Objective To investigate the etiology clinical diagnosis and treatment of pediatric neurogenic pulmonary edema(NPE).Methods The clinical data of 18 hospitalized children with NPE were retrospectively analyzed.Results 18 cases of NPE children with traumatic brain injury 2 cases( 11.1％ ),cervical spinal cord injury 1 case(5.5％ ) and,subarachnoid hemorrhage 2 cases( 11.1％ ),and epilepticus states 2 cases( 11.1％ ),non-HFMD caused encephalitis 3 cases( 16.6％ ),NPE caused hand,foot and mouth disease 8 cases(45.6％ ),survival 6 cases (33.3％) and 12 patients died (66.7％)in 18 hospitalized children with NPE.Conclusion The common cause of pediatric NPE was central nervous system infections and poor prognosis,early diagnosis and early treatment could improve the efficacy and prognosis.

BACKGROUND: Radio frequency (RF) magnetron sputtering is a mature technique to prepare metallic (ceramic) coating on ceramic (metallic) substrate, which possesses low-amplitude temperature increasing substrate,rapid deposition rate, even coating component, stable performance, high binding intensity and other advantages.OBJECTIVE: To investigate the structure of hydroxyapatite(HA) coating prepared with RF magnetron sputtering technique and the binding performance of coating and interface of substrate.DESIGN: Single-sample observation.SETTING: College of Material Science and Engineering, Jiangsu University.MATERIALS: 30 mm×30 mm×3 mm Ti-6Al-4V plate and JGP500 MultiFunction Ultrahigh Vacuum Magnetron Sputtering System were used in this experiment.METHODS: This experiment was carried out at the Center of Material Experiment, Jiangsu University from December 2003 to September 2004.HA coating was prepared on the surface of Ti-6Al-4V substrate with RF magnetron sputtering technique, appearance of coating surface and crosssection were observed with scanning electron microscope (SEM), phase structure of coating was analyzed with X-ray diffractometer,Ca/P of coating was analyzed with Energy Dispersive X-ray Spectrometer and binding intensity of coating and interface of substrate was measured with e thoxyline resin-7 butt joint.MAIN OUTCOME MEASURES: ① Micro-appearance of HA coating.② Composition of HA coating and the effect of postprocessing. ③ Binding status and intensity of HA coating and substrate interface.RESULTS: ①Under the SEM, coating surface of HA was rough and uneven in surface, presented many pores and reticular structure. Pore area was about 30% to 40%. ② Ca/P of HA coating was 1.7. The essential component of treated HA coating was HA with high crystallization, without other calcium and phosphonium phase. ③ The binding intensity of HA coating and substrate interface was 51.2 MPa.CONCLUSION: HA coating prepared with RF magnetron sputtering technique has good appearance, high binding intensity at the interface of substrate.

Objective To investigate the efficacy and the course of desensitization treatment in bronchial asthma with positive specific IgE to dust mite in children. Methods A total of 105 children with bronchial asthma with positive specific IgE to dermatophagoides farinae allergens were randomized into the observation group and the control group. Children in the control group were treated to continue anti-asthma according to the routine of prevention and treatment children with asthma. Chinldren in the observation group were treated by dermatophagoides farinae drops in addition to the treatment of children in the control group. The recurrence of asthma was compared between two groups at 25 weeks post-treatment. At 25 weeks post-treatment , children in the observation group was randomly divided into the observation groupⅠand group Ⅱ. Children in the observation groupⅠreceived continuous treatment except for desensitization treatment. Children in the observation group II received the sublingual immunotherapy with dermatophagoides farinae drops (No.4) for 1 year in addition to the treatment in the observation groupⅠ. The recurrence of asthma was also compared between the two sub-groups. Results The rate and times of recurrence of asthma were lower in the observation group than those in the control group(P < 0.05), with no significant differences between the observation groupⅠand groupⅡ (P > 0.05). Conclusion The recurrent rate and frequency of asthma could be reduced by the sublingual immunotherapy with dermatophagoides farinae drops in children with asthma of positive specific IgE to dust mite. The course of treatment may be half year long.

This is a report on the research of HA/Ti6Al4V composite implants that were successfully fabricated by radio frequency magnetron sputtering (RF-MS) technique. The mechanism and bioactivity of these implants immersed in simulated body fluid (SBF) were investigated. Changes in surface morphology, interfacial bond state, crystal structure and phase composition of HA coating before and after immersing in SBF were characterized by Scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FTIR), energy dispersive spectroscopy (EDS) and X-ray diffraction (XRD). Results indicate that a new substance on the surface of HA implant coatings produces accompanying with the dissolution of coatings. The substance is bone-like apatite containing CO3(2-) and lacking of Ca2+. Its ratio of n(Ca)/n(P) is about 1.56. This substance has very small grain size and similarly amorphous structure. Its structure and composition are similar to those of natural bone. Thus, it has good biocompatibility and bioactivity.
Biocompatible Materials ; Coated Materials, Biocompatible ; chemical synthesis ; Durapatite ; chemical synthesis ; Magnetics ; Materials Testing ; Prosthesis Implantation ; Radio Waves ; Titanium ; chemistry

Objective To evaluate the efficiency of levonorgestrel-releasing intrauterine system (LNG-IUS) in the treatment of recurrent endometriosis after conservative surgery or conservative surgery combined with medical treatment. Methods Twenty-three patients with recurrent endometriosis after conservative surgery or conservative surgery combined with medical treatment were treated by LNG-IUS. All patients rejected further operation and had no desire of fertility. The visual analogue scale (VAS) scores of pain, menstrual model, weight and serum CA125 level and the volume of ovarian endometriotic cysts before and after 3, 6, 12, 24 and 36 months of treatment were recorded and compared. Results ( 1 ) VAS score:after 12 months of using LNG-IUS, dysmenorrheal, chronic pelvic pain or dyspareunia were relieved significantly. VAS score were dropped from 5.9 ± 2. 3,4. 3 ± 2.0 to 1.0 ± 0. 7,1.4 ± 1. 1 ( P ＜ 0. 01 ). ( 2 )Volum of cysts :after 6 months of using LNG-IUS, the volume of recurrent ovarian endometriotic cysts in 11 patients were reduced from ( 11.4 ± 6. 1 ) em3 to ( 5. 5 ± 3.4 ) em3 significantly ( P ＜ 0. 01 ). At 12 months of follow-up, it suggested that 2 patients' ovarian endometriotic cysts disappeared. At 24 months follow-up,9 patients ovarian endometriotic cysts disappeared ( 3 ) CA125: serum CA125 decreased from ( 65.5 ± 19. 6 )kU/L to (42. 1 ± 13.6) kU/L at 6 months after treatment remarkably (P ＜ 0. 01 ). Continued to decrease after 12 months and then become steady. Irregular bleeding and spotting was the main side effects, weight gain was also observed in few patients. Conclusions LNG-IUS could be used in treatment of recurrent endometriosis after conservative surgery or conservative surgery combined with medical treatment effectively. It could relieve pain, reduce the level of CA125 and decrease the size of ovarian endometriotic cysts. LNG-IUS seems to be an effective, safe, and long term treatment for endometriosis with fewer side effects and better compliance.

GAP-43,netrin-1,collapsin-1,and neuropilin-1 have been regarded to play crucial roles in the formation of patterned neural connections.The cerebellum consists of five distinct concentric layers:white matter,internal granule layer (IGL),Purkinje cell layer (PCL),molecular layer (ML),and external granule layer (EGL) in young rodents.Cells in EGL are generated after birth.In contrast Purkinje neurons are born before birth,which receive main innervations of climbing fibers fi'om the inferior olivary nucleus and parallel fibers from the internal granule cells.These innervations are mostly established in the first three postnatal weeks,accompanying the sprouting and maturation of Purkinje cells.The potential roles of GAP-43,netrin-1,collapsin-1 and neuropilin-1 in the postnatal development of cerebellum remain unclear.To get insights into the above issue,the expression of GAP-43,netrin-1,collapsin-1,and neuropilin-1 mRNAs and proteins were examined in the cerebellum of mice at postnatal days (P) 5,P10,P20 and adulthood.The results showed that these four molecules were expressed in different temporal and spatial patterns in the postnatal cerebellum of mice,which was in match with axonal synaptogenesis,elongation and synapse formation during postnatal development and adulthood.By using double immunohistocbemistry,it was found that the Purkinje cells stained for GAP-43 were also positive for either netrin-1 or collapsin-1 at P10,and cells stained for collapsin-1 were also positive for netrin-1 or neuropilin-1.It was suggested that the four molecules are involved in the postnatal development of cerebellum.

Objective:To analyze the clinical characteristics of patients with anterior and posterior circulation large vessel occlusion ischemic stroke and clinical prognoses after successful endovascular recanalization.Methods:A retrospective analysis was performed; 170 patients with large vessel occlusive ischemic stroke, admitted to Stroke Center, Second Hospital of Dalian Medical University from January 2016 to September 2022 were chosen; these patients had modified Thrombolysis in Cerebral Infarction (mTICI) 2b or 3 after endovascular treatment. These patients were divided into anterior-circulation large vessel occlusion group ( n=138) and posterior-circulation large vessel occlusion group ( n=32) according to the locations of vessel occlusion. Clinical data, parameters related to endovascular treatment, and clinical prognoses of the 2 groups were collected and compared. Results:Posterior-circulation large vessel occlusion group had significantly higher percentages of male patients and patients with atherosclerotic type (81.3% vs. 61.6%; 78.1% vs. 47.1%), significantly higher ratio of neutrophil to lymphocyte and NIHSS scores (3.78 [1.93, 10.86] vs. 2.77[1.77, 4.72]; 20.50±8.96 vs. 14.83±4.67), significantly lower percentage of patients with atrial fibrillation (21.9% vs. 58%), and significantly longer times from onset to puncture, onset to recalculation, admission to puncture, and admission to recalculation (367.50 [246.25, 630.00] min vs. 240.00 [198.75, 330.00]; 515.00 [292.50, 701.25] vs. 345.50 [270.00, 425.75] min; 163.00 [123.25, 218.50] min vs. 125.50 [97.00, 161.00]; 258.00 [200.25,389.00] vs. 219.50 [178.00, 276.25]) than anterior-circulation large vessel occlusion group ( P<0.05). The NIHSS scores 24 h after endovascular treatment, NIHSS scores at discharge, and mortality within 90 d in posterior-circulation large vessel occlusion group were significantly higher than those in anterior-circulation large vessel occlusion group (21.31±9.23 vs. 15.74±6.53; 25.5 [4.25, 40.25] vs. 10.00 [4.00, 18.25]; 40.6% vs. 20.3%, P<0.05); however, no significant differences in symptomatic intracranial hemorrhage, incidence of intracranial hemorrhage, in-hospital mortality or 90-d good prognosis were noted between the 2 groups ( P>0.05). Conclusion:Posterior circulation large vessel occlusion ischemic stroke patients have higher neurological impairment at onset than anterior circulation acute large vessel occlusion ischemic stroke patients; both patients enjoy similar results in terms of 90-d good prognosis and complications, but 90-d mortality is higher than that in anterior ones.

Objective:To explore the effect and underlying mechanism of casein kinase 2 interacting protein-1 (CKIP-1) on hepatocyte apoptosis in nonalcoholic fatty liver disease (NAFLD).Methods:Experimental study. An NAFLD cell model was established by inducing human hepatoma cell line, HepG 2 cells, with oleic acid (OA). Flag-CKIP-1 expression vector and shRNA-CKIP-1 were transfected into HepG 2 cells. Flow cytometry was used to detect the effect of CKIP-1 on the activity and apoptosis of NAFLD hepatocytes. The levels of apoptosis-related proteins were detected by Western blot. CKIP-1 knockout mice in C57BL/6 back-ground were fed with either standard or high-fat diet for 8 weeks. Apoptosis-related signal proteins in NAFLD hepatocytes were detected by immunohistochemistry. Results:After CKIP-1 was transfected into HepG 2 cells, the degree of OA induced cell liposis was significantly reduced ( P<0.05). Annexin V-FITC/PI flow cytometry showed that CKIP-1 reduced the apoptosis of steatotic hepatocytes. Overexpression of CKIP-1 could significantly inhibit the expression of caspase-3 and caspase-9 and increase the expression of Bcl-2/Bax ( P<0.05). Knockdown of CKIP-1 could increase the expression of caspase-3 and caspase-9 ( P<0.05). CKIP-1 knockout could further increase the expression of caspase-3 and caspase-9 in NAFLD mice ( P<0.01, P<0.05), and further decrease the expression of Bcl-2/Bax ( P<0.05). Conclusion:CKIP-1 inhibited the apoptosis of steatotic hepatocytes by up-regulating the expression of apoptosis inhibitor gene, Bcl-2/Bax, and affecting the proteases, caspase-3 and caspase-9.

Objective:To explore the effectiveness of a hysteroscopic endometrial lesion diagnosis model de-veloped based on deep learning(DL)algorithm combined with gradient-weighted class activation mapping(Grad-CAM)visualization technology.Methods:303 hysteroscopy videos(4781 images)of 291 patients who un-derwent hysteroscopy examination in the Department of Gynecology,Renmin Hospital of Wuhan University from June 1,2021 to December 31,2022 were selected.The dataset was divided into a training set(3703 images)and a test set(1078 images)by weight sampling method.After the training set was used for model learning and train-ing,two model architectures,residual neural network(ResNet18)and efficient neural network(EfficientNet-B0),were selected to verify the model in the test set by five-class and two-class classification tasks,respectively.Tak-ing histopathology as the gold standard,the diagnostic efficacy was evaluated to select the optimal model,and the Grad-CAM layer was embedded in the optimal model to output hysteroscopy images of Grad-CAM.Results:①In the five-class classification tasks,the accuracy of EfficientNet-B0 model(93.23％)was higher than that of Res-Net18 model(84.23％);the area under the curve(AUC)of EfficientNet-B0 model in the diagnosis of five disea-ses,including atypical endometrial hyperplasia,endometrial polyps,endometrial cancer,endometrial atypical hy-perplasia,and submucous myoma,was slightly higher than that of ResNet18 model,and the AUC of both models was almost above 0.980.②In the binary classification task of accuracy and the evaluation of specificity,the two models were similar,both above 93.00％,and the sensitivity of EfficientNet-B0 model(91.14％)was significantly better than that of ResNet18 model(77.22％).③EfficientNet-B0 model combined with Grad-CAM algorithm could identify the abnormal areas in the image.After biopsy and pathological examination,it was confirmed that about 95％of the marked areas in the model's output heatmap were lesion areas.Conclusions:The hysteroscopy di-agnostic model developed by EfficientNet-B0 model combined with Grad-CAM has high diagnostic accuracy,sen-sitivity,and specificity,and has application value in the diagnosis of endometrial lesions.

Objective:To explore the effectiveness of a hysteroscopic endometrial lesion diagnosis model de-veloped based on deep learning(DL)algorithm combined with gradient-weighted class activation mapping(Grad-CAM)visualization technology.Methods:303 hysteroscopy videos(4781 images)of 291 patients who un-derwent hysteroscopy examination in the Department of Gynecology,Renmin Hospital of Wuhan University from June 1,2021 to December 31,2022 were selected.The dataset was divided into a training set(3703 images)and a test set(1078 images)by weight sampling method.After the training set was used for model learning and train-ing,two model architectures,residual neural network(ResNet18)and efficient neural network(EfficientNet-B0),were selected to verify the model in the test set by five-class and two-class classification tasks,respectively.Tak-ing histopathology as the gold standard,the diagnostic efficacy was evaluated to select the optimal model,and the Grad-CAM layer was embedded in the optimal model to output hysteroscopy images of Grad-CAM.Results:①In the five-class classification tasks,the accuracy of EfficientNet-B0 model(93.23％)was higher than that of Res-Net18 model(84.23％);the area under the curve(AUC)of EfficientNet-B0 model in the diagnosis of five disea-ses,including atypical endometrial hyperplasia,endometrial polyps,endometrial cancer,endometrial atypical hy-perplasia,and submucous myoma,was slightly higher than that of ResNet18 model,and the AUC of both models was almost above 0.980.②In the binary classification task of accuracy and the evaluation of specificity,the two models were similar,both above 93.00％,and the sensitivity of EfficientNet-B0 model(91.14％)was significantly better than that of ResNet18 model(77.22％).③EfficientNet-B0 model combined with Grad-CAM algorithm could identify the abnormal areas in the image.After biopsy and pathological examination,it was confirmed that about 95％of the marked areas in the model's output heatmap were lesion areas.Conclusions:The hysteroscopy di-agnostic model developed by EfficientNet-B0 model combined with Grad-CAM has high diagnostic accuracy,sen-sitivity,and specificity,and has application value in the diagnosis of endometrial lesions.