The progress and clinical application of medical image post-processing technology are introduced from the aspects of image preprocessing, image segmentation; registration-fusion and 3D reconstruction. Correlated problems and development trends are put forward.

Objective To report the improved operative technique and clinical results of posterior neurocutaneous vascular axial flap in the forearm Methods A reversed posterior neurocutaneous vascular flap in the forearm pedicle with dorsal branch of anterior interossea vessel were designed to repair the skin defects of hand and wrist Results The modified flaps were applied in 8 cases,all flaps survived completely The colour and texture of flaps were good,the outline and functional results were satisfactory after 6～12 months follow up Conclusion This type of flap is easy to dissect,blood supply is reliable,and major vessels in the forearm is preserved,It is suitable for repairing large skin and soft tissue defects of first web, dorsal aspects of wrist and palmar

OBJECTIVE:To prepare mesopocous molecular sieve SBA-15 surface molecularly imprinted polymer (SBA-15@MIP),and analyze the application of SBA-15@MIP in the determination of active micro-component. METHODS:Using baica-lein as the template molecule,acrylamide(AM)as the function monomer,tetrahydrofuran/ethanol(3∶2,V/V)as the polymeriza-tion solvent,ethylene glycol dimethacrylate(EGDMA)as the cross-linker,and 2,2-azobisisobutyronitrile(AIBN)as the initiator, SBA-15@MIP was synthesized on the surface of mesopocous molecular sieve SBA-15. The surface morphology and structure of the obtained polymer were characterized by TEM and FT-IR. Finally,the imprinted polymer was used as an adsorbent for solid-phase extraction (SPE) to detect baicalein in plasma samples by HPLC. RESULTS:It revealed that the well-ordered one-dimensional pore structure of SBA-15 was still preserved in the successful synthesized SBA-15@MIP,and baicalein molecule was imprinted suc-cessfully. The limit of detection(LOD)and limit of quantification(LOQ)for baicalein in plasma were 3.5 ng/ml and 11.6 ng/ml, respectively;the average recovery was 94.4%(RSD=2.9%). CONCLUSIONS:SBA-15@MIP is prepared successfully,and can be applied for the determination of active micro-component.

Objective To report the improved operative technique and clinical results of reversed saphenous neurocutaneous vascular flap. Method Under the guidance of Doppler flowmeter,a reversed saphenous neurocutaneous vascular flap pedicle with the perforating branches of the tibialis posterior artery were designed to repair the skin defects of the middle and lower leg,the ankle and the foot. Results The modified flaps were applied in 7 cases,all flaps survived completely. The size of the flaps ranged from 15cm?8cm to 5cm?4cm,the location of the perforating branches were 8～20 cm above the medial malleolus. The colour and texture of the flaps were excellent,the outline and functional results were satisfactory after 6～18 months follow up. Conclusions The flap is easy to design and dissect,blood supply is reliable,it is suitable for repairing the soft tissue defects of the middle and lower leg,the ankle and the foot. It is a new type of flap combining the neurocutaneous vascular flap with the perforator flap.

We constructed different N-terminal truncated variants based on Bacillus acidopullulyticus pullulanase 3D structure (PDB code 2WAN), and studied the effects of truncated mutation on soluble expression, enzymatic properties, and application in saccharification. Upon expression, the variants of X45 domain deletion existed as inclusion bodies, whereas deletion of CBM41 domain had an effective effect on soluble expression level. The variants that lack of CBM41 (M1), lack of X25 (M3), and lack both of CBM41 and X25 (M5) had the same optimal pH (5.0) and optimal temperature (60 degrees C) with the wild-type pullulanase (WT). The K(m) of M1 and M5 were 1.42 mg/mL and 1.85 mg/mL, respectively, 2.4- and 3.1-fold higher than that of the WT. k(cat)/K(m) value of M5 was 40% lower than that of the WT. Substrate specificity results show that the enzymes exhibited greater activity with the low-molecular-weight dextrin than with high-molecular-weight soluble starch. When pullulanases were added to the saccharification reaction system, the dextrose equivalent of the WT, M1, M3, and M5 were 93.6%, 94.7%, 94.5%, and93.1%, respectively. These results indicate that the deletion of CBM41 domain and/or X25 domain did not affect the practical application in starch saccharification process. Furthermore, low-molecular-weight variants facilitate the heterologous expression. Truncated variants may be more suitable for industrial production than the WT.
Bacillus ; enzymology ; Glycoside Hydrolases ; metabolism ; Molecular Weight ; Protein Conformation ; Sequence Deletion ; Substrate Specificity ; Temperature

OBJECTIVETo study a new method to repair forefoot skin defects.

METHODSBased on anatomical studies, a reverse medialis pedis flap was designed for coverage of forefoot skin defect. The flap was based on the distal end of the medial plantar artery and had distal anastomosis with the lateral plantar artery and dorsal metatarsal artery.

RESULTSThe flap was used clinically in 6 cases. The size of the flap ranged from 4 x 3 cm to 11 x 9 cm. The pedicle of the flap was 6 to 11 cm. All flaps survived completely. The aesthetic and functional results were satisfactory after 6-24 months follow-up.

CONCLUSIONThe flap is one of the best choices for repairing of forefoot skin defects.

Adolescent ; Adult ; Female ; Foot ; anatomy & histology ; surgery ; Humans ; Male ; Surgical Flaps

OBJECTIVETo investigate the bacterial flora and their drug resistance in hospitalized burn patients on tropical islands.

METHODSRetrospective study was carried out to analyze pathogenic microorganisms and their drug resistance characteristics in 392 burn patients hospitalized during 2000-2005.

RESULTS(1) Totally 671 strains of bacteria were isolated, among which Pseudomonas aeruginosa, Staphylococcus aureus, Aerobacter cloacae and Acinetobacter species were predominant, but the isolation rate of Pseudomonas aeruginosa was declining compared with that in 1990's. (2) The resistance rate of Pseudomonas aeruginosa to imipenem and cefepime was 32.2% and 36.7% , respectively, while that to other antibiotics was above 80%. (3) Among 141 strains of Staphylococcus aureus, 89 strains (63.1%) of MRSA were isolated, and none of them were resistant to Vancomycin.

CONCLUSIONPseudomonas aeruginosa, Staphylococcus aureus, Aerobacter cloacae and Acinetobacter species were predominant in tropical islands. The species of the pathogens are changing . The drug resistance rates of Pseudomonas aeruginosa and Staphylococcus aureus are rather high.

Adolescent ; Adult ; Aged ; Anti-Bacterial Agents ; pharmacology ; Burns ; drug therapy ; microbiology ; Child ; Child, Preschool ; Drug Resistance, Bacterial ; Female ; Humans ; Infant ; Male ; Microbial Sensitivity Tests ; Middle Aged ; Pseudomonas aeruginosa ; drug effects ; isolation & purification ; Retrospective Studies ; Staphylococcus aureus ; drug effects ; isolation & purification ; Tropical Climate ; Young Adult

Objective To explore the effect of preoperative administration of glycopyrronium bromide on postoperative cognitive dysfunction(POCD)in elderly patients undergoing laparoscopic inguinal hernia repair surgery.Methods 74 elderly patients underwent laparoscopic inguinal hernia repair surgery under general anesthesia with a laryngeal mask were randomly divided into control group(group C,25 cases),low-dose glycopyrronium bromide group(0.2 mg,group L,24 cases),medium-dose glycopyrronium bromide group(0.4 mg,group M,25 cases).Blood was collected from patients 1 d before surgery and 3 d after surgery,and serum levels of interleukin-1β(IL-1β),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),brain function related factors[5-hydroxytryptamine(5-HT),brain-derived neurotrophic factor(BDMF)]were measured by enzyme linked immunosorbent assay(ELISA).The Montreal Cognitive Assessment Scale(MoCA)was used to assess the cognitive function of the patients.Airway secretion scores,the incidence of arrhythmia,dry mouth and dysuria were recorded.Results There was no significant difference in the incidence of POCD among the three groups of patients(P＞0.05);At 3 d postoperatively,5-HT and BDNF levels in group L were higher than those in group C,the BDNF level in group L was higher than that in group M,there were statistically significant(P＜0.05);At 3 days after surgery,the levels of serum IL-1β,IL-6 and TNF-α in group C were significantly higher than those at 1 day before surgery(P＜0.05),the levels of serum IL-6 and TNF-α in group M were significantly higher than those at 1 day before surgery(P＜0.05),there were no significant differences in the levels of serum IL-1β,IL-6 and TNF-α in group L compared with those at 1 day before surgery(P＞0.05),there were no significant differences in the levels of serum IL-1β,IL-6 and TNF-α among the three groups at 3 days after surgery(P＞0.05);Postoperative airway secretion was significantly reduced in group L and group M compared with group C(P＜0.05),and there was no significant difference between group L and group M(P＞0.05).The incidence of adverse reactions(dry mouth and dysuria)in group M was significantly higher than that in group L and group C(P＜0.05).Conclusion Low-dose(0.2 mg)glycopyrronium bromide is more appropriately recommended as a preoperative medication for elderly patients undergoing laparoscopic inguinal hernia repair surgery,and increased dosage is associated with an increase in adverse reactions and POCD.

Objective:To investigate the clinical and pathological features and prognosis of patients with microfocal prostate adenocarcinoma.Methods:Clinical and pathological data of the patients diagnosed with microfocal adenocarcinoma on prostate biopsy at the West China Hospital from 2013 to 2019 were collected. Microfocal adenocarcinoma was defined as follows: Gleason score of 3+3=6, total number of the cores ≥10, number of the positive cores ≤2, and proportion of the tumor in each positive core<50%. Clinicopathological parameters, treatment plans and follow-up data were collected. Pathological information of the biopsy and radical resection specimens was used to analyze the correlation between pathological parameters in the biopsy report and adverse pathological features of radical resection specimens, including increased Gleason score, capsule invasion, positive surgical margin and perineural invasion.Results:A total of 206 cases of microfocal adenocarcinoma were diagnosed on prostate biopsies from 2013 to 2019, accounting for 6.7% of all adenocarcinoma cases. There were 139 cases of 1 positive core and 67 cases of 2 positive cores. Patients with microfocal adenocarcinoma were younger than those with non-microfocal adenocarcinoma (69 years versus 71 years, P<0.001). Compared with patients with non-microfocal adenocarcinoma, the pre-biopsy total prostate specific antigen (tPSA) and free prostate specific antigen (fPSA) levels in patients with microfocal adenocarcinoma were both lower (11.2 μg/L 2 versus 23.7 μg/L 2; 1.4 μg/L 2 versus 3.0 μg/L 2, P<0.001), the fPSA/tPSA level was higher (12.9% versus 10.7%, P<0.05), the prostate volume was larger (38.9 mL versus 34.3 mL, P<0.05), and the PSA density was lower (0.3 μg/L 2 versus 0.8 μg/L 2, P<0.001). 130 patients underwent radical prostatectomy, 30 patients chose active monitoring, 31 patients chose endocrine or radiation therapy, and 15 patients were lost to follow-up. Three patients in the active surveillance group underwent radical prostatectomy for disease progression after 21-39 months observation. Biochemical relapses occurred in two patients in the radical prostatectomy group. The remaining patients have no disease progression or recurrence at present. Compared with radical prostatectomy specimens, Gleason score in the biopsy material was increased in 64/115 patients (55.7%). Among resection excision specimens, 14 cases (12.2%) had extraprostatic extension (EPE), 35 cases (30.4%) had perineural invasion, and 16 cases (13.9%) had a positive margin. Univariate and multivariate analyses showed that low fPSA/tPSA ratio and 2 positive cores were independent risk factors for Gleason score increase in the radical prostatectomy specimens. A low fPSA/tPSA ratio was an independent risk factor for perineural invasion. Low fPSA/tPSA ratio and low prostate volume were associated with a positive margin in radical prostatectomy specimens. Conclusions:In this study, patients diagnosed with microfocal adenocarcinoma on prostate biopsy account for a high proportion of the patients with increased Gleason score in the radical prostatectomy specimens, and there is a certain proportion of adverse pathological features in the radical specimens. Therefore, for the patients with only a small amount of low-grade adenocarcinoma found in biopsy, PSA levels and PSA density should be taken into consideration in treatment selection.

ObjectiveTo explore the possible mechanism of the treatment of dry eye with liver-meridian constraint-heat syndrome by Runmu Xiaoyao Powder （润目逍遥散） by miR-146a-5p and interleukin-1 receptor-associated kinase 1/tumour necrosis factor receptor associated factor 6/nuclear factor-κB （IRAK1/TRAF6/NF-κB） signalling pathway. MethodsEighty C57BL/6J mice were randomly divided into normal group， model group， agonist group， inhibitor group， sodium hyaluronate group， and Runmu Xiaoyao Powder high-， medium-， and low-dose groups， with 10 mice in each group. Except for the normal group， the mice of dry eye with liver-meridian constraint-heat syndrome were modeled by using benzalkonium chloride solution eye drops combined with chronic pain stimulation. Beginning on the 30th day of modelling， mice in Runmu Xiaoyao Powder high-， medium-， and low-dose groups were given 29， 14.5， and 7.25 g/kg of Runmu Xiaoyao Powder respectively twice daily by gavage； mice in sodium hyaluronate group were given 5 μl of sodium hyaluronate drops twice daily； mice in the agonist group were given 2 nmol of agomir-146a-5p drops in each eye at a time， and those in the inhibitor group were given 5 nmol of antagomir-146a-5p drops in each eye， with every other day， 3 times per week； mice in the normal and model groups were gavaged with deionised water at 1 ml/（100 g·d）. The intervention was continued for 14 days in each group， and mice in each group were examined for tear secretion， tear film rupture time， corneal fluorescein staining， and irritability scores on the day following the last intervention； HE staining was used to observe the pathological conditions of the cornea and lacrimal glands in each group； corneal and lacrimal gland inflammatory factors， such as interleukin 1β （IL-1β）， tumour necrosis factor α （TNF-α）， miR-146a-5p expression， were examined； matrix metalloproteinase 3 （MMP-3） and matrix metalloproteinase 9 （MMP-9） expression in cornea， IRAK1， TRAF6， nuclear factor κB p65 （NF-κB p65） protein and mRNA expression in cornea and lacrimal gland， and phosphorylated nuclear factor κB p65 （p-NF-κB p65） protein expression were detected. ResultsCompared with the normal group， mice in the model group showed reduced tear secretion， shorter tear film rupture time， higher irritability score （P＜0.05）， and pathological examination showed staining in the centre of the cornea， obvious corneal damage， increased volume of lacrimal gland follicular cells， disordered arrangement， a large number of inflammatory cell infiltration， and increased neovascularisation； corneal and lacrimal gland tissues showed elevated expression of IL-1β and TNF-α， decreased expression of miR -146a-5p， elevated expression of IRAK1， TRAF6， NF-κB p65， p-NF-κB p65 protein and IRAK1， TRAF6， NF-κB p65 mRNA， and elevated expression of MMP-3， MMP-9 protein in the cornea （P＜0.05）. Compared with the model group， all of the above indexes were significantly improved in high-dose group of Runmu Xiaoyao Powder， while some indexes were improved in the sodium hyaluronate group and the middle- and low-dose Runmu Xiaoyao Powder groups （P＜0.05）. Compared with the model group， corneal and lacrimal IRAK1 and TRAF6 mRNA and IRAK1， TRAF6 and p-NF-κB p65 protein expression decreased in the agonist group； compared with the inhibitor group， IRAK1， TRAF6， NF-κB p65 mRNA and protein expression in the cornea and lacrimal gland in the Runmu Xiaoyao Powder groups decreased （P＜0.05）. ConclusionRunmu Xiaoyao Powder can negatively regulate the IRAK1/TRAF6/NF-κB signalling pathway in the cornea and lacrimal gland of mice with dry eye of liver-meridian constraint-heat syndrome by up-regulation of miR-146a-5p， so as to inhibit inflammatory response and reduce the damage of the ocular surface tissues， and the high doses group showed the best effect.