Preliminary study on predicting hepatic artery thrombosis formation and evaluating treatment efficacy with ultrasound hemodynamic parameters in transplanted liver / 中华超声影像学杂志

Objective:To clarify the changes of intrahepatic ultrasound hemodynamics before and after hepatic artery thrombosis (HAT) after liver transplantation (LT), providing early warning and anticoagulation guidance to clinicians.Methods:The clinical data of patients who underwent liver transplantation at Zhongshan Hospital of Fudan University between June 2006 and October 2022 were retrospectively analyzed, 47 patients with a diagnosis of HAT confirmed by DSA (digital subtraction angiography) were included in the HAT group, and 71 patients without vascular complications were included in the non-HAT group. Differences in peak flow velocity (PSV), resistance index (RI), and portal vein velocity (PVV) were compared between the two groups. Logistic regression analysis was used to determine the relationship between postoperative PSV decline and HAT occurrence, while ROC curve were used to determine the critical value and evaluate the diagnostic efficacy. Patients with HAT were divided into well-treatment group and poor-treatment group according to whether the blood flow was restored after multiple surgeries or thrombolytic treatments. The changes of early intrahepatic hemodynamics after surgical or thrombolytic therapy were compared between the two groups.Results:①A decrease in PSV of the transplanted hepatic artery was measured 1 d before HAT, and PSV<0.39 m/s predicted thrombus formation with a sensitivity of 0.70, specificity of 0.86, and the AUC was 0.83. ②After treatment, PSV in the HAT group increased immediately, approaching the normal level on the 2nd day. In the well-treatment group, PSV and PVV reached normal levels on the first day after treatment, which were significantly higher than the corresponding values in the poor-treatment group ( P=0.030, 0.021). Conclusions:In the early stage after liver transplantation, a PSV<0.39 m/s is related to the occurrence of HAT thrombosis 1 d later. A significant increase in PSV on the first day after treatment indicates a good treatment response, and there is no need for further DSA re-examination or increasing the number of thrombolysis.

Clinical feasibility of deep learning reconstruction in liver diffusion-weighted imaging: Improvement of image quality and impact on apparent diffusion coefficient value.

PURPOSE: Diffusion-weighted imaging (DWI) of the liver suffers from low resolution, noise, and artifacts. This study aimed to investigate the effect of deep learning reconstruction (DLR) on image quality and apparent diffusion coefficient (ADC) quantification of liver DWI at 3 Tesla. METHOD: In this prospective study, images of the liver obtained at DWI with b-values of 0 (DWI0), 50 (DWI50) and 800 s/mm2 (DWI800) from consecutive patients with liver lesions from February 2022 to February 2023 were reconstructed with and without DLR (non-DLR). Image quality was assessed qualitatively using Likert scoring system and quantitatively using signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and liver/parenchyma boundary sharpness from region-of-interest (ROI) analysis. ADC value of lesion were measured. Phantom experiment was also performed to investigate the factors that determine the effect of DLR on ADC value. Qualitative score, SNR, CNR, boundary sharpness, and apparent diffusion coefficients (ADCs) for DWI were compared using paired t-test and Wilcoxon signed rank test. P < 0.05 was considered statistically significant. RESULTS: A total of 85 patients with 170 lesions were included. DLR group showed a higher qualitative score than the non-DLR group. for example, with DWI800 the score was 4.77 ± 0.52 versus 4.30 ± 0.63 (P < 0.001). DLR group also showed higher SNRs, CNRs and boundary sharpness than the non-DLR group. DLR reduced the ADC of malignant tumors (1.105[0.904, 1.340] versus 1.114[0.904, 1.320]) (P < 0.001), but there was no significant difference in the diagnostic value of malignancy for DLR and non-DLR groups (P = 57.3). The phantom study confirmed a reduction of ADC in images with low resolution, and a stronger reduction of ADC in heterogeneous structures than in homogeneous ones (P < 0.001). CONCLUSIONS: DLR improved image quality of liver DWI. DLR reduced the ADC value of lesions, but did not affect the diagnostic performance of ADC in distinguishing malignant tumors on a 3.0-T MRI system.

A two-dimensional video based quantification method and clinical application research of motion disorders / 生物医学工程学杂志

The increasing prevalence of the aging population, and inadequate and uneven distribution of medical resources, have led to a growing demand for telemedicine services. Gait disturbance is a primary symptom of neurological disorders such as Parkinson's disease (PD). This study proposed a novel approach for the quantitative assessment and analysis of gait disturbance from two-dimensional (2D) videos captured using smartphones. The approach used a convolutional pose machine to extract human body joints and a gait phase segmentation algorithm based on node motion characteristics to identify the gait phase. Moreover, it extracted features of the upper and lower limbs. A height ratio-based spatial feature extraction method was proposed that effectively captures spatial information. The proposed method underwent validation via error analysis, correction compensation, and accuracy verification using the motion capture system. Specifically, the proposed method achieved an extracted step length error of less than 3 cm. The proposed method underwent clinical validation, recruiting 64 patients with Parkinson's disease and 46 healthy controls of the same age group. Various gait indicators were statistically analyzed using three classic classification methods, with the random forest method achieving a classification accuracy of 91%. This method provides an objective, convenient, and intelligent solution for telemedicine focused on movement disorders in neurological diseases.

Application of liquid biopsy technology in early screening and diagnosis of pancreatic cancer / 国际检验医学杂志

Pancreatic cancer is a kind of digestive system tumor with insidious clinical manifestations,rapid development and very poor prognosis,and its early diagnosis and surgical treatment can significantly improve the survival rate and prognosis of patients.So far,no tumor marker with sufficient sensitivity and specificity for early pancreatic cancer has been found for tumor screening.In recent years,more and more pancreatic canc-er-related tumor markers have been discovered and studied.Liquid biopsy has shown potential utility in a range of applications,with the advantages of non-invasive,non-destructive,real-time,multiple,and has broad prospects in many aspects of tumor diagnosis and treatment.This article discusses and summarizes the screen-ing and early diagnosis of circulating tumor cells and circulating tumor DNA in liquid biopsy,so as to provide reference for early detection and early treatment of pancreatic cancer.

Analysis of joint R&D project management between a grade A tertiary hospital and an innovative enterprise in Beijing / 中华医学科研管理杂志

Objective:In the context of strengthening joint research and development projects between hospitals and innovative enterprises (referred to as hospital-enterprise joint R&D), we studied the role of focused and systematic integrated management strategies in facilitating the implementation of joint R&D projects between hospitals and enterprises, and to continuously improve project management capabilities.Methods:This study analyzed the basic data of a grade A tertiary hospital in Beijing before and after the systematic optimization of the hospital-enterprise joint R&D project management strategy, including the differences in project quantity, quality, funding level, collaborators, type, and duration to analyze the significance of optimizing management strategy to improve project management capabilities.Results:Compared with the period before the optimization of management strategy, the number of joint R&D projects and the total amount of R&D funding by medical enterprises increased year by year, and the proportion of high-investment and high-level projects was getting higher and higher. At the same time, the subject of cooperation showed a diversified development trend, and the core position of hospitals in the R&D process became increasingly obvious. The proportion of investigator-initiated innovation research exceeded 69% in all 3 years. Management efficiency improved significantly, the proportion of project approval within two weeks.Conclusions:The development of all-around process management measures and integrated promotion and implementation of hospital-enterprise joint R&D are effective in guaranteeing the efficiency and quality of projects. However, the amount and results of high-quality innovative projects are still relatively small and disorganized, and the process of project management also has shortcomings. There is still a long way for researchers to further explore and improve the support platform and guarantee mechanisms.

Progress in application of virtual reality in prevention and treatment of childhood obesity / 中国学校卫生

Abstract@#As a new non drug treatment technology, virtual reality technology is commonly available for childhood obesity prevention and treatment. This technology offers a great opportunity to carry out research on parental feeding behavior. Also, its combination with child nutritional education and exercise managementis is gaining popularity. This review summarizes the application progress of virtual reality technology in childhood obesity prevention and treatment, such as parental feeding,children s nutrition education and children s sports management, providing reference for childhood weight management and related research.

Bell's Palsy Following SARS-CoV-2 Vaccines: A Systematic Review and Meta-Analysis

Background and ObjectiveBells palsy (BP) has been considered as a serious adverse event following the SARS-CoV-2 vaccination. Many studies have reported BP following vaccination, although neither a causative relationship nor a prevalence of the condition higher than the general population has been established. The outcomes of interest were to compare BP incidence among (a) SARS-CoV-2 vaccine recipients, (b) nonrecipients in the placebo or unvaccinated cohorts, (c) different types of SARS-CoV-2 vaccines, and (d) SARS-CoV-2 infected vs. SARS-CoV-2 vaccinated individuals. MethodsWe performed a systematic search through MEDLINE (via PubMed), Web of Science, Scopus, Cochrane library, and Google Scholar from the inception to August 15, 2022. We included articles reporting individuals receiving any SARS-CoV-2 vaccine in whom BP had occurred. Studies reporting facial paralysis due to etiologies other than BP were excluded. Random- and fixed-effects meta-analyses using the Mantel-Haenszel method were conducted for the quantitative synthesis. Newcastle-Ottawa scale (NOS) was used to assess the quality. The study was conducted in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline, and the protocol was registered with PROSPERO (CRD42022313299). Analyses were carried out using the R, version 4.2.1 (R package meta version 5.2-0). ResultsFifty studies were included, of which 17 entered the quantitative synthesis. First, pooling four phase-3 randomized controlled trials (RCT) indicated BP occurrence was significantly higher in SARS-CoV-2 vaccines (77, 525 doses) compared to placebo (66, 682 doses) (OR = 3.00, 95% CI = 1.10 - 8.18, I2 = 0%). Second, pooling nine observational studies of mRNA SARS-CoV-2 vaccine doses (13, 518,026) and matched unvaccinated individuals (13, 510,701) revealed no significant increase in the odds of BP in the vaccinated group compared to the unvaccinated group (OR: 0.70 (95% CI 0.42-1.16), I2=94%). The third meta-analysis suggested that post-vaccination BP among first dose Pfizer/BioNTech recipients (22,760,698) did not significantly differ from that in first dose Oxford/AstraZeneca recipients (22,978,880) (OR = 0.97, 95% CI = 0.82 - 1.15, I2 = 0%). According to the fourth meta-analysis, BP was significantly more commonly reported after SARS-CoV-2 infection (2,641,398) than after SARS-CoV-2 vaccinations (36,988,718) (RR = 4.03, 95% CI = 1.78 - 9.12, I2 = 96%). ConclusionOur meta-analysis suggests a higher incidence of BP among vaccinated vs. placebo groups. BP occurrence did not significantly differ between Pfizer/BioNTech and Oxford/AstraZeneca vaccines. SARS-CoV-2 infection posed a significantly greater risk for BP than SARS-CoV-2 vaccines.

Design and experiment of online monitoring system for long-term culture of embryo / 生物医学工程学杂志

In the study of embryo development process, the morphological features at different stages are essential to evaluate developmental competence of the embryo, which can be used to optimize and improve the system for

Research progress in material surface microstructure regulating osteoclastic cells / 国际生物医学工程杂志

The development of bone tissue engineering puts forward higher requirements for scaffold materials. Based on the theory of complete regeneration in regenerative medicine, bone graft substitutes are required to be osteoinducible, and to be degraded by osteoclasts and replaced with new bone tissue. Absorbable scaffold materials can be degraded by osteoclasts, and their physical and chemical properties also affect the behavior of osteoclasts. The surface microstructure of the materials is the key to initiating osteoinduction, and it has an important influence on the behavior of osteoclasts. In addition, the surface roughness of the materials can enhance the functional activity of osteoclasts within a certain range. In this paper, the research progress in material surface microstructure regulating osteoclastic cells were reviewed, in order to further explore its mechanism of action, and provide a reference for the preparation of better performance tissue engineering scaffold materials.

The factors affecting the late-onset sepsis in very low and extremely low birth weight infants / 中国小儿急救医学

Objective To explore the risk factors and short outcomes associated with late-onset sep-sis (LOS) in very low and extremely low birth weight infants.Methods Retrospective analysis were per-formed to predict risk factors for LOS in very low and extremely low birth weight infants (birth weight less than 1 200 g) admitted to NICU of Shengjing Hospital from Jan 2010 to Dec 2015.Infants with similar birth weight without LOS were as controls.We compared the characteristics of maternal and neonatal periods in both groups.Multivariable Logistic regression models were derived to predict LOS sepsis.Short outcomes of the infants were assessed.Results Total of 381 very low birth weight infants were admitted during the study period.LOS occurred in 138 infants(36.2%,138/381),who developed sepsis at a mean age of (19.8 ± 11.0)days;the mean gestational age,birth weight and hospitalization time were(29.4 ± 2.1)week,1 064 (953,1 126)g and 55(43,72)d.Other 243 cases were control,mean gestational age,brith weight and hospi-talization time were(29.3 ± 2.0)week,1 060(955,1 144)g and 49(37,63)d.Ninety-seven cases had posi-tive blood culture(70.3%,97/138) in LOS group.Out of the 138 cases of LOS,8 cases(5.8%,8/138) died from their sepsis with a positive blood culture.Infants with LOS were more likely to have a long-term use of ventilation and peripherally inserted central catheteh(PICC),the failure of early enteral feeding,delayed com-plete enteral feeding time and the longer hospital stays compared to uninfected infants.Multivariate Logistic regression analysis showed that long-term use of PICC(OR 1.039,95%CI 1.012-1.067,P=0.004)was an independent risk factor for LOS in very low birth weitht infants. Septic infants,compared with nonseptic infants,had significantly more serious morbidity,including white matter damage(20.3% vs.10.3%),necro-tizing enterocolitis(9.4% vs.2.9%),retinopathy of prematurity(10.9% vs.3.7%),and cholestatic jaun-dice(19.6% vs.11.9%)(P<0.05).Conclusion A number of factors are related to LOS.LOS is associated with poor prognosis of preterm infants.Long-time PICC is a risk factor for LOS.

ROCK1 and the relative signal molecules participate in proliferation of vascular smooth muscle cells induced by cyclic strain / 医用生物力学

Objective To investigate the role of Rho-associated coiled-coil containing protein kinase 1 (ROCK1) and the relative signal molecules in sensing the mechanical stimulation from tensile strain and regulating the proliferation of vascular smooth muscle cells (VSMCs).Methods Physiological cyclic strain with magnitude of 10％ and at frequency of 1.25 Hz was applied to VSMCs in vitro by using the strain loading system.The proliferation level of VSMCs was analyzed by BrdU ELISA;the expression level of ROCK1,phosphorylations of protein kinase C (PKC) α/β Ⅱ,protein kinase D (PKD) and extracellular regulated protein kinase (ERK) in VSMCs modulated by cyclic strain were detected with Western blotting;the expression of ROCK1 was specifically repressed by using RNA interference (RNAi).Results Compared with the static control,10％ cyclic strain significantly decreased the expression of ROCK1 and phosphorylations of PKD and ERK.The phosphorylation of PKCα/βⅡ decreased significantly under 10％ cyclic strain for 12 h,but returned to normal level after loading for 24 h.Repressed expression of ROCK1 with RNAi significantly down-regulated VSMC proliferation,suppressed phosphorylations of PKCα/βⅡ and PKD,but no obvious changes were found in phosphorylation of ERK.Conclusions Physiological cyclic strain with magnitude of 10％ may repress the phosphorylation of PKCα/βⅡ and PKD via inhibiting the expression of ROCK1,and subsequently affects VSMC proliferation and maintains vascular hemostasis.The investigation on intracellular mechanotransduction network of VSMCs under mechanical stimulation of cyclic strain may contribute to studying the physiological and pathological mechanisms of cardiovascular diseases.

A primary analysis on CT and MRI features of common malignant sinonasal tumors / 实用医学杂志

Objective To explore the imaging characteristics of common malignant sinonasal tumors for improving the diagnostic accuracy of the disease. Methods Radiological and clinical data of 78 patients with sino-nasal malignant tumors confirmed by pathological examination were retrospectively analyzed. Results Sinonasal malignant tumors lacked imaging specificity. Most of CT showed uneven soft tissue densities with unclear boundary and destruction of bone which invaded the soft tissue outside of the cavity including orbit or intra-cranium. There was moderate to remarkable enhancement of the lesion. T1WI in MR demonstrated homo-and hypo-intense signal , while T2WI revealed homo- and hyper-intense signal ,and post contrast MR imaging displayed heterogeneous con-trast enhancement. There was no significant statistical difference between CT and MRI in the detection rate of ma-lignant tumors(P > 0.05),but CT in combination with MRI improved the positive rate of detection(P < 0.05). Conclusions The imaging of sinonasal malignant tumors is complicated and lacks specificity. For complicated si-nonasal malignant tumors,enhanced CT in combination with MRI should be used to determine the nature and limi-tation of the tumor,and its relationship with the surrounding structures,resulting in improvement of the diagnostic accuracy of the disease.

Pathogenic bacteria and drug resistance analysis of 72 cases of premature infants with nosocomial fungal infection / 中国小儿急救医学

Objective To understand the distribution of pathogen and antibiotic resistance of nosocomial fungal infection,and provide evidence for the prevention of fungal infection in premature infants in hospital.Methods The clinical data of 72 cases of premature infants with nosocomial fungal infections were retrospectively analyzed.Results The top three of the pathogenic of fungal infection in premature infants in our hospital were 38 strains of Candida pelliculosa (52.8％,38/72),10 strains of Candida albicans (13.9％,10/72),9 strains of Candida parapsilosis (12.5％,9/72).The weights of 72 cases with nosocomial fungal infection in preterm infants were below 2000 g,who were dominated by very low birth weight infants.Gestational age of 27 ～ 30 weeks were in the majority,which accounted for 36.1％ of 27 ～ 28 weeks (26/72) and 34.7％ of 29 ～30 weeks (25/72),each group were dominated by bacteria pathogen candida.Seventy-two strains of fungi were isolated to amphotericin B drug resistance,the 1.4％ (1/72) resistance rate to fluconazole,4.2％ (3/72) pairs of voriconazole resistance rate,2.8％ (2/72) for itraconazole resistant rate.There were no significant differences among the last three resistant rate (x2 =1.02,P ＞ 0.05).The 5-fluorine cytosine resistance accounted for 59.7％ (43/72),and the 4 kinds of drug resistance rate had significant difference (x2 =57.73,P ＜ 0.05).There was no significant difference in resistance rate between amphotericin B and fluconazole (x2 =1.01,P ＞ 0.05).Conclusion Fluconazole could be used to those premature infants with high risk factors of fungal infection.Once the fungal infection is diagnosed,intravenous fluconazole could be the first choice,when necessary,amphotericin B can be used together.