: The 10 µm otology CT image data from 79 cases (56 cases were from volunteers and 23 cases were from specimens) were retrospectively collected in the Radiology Department of Beijing Friendship Hospital from October 2019 to December 2020. An annotation of malleus, incus, and stapes were conducted. Then the datasets were established and were divided into training set (n=55), validation set (n=8), and test set (n=16). Using the rapid localization of the region of interest combined with the precise segmentation algorithm, the malleus, incus and stapes were segmented and fused from three perspectives of coronal, sagittal and cross-sectional views. Besides, an active contour loss was designed simultaneously for the segmentation of stapes. Dice similarity coefficient (DSC) was used as the objective evaluation metric for the evaluation of the segmentation results. The inter group DSC of the proposed method was compared with that of the basic method and other methods. Results: The average DSC values of the multi-view fusion segmentation algorithm for malleus, incus and stapes reached up to 94.2%±2.7%, 94.6%±2.6% and 76.0%±5.5%, respectively. After adopting the constraint of active contour loss method, the average DSC of stapes was improved (76.4%±5.4% vs 76.0%±5.5%). The visualization results also demonstrated that the segmentation results of the stapes were more complete. Conclusions: Multi-view fusion algorithm based on 10 µm otology CT images can realize accurate segmentation of malleus and incus. Combined with the constraint of active contour loss method, the segmentation accuracy of stapes can be further improved.

[Analysis of upper airway structure development in children with different characteristics].

Objective: To analyze the development of upper airway in children with different characteristics. Methods: From June 2018 to June 2020, a total of 425 children younger than 16 years old who underwent head MRI examination and did not have sleep-disordered breathing were included in the study. The length of soft palate, tongue, upper airway, mental spine clivus, adenoid thickness and nasopharyngeal width were measured in the midsagittal plane of MRI image. Single factor variance analysis was used to compare the gender differences of upper airway parameters within certain age groups. Pearson correlation analysis was used to analyze the correlation between upper airway parameters and age. Results: The numbers of subjects in infant, young child, preschool, school age and adolescent group were 80, 86, 90, 90 and 79, respectively. There were 219 males, accounting for 51.5% of the study population. The adenoid thickness in the preschooler group was (1.26±0.26) cm, higher than that in the female group (1.15±0.20) cm (P=0.025). The upper airway length (5.89±0.60) cm and the ratio of upper airway length/mental spine-slope length (0.73±0.08) in males were higher than those in females [(5.31±0.45) cm and 0.67±0.07, respectively, P<0.05]. There was no gender difference in other upper airway parameters among different age groups (all P values>0.05). The length of upper airway, mental spine-slope, tongue, soft palate, the width of nasopharyngeal cavity and the thickness of adenoids were positively correlated with age (r=0.932, 0.912, 0.898, 0.705, 0.734 and 0.168, respectively), all P values<0.05. Adenoid thickness was positively correlated with age from birth to age 5 years (r=0.603, P<0.001), and negatively correlated with age after age 6 years (r=-0.259, P=0.001). Conclusion: There are gender differences in the development of upper airway structure in children of different ages.

[Efficacy of endovenous microwave ablation in treating primary varicose veins of the lower extremities].

Objective: To explore the efficacy of endovenous microwave ablation in treating primary varicose veins of the lower extremities. Methods: A total of 214 patients with primary varicose veins of the lower extremities in the First Affiliated Hospital of Sun Yat-sen University from January 2017 to November 2019 were included and divided into microwave ablation group (n=128) and high ligation with microwave ablation group (n=86) according to surgical approach. Further subgroups including subgroup S (diameter<10 mm) and subgroup L (diameter≥10 mm) were established. The surgical success rate, postoperative incidence and recovery of local skin numbness and ecchymosis, and the postoperative recovery of active skin ulcer were compared between the two groups and subgroups. Results: The surgical success rate was 96% (136/141) in microwave ablation group, 100% in subgroup S (116/116), and 80% in subgroup L (20/25), respectively. In addition, the surgical success rate in high ligation with microwave ablation group, subgroup S, and subgroup L was all 100% (90/90, 73/73, and 17/17). In subgroup L of microwave ablation group, the diameter of 5 great saphenous veins in patients who failed the microwave ablation was 13.0-17.1 mm. The mean follow-up time was (24±4) months in microwave ablation group and (36±6) months in high ligation with microwave ablation group, respectively. In the microwave ablation group and high ligation with microwave ablation group, the incidence of postoperative skin numbness was 15.6% and 14.4%, respectively, and the incidence of skin ecchymosis was 5.7% and 3.3%, respectively, with no statistically significant difference between the two groups (both P>0.05). The rate of active skin ulcer in the two groups was 6.4% and 15.6%, respectively, and the difference was statistically significant (P=0.020). Local skin ecchymosis in the two groups recovered within 1 month after operation. Local skin numbness in both groups recovered within the maximum 2 years of follow-up, and active skin ulcer in both groups recovered within the maximum 1 years of follow-up. Conclusion: The endovenous microwave ablation is safe and effective, especially combining with high ligation of great saphenous vein. Good follow-up results can be achieved for great saphenous vein with diameter smaller than 10 mm. However, for those with diameter greater than 10 mm, the surgical success rate of endovenous microwave ablation decreases.

Genetic signature of hybridization between Chinese spot-billed ducks and domesticated ducks.

In this study, we analyzed 93 whole genomes from Chinese spot-billed ducks (CSB), meat-type ducks (MET), and egg and dual purpose-type ducks (EDT) to characterize the genetic material flowing between the CSB and modern ducks. Using a frequency of shared identical-by-descent method, approximately 10.9 Mb introgression segments containing 140 genes were identified showing the signatures of introgression between CSB and EDT. Meanwhile, nearly 10.6 M introgression regions containing 149 genes were identified between CSB and MET. Based on the haplotypes tree of each segment, we found that the introgression between CSB and domesticated ducks was asymmetric with a high level of gene flow from domestic to CSB and a low level of migration in the opposite direction. Moreover, we identified several genes that were introgressions from CSB and showed the signature of positive selection, which may contribute to the breeding of modern ducks. Our results provide new insight into the evolution and breeding history of domestic ducks and may be useful for the future management of wild and domestic duck populations.

[Medical imaging clinical appropriateness:rational examination according to evidence-based medical imaging].

The rational clinical examination is important. The authors raised the concept of "medical imaging clinical appropriateness (MICA) " to meet the medical need in clinic (for diagnosis or assessment of a kind of disease or syndrome), which means radiologists and clinicians work together to carefully evaluate the necessity and rationality of an examination according to evidence of evidence-based medicine, expertise, experience, and patient's willing.The necessity is prerequisite, the rationality is the core, the evaluation of evidence is the basis, the application of evidence-based medicine is the important method. This work will provide us a series of criteria in the format of guidelines, providing evidence of rational examination for clinicians. Based on hard working and cooperation between radiologists and clinicians, we will establish the system of MICA in China, standardizing medical process, promoting rationalization, optimizing medical resources allocation and usage.