Limited value of platelet-related markers in diagnosing periprosthetic joint infection.

OBJECTIVE: To evaluate the diagnostic values of serum platelet count (PC), mean platelet volume ratio (MPV), platelet count to mean platelet volume ratio (PVR), platelet to lymphocyte ratio (PLR), platelet to neutrophil ratio (PNR), PC/Albumin-globulin ratio (PC/AGR), and PC/C-reactive protein (PC/ CRP) in the diagnosis of periprosthetic joint infection (PJI). METHODS: The medical records were retrospectively analyzed of the 158 patients who had undergone hip or knee revisions from January 2018 to May 2022. Of them, 79 cases were diagnosed with PJI and 79 with aseptic loosening (AL). PJI was defined using the Musculoskeletal Infection Society criteria. The plasma levels of CRP, the erythrocyte sedimentation rate (ESR), PC, MPV, PVR, PLR, PNR, PC/AGR, and PC/CRP in the 2 groups were recorded and analyzed. In addition, tests were performed according to different joint types. The receiver operating characteristic curve was used to calculate the sensitivity and specificity of each indicator. The diagnostic value for each indicator was calculated according to the area under the curve (AUC). RESULTS: The PC, PVR, PLR and PC/AGR levels in the PJI group were significantly higher than those in the AL group, while PC/CRP levels were significantly lower (P < 0.001). The AUC for PC/CRP, and PC/AGR was 0.804 and 0.802, respectively, which were slightly lower than that of CRP (0.826) and ESR (0.846). ROC analysis for PC/CRP, and PC/AGR revealed a cut-off value of 37.80 and 160.63, respectively, which provided a sensitivity of 73.42% and 84.81% and a specificity of 75.95% and 65.82% for PJI. The area under the curve of PLR and PC was 0.738 and 0.702. The area under the curve values for PVR, PNR, and MPV were 0.672, 0.553, and 0.544, respectively. CONCLUSIONS: The results of this study suggest that PC, PLR, PC/CRP, and PC/AGR values do not offer significant advantages over ESR or CRP values when employed for the diagnosis of PJI. PVR, PNR, and MPV were not reliable in the diagnosis of PJI.

Construction of a Column Line Chart-Based Predictive Model for Postoperative Pulmonary Infection Severity in Tracheostomized Patients with Cranial Brain Injuries.

Objective: To explore the construction of a column line chart-based predictive model for postoperative pulmonary infection severity in tracheostomized patients with cranial brain injuries. Methods: The study included 187 patients with cranial brain injuries who underwent tracheostomy between December 2021 and June 2023. These patients were categorized into moderate-to-severe and mild groups based on the severity of postoperative pulmonary infections. Logistic regression analysis was employed to pinpoint the autonomous risk elements for the severity of postoperative pulmonary infection in tracheostomized patients with cranial brain injuries, and a column line chart predictive model was established using these identified independent risk factors. Receiver Operating Characteristic (ROC) curves and calibration curves were used to assess the predictive performance and clinical application potential of the column line chart model for postoperative pulmonary infection risk in tracheostomized patients with cranial brain injuries. Results: Among the 187 patients, 83 (44.39%) experienced moderate-to-severe pulmonary infection. Factors such as age ≥60 years, GCS score <8, a history of long-term smoking, ASA >II, non-washable tracheal tubes, malnutrition, using a ventilator, and longer operative time were more prevalent in the moderate-to-severe group compared to the mild group (P < .05). Multivariate logistic regression analysis revealed that age ≥60 years, GCS score <8, a history of long-term smoking, ASA >II, non-washable tracheal tubes, malnutrition, using a ventilator, and longer operative time were independent risk factors for moderate-to-severe pulmonary infection in tracheostomized patients with cranial brain injuries (P < .05). Build a predictive model based on the above six independent risk factors and plot the ROC curve. ROC curve analysis demonstrated that the AUC values for age ≥60 years, GCS score <8, a history of long-term smoking, ASA >II, non-washable tracheal tubes, malnutrition, using a ventilator, and longer operative time in the column line chart model were 0.578, 0.654, 0.711, 0.652, 0.892, 0.598, 0.712, and 0.752, respectively, indicating good predictive performance of the model. Conclusion: The column line chart-based predictive model for postoperative pulmonary infection severity in tracheostomized patients with cranial brain injuries has a high discriminative power and predictive accuracy. It provides a reliable and intuitive means of predicting the severity of postoperative pulmonary infections in these individuals, enabling healthcare personnel to implement timely intervention measures, thus reducing the occurrence of pulmonary infections.

Efficiency of ear molding for treating constricted ears of different severity.

PURPOSE: To investigate the treatment time and efficiency of constricted ears of different severity after correction. MATERIALS AND METHODS: We included the patients with constricted ear presented to our hospital for treatment between December 2021 and December 2023 in this retrospective analysis. The patients were divided into class I, II and III groups based on the severity of the constriction. Then we collected the data on classification of severity from each patient, together with sex, family history, age at initial correction, being informed upon diagnosis after birth, as well as utilization of auricle correction system. Logistic regression analysis was performed to identify the factors associated with the treatment time and efficiency. RESULTS: The correction system yielded a high effective rate in the constricted ears. The treatment time in class II was significantly longer compared with those of class I after adjusting these parameters. Compared with the cases of class I, those with a class III showed significant attenuation in the symptoms and conditions (95 % CI: 0.034, 0.365; P < 0.001), after adjusting the age at initial correction, being informed upon diagnosis after birth, and utilization of auricle correction system. There were no statistical differences between class II and III in the treatment efficiency after correction. CONCLUSIONS: The Amazing Ear Correction System was effective in treating constricted ear, yielding satisfactory treatment efficiency. Patients with class II constriction required longer treatment time compared with those of class I. The treatment outcome in the class I constriction was better than that of class III.

Risk factors of reinfection after prosthesis removal and antibiotic bone cement spacer implantation for the treatment of periprosthetic joint infection.

BACKGROUND: Prosthesis removal and antibiotic bone cement spacer implantation is a very important link in two-stage revision of periprosthetic joint infection (PJI) after artificial joint replacement, which is key to the smooth progress of second-stage revision surgery. There are few reports on the risk factors of reinfection after prosthesis removal and antibiotic bone cement spacer implantation for PJI. This study aimed to investigate the risk factors of reinfection after prosthesis removal and antibiotic bone cement spacer implantation for the treatment of PJI. METHODS: Clinical data of 40 patients who underwent prosthesis removal and antibiotic bone cement spacer implantation for PJI after arthroplasty in our hospital from January 2013 to July 2019 were retrospectively analyzed. During the follow-up period of at least 2 years, 21 patients underwent complete two-stage revision after the removal of the antibiotic bone cement spacer, and 19 patients did not receive a new prosthesis due to other factors, such as reinfection or the patient's wishes, record the infection control of patients during the treatment. Reinfection after prosthesis removal and antibiotic bone cement spacer implantation was defined as failure of effective control of infection, symptoms of reinfection, requires increased antibiotic therapy or reoperation. Multivariate Cox proportional hazards model was used to analyze the risk factors associated with reinfection after prosthesis removal and antibiotic bone cement spacer implantation. RESULTS: Of the 40 patients, nine (22.5%) developed reinfection after prosthesis removal and antibiotic bone cement spacer implantation with a mean follow-up duration of 31 months, and multivariate analysis revealed that history of prior revision surgery (hazard ratio [HR] = 6.317, confidence interval [CI]: 1.495-26.700; p = 0.012) and presence of sinus tract before treatment (HR = 5.117, 95% CI: 1.199-21.828; p = 0.027) were independent risk factors for reinfection after prosthesis removal and antibiotic bone cement spacer implantation. CONCLUSION: History of prior revision surgery and presence of sinus tract are two independent risk factors for reinfection in patients with PJI treated with prosthesis removal and antibiotic bone cement spacer implantation.

Down-Regulation of Ubiquitin-Specific Peptidase 9X Inhibited Proliferation, Migration and Invasion of Osteosarcoma via ERK1/2 and PI3K/Akt Signaling Pathways.

Ubiquitin-specific peptidase 9X (USP9X) has been reported to be closely associated with the formation and progression of a variety of malignant tumors. However, the mechanism by which USP9X is involved in osteosarcoma and development has not been clearly studied. This work aimed to probe the influence of USP9X on osteosarcoma cell proliferation, migration and invasion. This study recruited sixty-seven patients with histologically definited osteosarcoma. Osteosarcoma samples and cell-line were used to reflect the expression level of USP9X. Analysis of cell proliferation by thiazolium blue (MTT) assays. Transwell experiments and wound healing were used to verify cell migration and invasion capabilities. The effect of USP9X was investigated through in vivo experiments. USP9X-related pathway proteins were detected by Western blot and quantitative real-time PCR (qRT-PCR). The expression of USP9X in osteosarcoma was higher than that in adjacent tissues. The overall survival of patients with USP9X-negative patients was better than that of patients with USP9X-positive. The growth of osteosarcoma cells in vivo and in vitro was inhibited by USP9X inhibitor. Cell migration and invasion were significantly inhibited by down-regulation of USP9X. USP9X was involved in extracellular signal-regulated kinase 1/2 (ERK1/2) and phosphatidylinositol-3-kinases/protein-serine-threonine kinase (PI3K/Akt) pathway in osteosarcoma cells. Proliferation, migration and invasion of osteosarcoma cells were inhibited by down-regulation of USP9X, and were related to the ERK1/2 and PI3K/Akt signaling pathways, therefore, it might probably become a new target for the prevention and treatment of osteosarcoma.

Albumin to Globulin ratio, Neutrophil to Lymphocyte ratio, and Globulin levels do not outperform ESR or CRP when diagnosing periprosthetic joint infection.

OBJECTIVE: To evaluate the relative performance of clinical readouts including serum C-reactive protein (CRP) levels, the erythrocyte sedimentation rate (ESR), globulin (GLB) levels, the albumin to GLB ratio (A/G), and the neutrophil to lymphocyte ratio (NLR) when diagnosing periprosthetic joint infection (PJI). METHODS: Clinical data was collected from 115 individuals diagnosed in our department between January 2017 and December 2020 with either chronic PJI (29 female, 24 male; median age 71.00 years [range, 41-94 years]) or aseptic loosening (30 female, 32 male; median age 68.50 years [range, 34-85 years]). Patient demographic data were compared, and the relative sensitivity and specificity of preoperative GLB, ESR, CRP, NLR, and A/G values as predictors of PJI diagnosis were assessed. RESULTS: Median globulin levels in the PJI and aseptic groups were 31.700 g/L (interquartile range [IQR], 28.400-35.300) and 26.600 g/L (IQR, 24.375-30.550), respectively (p < 0.001). The median A/G values in the PJI and aseptic groups were 1.150 (IQR, 0.960-1.255) and 1.510 (IQR, 1.265-1.670), respectively (p < 0.001). The median NLR values in the PJI and aseptic groups were 2.510 (IQR, 1.900-3.335) and 1.850 (IQR, 1.425 to 2.362), respectively (p < 0.001). The median ESR values in the PJI and aseptic groups were 53.000 mm/h (IQR, 35.000-76.500) and 16.000 mm/h (IQR, 7.000-33.000), respectively (p < 0.001). Median CRP levels in the PJI and aseptic groups were 24.890 mg/L (IQR, 10.595-54.095) and 2.245 mg/L (IQR, 0.865-8.6075), respectively (p < 0.001). Area under the receiver operating characteristic (ROC) curve (AUC) values for CRP, ESR, GLB, A/G, and NLR were 0.841 (95% confidence interval, 0.761-0.903), 0.850 (0.771-0.910), 0.747 (0.658-0.824), 0.779 (0.692-0.851), and 0.708 (0.616-0.789), respectively. When GLB > 26.6 g/L, A/G < 1.32, and NLR > 2.1 were utilized as threshold values to diagnose PJI, GLB and A/G were found to exhibit superior sensitivity (90.57%, 81.13%) to that observed for CRP (71.70%) and ESR (79.25%), but the specificity of these two metrics (GLB: 51.61%, A/G: 72.58%) was significantly reduced relative to that for CRP (87.10%) or ESR (75.81%). ROC analyses further revealed that NLR did not exhibit significant advantages in sensitivity (73.58%) or specificity (70.97%) relative to CRP or ESR. CONCLUSION: Globulin levels, NLR values, and A/G values do not outperform ESR or CRP levels when used to diagnose PJI.

Optical Fiber Vibration Signal Recognition Based on the Fusion of Multi-Scale Features.

Because of the problem of low recognition accuracy in the recognition of intrusion vibration events by the distributed Sagnac type optical fiber sensing system, this paper combines the traditional optical fiber vibration signal recognition idea and the characteristics of automatic feature extraction by a convolutional neural network (CNN) to construct a new endpoint detection algorithm and a method of fusing multiple-scale features CNN to recognize fiber vibration signals. Firstly, a new endpoint detection algorithm combining spectral centroid and energy spectral entropy product is used to detect the vibration part of the original signal, which is used to improve the detection effect of endpoint detection. Then, CNNs of different scales are used to extract the multi-level and multi-scale features of the signal. Aiming at the problem of information loss in the pooling process, a new method of combining differential pooling features is used. Finally, a multi-layer perceptron (MLP) is used to recognize the extracted features. Experiments show that the method has an average recognition accuracy rate of 98.75% for the four types of vibration signals. Compared with traditional EMD and VMD pattern recognition and 1D-CNN methods, the accuracy of the optical fiber vibration signal recognition is higher.

Optical Fiber Vibration Signal Identification Method Based on Improved YOLOv4.

In the traditional peripheral-security-early-warning system, the endpoint detection and pattern recognition of the signals generated by the distributed optical fiber vibration sensors is completed step-by-step and in an orderly manner. The method by which these two processes may be placed end-to-end in a network model and processed simultaneously to improve work efficiency has increasingly become the focus of research. In this paper, the target detection algorithm combines the endpoint-detection and pattern-recognition processes of the vibration signal, which can not only quickly locate the start and end vibration positions of the signal but also accurately identify a certain type of signal. You Only Look Once v4 (YOLOv4) is one of the most advanced target detection algorithms, achieving the optimal balance of speed and accuracy. To reduce the complexity of the YOLOv4 model and solve the dataset's unbalanced sample classification problem, we use a deep separable convolution (DSC) network and a focal loss function to improve the YOLOv4 model. In this paper, the five kinds of signals collected in real-time are visualized as two different datasets in oscillograph and time-frequency diagrams as detection objects. According to the experimental results, we obtained 98.50% and 93.48% mean Average Precision (mAP) and 84.8 and 69.9 frames per second (FPS), respectively, which are improved compared to YOLOv4. Comparing the improved algorithm with other optical fiber vibration signal recognition algorithms, the mAP and FPS values were improved, and the detection speed was about 20 times faster than that of other algorithms. The improved algorithm in this paper can quickly and accurately identify the vibration signal of external intrusion, reduce the false-alarm rate of the early-warning system, and improve the real-time detection rate of the system while ensuring high recognition accuracy.

[Study on Behavioral Factors Affecting the Risk of New HBV Infection among Diabetic Patients].

OBJECTIVE: To analyze the behavioral factors influencing of new hepatitis B virus (HBV) infection in diabetic patients, so as to provide evidence for reducing the risk of new HBV infection in diabetic patients. METHODS: A nested case-control study was conducted to follow up and observe 4 586 diabetic patients. The 114 diabetic patients who newly developed HBV infection during the follow-up period were selected as the case group, and 228 diabetic patients who did not develop HBV infection in the same period were selected as the control group from the cohort population at a matching ratio of 1∶2 according to the age ±2 years. Questionnaire surveys and laboratory examinations were conducted in the cohort. The contents of the questionnaire included family history of hepatitis B, history of trauma, history of receiving/donating blood, individual-related behavioral characteristics, diabetes severity, and behavior related to diabetes treatment and management. In addition, the blood samples of the cohort were tested for hepatitis B surface antigen (HBsAg) by enzyme-linked immunosorbent assay (ELISA). The conditional logistic regression model was used to analyze the related behavioral factors affecting new HBV infection in diabetic patients. RESULTS: The median ages of the HBV group and the control group were 64 years old and 66 years old, respectively. There was no statistically significant difference in the composition of sex, age, ethnicity, occupation and amount of formal education between the two groups ( P>0.05). Multivariate analysis showed that diabetic patients with a family history of hepatitis B ( OR=13.052, 95% CI: 3.799 to 44.847) had a higher risk of new HBV infection, while diabetic patients who used blood collection/injection devices in a standardized way ( OR=0.189, 95% CI: 0.082 to 0.436), safety locking blood glucose needles ( OR=0.142, 95% CI: 0.073 to 0.276) and venous blood collection needles ( OR=0.019, 95% CI: 0.001 to 0.262) and self-testing of blood sugar at home ( OR=0.466, 95% CI: 0.222 to 0.980) had a lower risk of new HBV infection. CONCLUSION: Family history of hepatitis B is an independent factor that increases the risk for new HBV infection in diabetic patients. During the process of long-term blood glucose management of diabetic patients, standardized use of blood collection/injection devices, use of safer types of blood sampling lancet, and self-testing of blood glucose help can reduce the risk of HBV infection.

[Survey on the behavior and attitude of nutrition labels by Chengdu fast food and light meal takeaway merchants].

OBJECTIVE: Learn about the view, cognition, willingness and attitude of the employees of Chengdu fast food takeaway business on nutrition labels and their attitude towards labeling nutrition labels on takeaway meals. METHODS: Using a multi-stage random sampling method, five districts were randomly selected in Chengdu City, Sichuan Province, and two streets were randomly selected in each of the selected districts, and the questionnaire was administered on a one-to-one basis. RESULTS: A total of 834 chefs and caterers were surveyed in the fast food, simple meals category of takeaway businesses. The rate of viewing the nutrition labels on pre-packaged food by chefs and catering staff in takeaway businesses was 48. 07%, and the viewing rate was increasing with the improvement of education(χ~2=15. 379, P=0. 001). The mastery rate of nutrition label knowledge was 15. 08%, which was different for different ages(χ~2=6. 072, P=0. 048). The mastery rate of men(18. 72%) was higher than that of women(9. 91%)(χ~2=12. 193, P<0. 001), and that of chefs(18. 01%) was higher than that of catering staff(12. 88%)(χ~2=4. 172, P=0. 041). The nutritional label understanding intention of the subjects was 28. 10%, and the difference of willingness to know about nutrition label-related knowledge was statistically significant in different age groups(χ~2=6. 183, P=0. 045). The respondents' viewing of nutrition labels was associated with willingness to understand, with a Person coefficient of contingency of 0. 104. The proportion of supporting nutrition labels on takeaway meals was 56. 69%. There were statistically significant differences in attitudes towards nutrition labels on takeaway food packages among respondents of different age groups, gender, education, working years and whether they were chain stores(χ~2=21. 445, 8. 675, 14. 684, 12. 198, 25. 852, P<0. 05). CONCLUSION: The take-out industry chefs and catering staff have insufficient review rate and mastery of nutrition labels, and their willingness to understand nutrition labels is not high.

Errors in the absorbed and the administered 131I therapeutic dose in patients with Graves' disease. A suggested more precise technique.

OBJECTIVE: The aim of this study was to evaluate the relative error (RE) in the thyroid absorbed dose (TD) of iodine-131 (131I) in patients with Graves' disease comparing the simplified Quimby-Marinelli-Hine formula method (sQMHF) and the Standard Operational Procedures for dosimetry (SOPD) recommended by the European Association of Nuclear Medicine. PATIENTS AND METHODS: This study included 45 patients with Graves' disease 12 men and 33 women; age 44.1±12.8 years. Thyroid mass (TM) was measured using ultrasound. Uptake of 131I (RAIU) was tested at 2, 4-6, 24, 48-72, and 96-168h after its administration and the half-life (T1/2eff) and resident time (RT) of 131I were computed. According to the sQMHF, a prescribed TD of 75Gy required 3.7MBq/g of 131I, correction based on the RAIU24h and T1/2eff. Subsequently, the therapeutic TD was computed according to the SOPD and the RE was recorded. The data were analyzed using t-tests. RESULTS: The TM, RAIU24h, therapeutic TD, and RE were 36.5±23.9g, 0.54±0.14, 89.4±9.4Gy, and -0.01±0.02, respectively. There was a significant difference (t-value 9.84, P<0.01) between the prescribed and therapeutic TD because the sQMHF ignores the absorbed dose deposited in the thyroid during the first 24h, which is included in the SOPD. In addition, the RE was significantly smaller than the variable coefficient (VC) of the therapeutic TD (t=-39.6, P<0.01). CONCLUSION: When the activity of 131I was calculated using the simplified Q-M-H formula, the therapeutic absorbed thyroid dose was significantly higher than what was expected for the prescribed dose. Precision of the individualized therapeutic absorbed dose could be improved by computing the activity of 131I using the standard operational procedures for dosimetry of the EANM.

EEG multi-domain feature transfer based on sparse regularized Tucker decomposition.

Tensor analysis of electroencephalogram (EEG) can extract the activity information and the potential interaction between different brain regions. However, EEG data varies between subjects, and the existing tensor decomposition algorithms cannot guarantee that the features across subjects are distributed in the same domain, which leads to the non-objectivity of the classification result and analysis, In addition, traditional Tucker decomposition is prone to the explosion of feature dimensions. To solve these problems, combined with the idea of feature transfer, a novel EEG tensor transfer algorithm, Tensor Subspace Learning based on Sparse Regularized Tucker Decomposition (TSL-SRT), is proposed in this paper. In TSL-SRT, new EEG samples are considered as the target domain and original samples as the source domain. The target features can be obtained by projecting the target tensor to the source feature space to ensure that all features are in the same domain. Furthermore, to solve the problem of dimension explosion caused by TSL-SRT, a redundant EEG features screening algorithm is adopted to eliminate the redundant features, and achieves 77.8%, 73.2% and 75.3% accuracy on three BCI datasets. By visualizing the spatial basic matrix of the feature space, it can be seen that TSL-SRT is effective in extracting the features of active brain regions in the BCI task and it can extract the multi-domain features of different subjects in the same domain simultaneously, which provides a new method for the tensor analysis of EEG.

Modulating built-in electric field via Bi-VO4-Fe interfacial bridges to enhance charge separation for efficient photoelectrochemical water splitting.

Photoelectrochemical (PEC) water splitting on semiconductor electrodes is considered to be one of the important ways to produce clean and sustainable hydrogen fuel, which is a great help in solving energy and environmental problems. Bismuth vanadate (BiVO4) as a promising photoanode for photoelectrochemical water splitting still suffers from poor charge separation efficiency and photo-induced self-corrosion. Herein, we develop heterojunction-rich photoanodes composed of BiVO4 and iron vanadate (FeVO4), coated with nickel iron oxide (NiFeOx/FeVO4/BiVO4). The formation of the interface between BiVO4 and FeVO4 (Bi-VO4-Fe bridges) enhances the interfacial interaction, resulting in improved performance. Meanwhile, high-conductivity FeVO4 and NiFeOx oxygen evolution co-catalysts effectively enhance bulk electron/hole separation, interface water's kinetics and photostability. Concurrently, the optimized NiFeOx/FeVO4/BiVO4 possesses a remarkable photocurrent density of 5.59 mA/cm2 at 1.23 V versus reversible hydrogen electrode (vs RHE) under AM 1.5G (Air Mass 1.5 Global) simulated sunlight, accompanied by superior stability without any decreased of its photocurrent density after 14 h. This work not only reveals the crucial role of built-in electric field in BiVO4-based photoanode during PEC water splitting, but also provides a new guide to the design of efficient photoanode for PEC.

miR-1293 suppresses osteosarcoma progression by modulating drug sensitivity in response to cisplatin treatment.

Chemotherapy is considered the primary treatment for osteosarcoma. however, its effectiveness is limited due to drug resistance and toxicity. Thus, identifying novel therapeutic targets to enhance the efficacy of chemotherapy is urgently needed. Here, we identified a novel cisplatin-sensitivity enhancing mechanism via up-regulation of the tumour suppressor gene, miR-1293. Meanwhile, higher levels of miR-1293 observed in prechemotherapy patients were associated with a more favorable prognosis. The mechanism underlying cisplatin upregulated miR-1293 expression involves hypomethylation of the miR-1293 promoter, which blocks the binding of the transcription repressor TFAP2A to the promoter. Furthermore, miR-1293 inhibits osteosarcoma progression by targeting TIMP1 to inactivate the Notch1/Hes1 and TGFBR1/Smad2/3 pathways, thereby promoting tumour cell death. The findings presented herein unveil a novel mechanism for enhancing cisplatin sensitivity and proposed a potential therapeutic strategy for osteosarcoma through pre-chemotherapy supplementation of miR-1293.

The learning curve of laparoscopic single-site salpingectomy with conventional laparoscopic instruments: A retrospective cohort study.

Tubal pregnancy is a common cause of maternal mortality in early pregnancy. Transumbilical laparoendoscopic single-site surgery (TU-LESS) has gained popularity due to its safety and aesthetic advantages. However, the lack of affordable disposable entry platforms hinders its widespread adoption. This study aimed to investigate the learning curve of tubal pregnancy removal using single-incision multiport (SIMP) laparoscopy and provide guidance for novice gynecologists. A retrospective analysis was conducted on cases of ectopic pregnancy (EP) diagnosed at Dongguan Songshan Lake Central Hospital from June 2020 to June 2022. The analysis included 50 cases, with 25 undergoing single-port laparoscopy and 25 undergoing conventional laparoscopy (CL). Various indicators, including body mass index (BMI), previous pregnancies, mass size, hemoglobin levels, surgical duration, and complications, were collected. Learning curve analysis using the cumulative sum (CUSUM) technique was performed to assess procedural proficiency. There were no significant differences in patient characteristics or complications between the 2 groups. However, the single-port laparoscopy group exhibited a statistically significant longer average surgical time (41.60 ±â€…13.38 minutes) compared to the conventional laparotomy group (32.96 ±â€…7.32 minutes). The CUSUM analysis demonstrated a decline in surgical time after the completion of approximately 11 cases, indicating an improvement in SIMP laparoscopy surgical proficiency. SIMP laparoscopy for tubal pregnancy removal achieved similar safety outcomes as CL. Notably, the CUSUM analysis revealed that proficiency in single-port laparoscopy could be achieved after approximately 11 cases, leading to stable surgical times. These findings serve as valuable guidance for novice gynecologists interested in adopting single-incision laparoscopy.

Correction of congenital auricle deformities with ear mould: A systematic review and meta-analysis.

OBJECTIVE: To assess the effectiveness and safety of ear moulds for congenital auricle deformities. METHODS: Databases including Medline, EMBASE, Cochrane Library, Chinese BioMedical Literature Database (CBM) and Web of Science were systematically reviewed. Randomised controlled trials (RCT), non-randomised control trials (non-RCT), quasi-randomised control trials (quasi-RCT) and self-controlled before-after trials were also included. Data extraction was independently conducted by two authors. The Risk Of Bias In Non-randomised Studies of Interventions (ROBIN-I) was used to evaluate the risk bias. Heterogeneity was assessed using I2 and chi-square tests. Effective rate, adverse reaction rate and their 95%CI were calculated. Funnel plots, Begg's test as well as sensitivity and subgroup analyses were performed. RESULTS: The analysis encompassed ten studies, comprising one RCT and nine self-controlled before-after trials, involving 1860 ears (1248 children). The pooled effective rate and adverse reaction rate of ear mould were 91% (95% CI: 0.87-0.94) and 9% (95%CI: 0.02-0.17), respectively. No serious adverse reactions were reported. The effective rate of ear mould intervention showed no significant difference between age at correction≤42 days group (90%, 95%CI: 0.85-0.94) and that >42 days group (93%, 95%CI: 0.83-0.99). Similarly, there was no statistical difference in the correction efficiency between duration of wearing ear mould≤30 days group (90%, 95%CI: 0.85-0.94) and that >30 days group (92%, 95%CI: 0.86-0.96). The effective rate for correcting cryptotia ear (98%, P < 0.001), cup ear (93%, P = 0.004) and prominent ear (90%, P = 0.014) was higher than that of helical rim deformity (66%). CONCLUSIONS: In the short term, the use of ear moulds is effective and safe in correcting congenital auricle deformities. Notably, the correction efficacy for cryptotia, cup ear and prominent ear deformities surpasses that of helical rim deformities. However, further research is required to ascertain the impact of the duration of wearing on the correction of congenital auricle deformities.

Metagenomic next-generation sequencing promotes pathogen detection over culture in joint infections with previous antibiotic exposure.

Objective: To investigate the diagnostic value of metagenomic next-generation sequencing (mNGS) in detecting pathogens from joint infection (JI) synovial fluid (SF) samples with previous antibiotic exposure. Methods: From January 2019 to January 2022, 59 cases with suspected JI were enrolled. All cases had antibiotic exposure within 2 weeks before sample collection. mNGS and conventional culture were performed on SF samples. JI was diagnosed based on history and clinical symptoms in conjunction with MSIS criteria. The diagnostic values, including sensitivity, specificity, positive/negative predictive values (PPV/NPV), and accuracy, were in comparison with mNGS and culture. Results: There were 47 of the 59 cases diagnosed with JI, while the remaining 12 were diagnosed with non-infectious diseases. The sensitivity of mNGS was 68.1%, which was significantly higher than that of culture (25.5%, p<0.01). The accuracy of mNGS was significantly higher at 71.2% compared to the culture at 39.0% (p <0.01). Eleven pathogenic strains were detected by mNGS but not by microbiological culture, which included Staphylococcus lugdunensis, Staphylococcus cohnii, Finegoldia magna, Enterococcus faecalis, Staphylococcus saprophytics, Escherichia coli, Salmonella enterica, Pseudomonas aeruginosa, Acinetobacter pittii, Brucella ovis, andCoxiella burnetii. Antibiotic therapy was adjusted based on the mNGS results in 32 (68.1%) patients, including 12 (25.5%) and 20 (42.6%) patients, in whom treatment was upgraded and changed, respectively. All JI patients underwent surgery and received subsequent antibiotic therapy. They were followed up for an average of 23 months (20-27 months), and the success rate of treatment was 89.4%. Out of the 33 patients who had positive results for pathogens, reoperation was performed in 1 case (3.03%), while out of the 14 cases with negative results for both mNGS and cultures, reoperation was performed in 4 cases (28.6%). Conclusions: mNGS has advantages over conventional culture in detecting pathogens in SF samples from JI patients previously treated with antibiotics, potentially improving clinical outcomes.

Multifunctional Interface Modification Enables Efficient and Stable HTL-Free Carbon-Electroded CsPbI2Br Perovskite Solar Cells.

In recent years, hole transport layer-free all-inorganic CsPbI2Br carbon-electroded perovskite solar cells (C-PSCs) have garnered significant attention due to a trade-off between stability and photovoltaic performance. However, there are inevitably many defects generated at the surfaces or grain boundaries of CsPbI2Br perovskite films, which will serve as carrier non-radiative recombination centers, and CsPbI2Br perovskite films are sensitive to water molecules to degrade, together with energy level mismatch between CsPbI2Br perovskite and carbon electrodes. Herein, 1-benzyl-3-methylimidazolium hexafluorophosphate (1-B-3-MIMPF6), an imidazolium-based ionic liquid simultaneously containing benzene ring and fluorine atoms, was introduced for the modification of the perovskite/carbon interface. The results showed that it could effectively reduce defects, enhance carrier transfer, mitigate carrier non-radiative recombination, facilitate energy alignment, and block moisture intrusion. Therefore, the photovoltaic performance of the modified PSCs with ITO/SnO2/CsPbI2Br/1-B-3-MIMPF6/carbon architecture has been boosted with a champion power conversion efficiency (PCE) of 13.47 %, open circuit voltage of 1.20 V, short circuit current density of 14.69 mA/cm2, and fill factor of 76 %. Moreover, the unencapsulated modified devices exhibited an improved stability and the PCE maintained 78 % of their initial PCE after 24 h storage at room temperature in a 30 %-35 % humidity environment, whereas that of the pristine devices dropped to almost zero.

The suture fixation of levonorgestrel-releasing intrauterine device in the treatment of adenomyosis: A case report.

INTRODUCTION: The report on Levonorgestrel⁃releasing intrauterine system (LNG⁃IUS) suture under hysteroscopy is very rare, and currently only three articles have been reported. We reported a patient with adenomyosis who had previously had LNG-IUS, but the LNG-IUS moved downward. We sutured and fixed the LNG-IUS under hysteroscopy. CASE PRESENTATION: A 42-year-old woman presented with a 7-year history of adenomyosis of the uterus and adenomyoma adenomyosis. Half a year ago, due to increased menstrual flow, LNG-IUS was placed in the uterine cavity, and the treatment effect was satisfactory. Nine days ago, vaginal bleeding occurred, and ultrasound showed that LNG-IUS had moved downward. We performed LNG-IUS suturing under hysteroscopy for her, and a half-year follow-up ultrasound showed that the position of LNG-IUS was normal. CLINICAL DISCUSSION: For adenomyosis, LNG-IUS is the most promising medical therapy due to its ability to suppress hormones to improve symptoms with a low profile of adverse effects while enabling women to maintain fertility. However, the high excretion rate of LNG-IUS may cause patients with adenomyosis to lose confidence in continuing to use this treatment method. CONCLUSION: Our case report demonstrated the feasibility and effectiveness of LNG-IUS suture fixation under hysteroscopy. It provided another reliable treatment option for those patients with adenomyosis for whom the LNG-IUS fell off or fell down.

Rare case of endometrial vascular dystrophy: Three case reports.

RATIONALE: Endometrial vascular dystrophy refers to abnormal vessels that are very tortuous, dilated, and sometimes thrombosed. Endometrial vascular dystrophy is rare under hysteroscopy. PATIENT: All three patients had a history of abnormal uterine bleeding. The duration of vaginal bleeding ranged from 1 month to 2 years. There was no history of unusual diseases, alcohol or drug abuse, or genetic history. DIAGNOSES: Endometrial vascular dystrophy. INTERVENTION: Three patients underwent hysteroscopy and curettage under intravenous general anesthesia. Pathological examination showed secretory endometrium, with one case coexisting with endometrial polyps. OUTCOMES: No recurrence was found during postoperative follow-up at 12 months. LESSONS: Endometrial vascular dystrophy is a rare hysteroscopy phenomenon shown in the secretory endometrium. We believe that it was a capillary loop with different manifestations.