Objective To summarize clinical experience in removal of residual metallic foreign body in the soft tissue.Methods Clinical data of 742 cases with residual metallic foreign body in the soft tissue were analyzed.All the patients were forward from other hospitals with failed removal of the foreign body.Second surgery was performed in our hospital by grasping forceps using 3D-locator under the guidance of the C-shaped arm X-ray machine.Results Foreign body,such as scrap-iron,broken needle,nails,wine and so on located at different regions of soft tissues including neck,chest and abdomen,pelvis,and the four limbs were all successfully taken out.Removal rate of the foreign body was 100％.No complications such as bleeding,infection and nerve damage was occurred.The mean time of the procedures and radiation exposure for the removal surgery was 5 minutes.Conclusion Using 3D-locator and grasping forceps under the guidance of the X-ray,the residual metallic foreign bodies can be removed safely and efficiently.

Objective To study the changes of hearing function and cochlear morphology on diffuse brain in-jury model in rat .Methods One hundred and fifty SD rats with normal hearing were randomly divided into five groups ,each group consisted of 30 SD rats ,including a control group and four experimental groups which endured diffuse brain injury(DBI) from one to four weeks .Diffuse brain injury model of rats were established ,then ABR , 40 Hz AERP and ASSR examination ,light microscopy ,electron microscopy were used to evaluate the change of hearing function and morphology .Results The difference of ABR ,40 Hz AERP and ASSR thresholds between the experimental and the normal control group were significant (P<0 .05) .The thresholds of ABR ,40HzAERP and AS-SR were increased in the first week of DBI ,then the threshold continuously increased in the second and third week , at last the threshold decreased in the fourth week .The results under scaning electron microscope demonstrated that the ciliums of the majority of outer hair cells lodged in the first week of DBI .The results under transmission electron microscope showed that in the first week of DBI ,there were edema and denuration of mitochondrial ,mitochondrial cristaes were obscured or disappeared .The changes were deteriorate in the second and third week ,whereas the changes were mitigatal in the fourth week .Conclusion Cochlear morphology and hearing damage were observed in diffuse brain injury model of rats .

Objective:To evaluate the role of tumour necrosis factor-α-induced protein 8-like 2 (TIPE2) in the acute lung injury (ALI) induced by endotoxin in mice.Methods:Forty SPF healthy adult male BALB/c mice, aged 6-8 weeks, weighing 20-25 g, were divided into 4 groups ( n=10 each) using a random number table method: vehicle plasmid group (VP group), vehicle plasmid plus ALI group (VP+ ALI group), TIPE2 adeno-associated virus overexpression group (T group) and TIPE2 adeno-associated virus overexpression plus ALI group (T+ ALI group). The mice in VP and VP+ ALI groups were injected with empty adeno-associated virus, while the mice in T and T+ ALI groups were intratracheally given adeno-associated virus carrying TIPE interference sequence.Three weeks later, the model of endotoxin-induced ALI was established.Lipopolysaccharide (LPS) 5 mg/kg was intratracheally given in VP+ ALI and T+ ALI groups, and the equal volume of phosphate buffered saline (PBS) was given in VP and T groups.Blood samples were obtained from the abdominal aorta at 24 h after injection of LPS for blood gas analysis, oxygenation index (OI) was calculated, and tumor necrosis factor-alpha (TNF-α) in serum were detected by enzyme-linked immunosorbent assay.The animals were then sacrificed, and lung tissues were removed for examination of pathological changes which were scored after haematoxylin and eosin staining, for calculation of the wet/dry weight ratio (W/D ratio) and for determination of myeloperoxidase (MPO) activity and the expression of TIPE2, phosphorylated c-Jun N-terminal kinase (p-JNK) and nuclear factor kappa B(NF-κB) (by Western blot). Results:Compared with VP group, the lung injury score, W/D ratio, MPO activity and concentration of serum TNF-α were significantly increased, PaO 2 and OI were decreased, expression of TIPE2 was down-regulated and expression of p-JNK and NF-κB was up-regulated in VP+ ALI group ( P<0.05). Compared with VP+ ALI group, the lung injury score, W/D ratio, MPO activity and concentration of serum TNF-α were significantly decreased, PaO 2 and OI were increased, expression of TIPE2 was up-regulated and expression of p-JNK and NF-κB was down-regulated in T+ ALI group ( P<0.05). Conclusion:The down-regulation of TIPE2 expression is involved in the process of ALI induced by endotoxin in mice.

Objective:To evaluate the effects of esketamine on pyrolysis in lung tissues of rats with endotoxin-induced acute lung injury (ALI).Methods:SPF healthy adult male Sprague-Dawley rats, weighing 200-220 g, aged 8 weeks, were divided into 3 groups ( n=10 each) using a random number table method: control group (group C), endotoxin-induced ALI group (group ALI) and esketamine group (group E). Lipopolysaccharide (LPS) 10 mg/kg was intraperitoneally injected to establish the model of endotoxin-induced ALI model.The equal volume of 0.9% sodium chloride injection was intraperitoneally injected in group C. Esketamine 10 mg/kg was intraperitoneally injected at 30 min of injection of LPS in group E. Lung tissues were removed after blood samples were collected from hearts at 24 h after injection of LPS for determination of concentrations of serum interleukin-1beta (IL-1β) and IL-8 (by enzyme-linked immunosorbent assay), the wet/dry weight ratio (W/D ratio), activities of myeloperoxidase (MPO) (by colorimetric assay) and the expression of nucleotide-binding oligomerization domain-like receptor containing pyrin domain 3 (NLRP3), caspase-1 and gasdermin D (GSDMD) (by Western blot) and for examination of pathological changes which were scored after haematoxylin and eosin staining and ultrastructure (using an electron microscope). Results:Compared with group C, the lung injury score, W/D ratio, MPO activity, expression of NLRP3, caspase-1 and GSDMD and concentrations of IL-1β and IL-18 in serum were significantly increased in ALI and E groups ( P<0.05). Compared with group ALI, the lung injury score, W/D ratio, MPO activity, expression of NLRP3, caspase-1 and GSDMD and concentrations of IL-1β and IL-18 in serum were significantly decreased in group E ( P<0.05). Conclusion:The mechanism by which esketamine reduces endotoxin-induced ALI is related with inhibition of pyrolysis in lung tissues of rats.

Objective:To evaluate the effect of esketamine on Toll-like receptor 4 (TLR4)/nuclear factor-kappaB (NF-κB) during endotoxin-induced acute lung injury (ALI) in rats.Methods:Thirty SPF healthy male Srague-Dawley rats, weighing 200-220 g, were divided into 3 groups ( n=10 each) using a random number table method: control group (group Con), endotoxin-induced ALI group (group ALI) and esketamine group (group AK). Septic ALI model was developed by intraperitoneal injection of lipopolysaccharide 10 mg/kg. The equal volume of 0.9% sodium chloride was intraperitoneally injected in group Con. Esketamine 10 mg/kg was intraperitoneally injected at 30 min and 12 h after lipopolysaccharide injection in group AK. The rats were anesthetized at 24 h after developing the model, and the carotid blood samples were collected for measurement of PaO 2, and PaO 2/FiO 2 was calculated. The rats were then sacrificed for microscopic examination of the pathological changes of lung tissues which were scored and cell ultrastructure of lung tissues (with an electron microscope) and for determination of the count of the polymorphonuclear leukocyte (PMN) in broncho-alveolar lavage fluid(BALF), activity of myeloperoxidase (MPO) (by colorimetric assay) and expression of TLR4 and NF-κB p65 (by Western blot). The wet/dry lung weight (W/D) ratio was calculated. Results:Compared with group Con, the PaO 2 and PaO 2/FiO 2 were significantly decreased, the lung injury score, PMN count in BALF, W/D ratio and MPO activity were increased, the expression of TLR4 and NF-κB p65 was up-regulated in group ALI ( P<0.05). Compared with group ALI, PaO 2 and PaO 2/FiO 2 were significantly increased, the lung injury score, PMN count in BALF, W/D ratio and MPO activity were decreased, the expression of TLR4 and NF-κB p65 was down-regulated ( P<0.05), and the ultrastructure of lung tissue cells was improved in group AK. Conclusions:The mechanism by which esketamine attenuates endotoxin-induced ALI is associated with the blockade of TLR4/NF-κB signaling pathway in rats.

Objective To explore the value of deep learning(DL)models semi-automatic training system for automatic optimization of clinical image quality control of transthoracic echocardiography(TTE).Methods Totally 1 250 TTE videos from 402 patients were retrospectively collected,including 490 apical four chamber(A4C),310 parasternal long axis view of left ventricle(PLAX)and 450 parasternal short axis view of great vessel(PSAXGv).The videos were divided into development set(245 A4C,155 PLAX,225 PSAXGV),semi-automated training set(98 A4C,62 PLAX,90 PSAXGV)and test set(147 A4C,93 PLAX,135 PSAXGV)at the ratio of 5:2:3.Based on development set and semi-automatic training set,DL model of quality control was semi-automatically iteratively optimized,and a semi-automatic training system was constructed,then the efficacy of DL models for recognizing TTE views and assessing imaging quality of TTE were verified in test set.Results After optimization,the overall accuracy,precision,recall,and F1 score of DL models for recognizing TTE views in test set improved from 97.33％,97.26％,97.26％and 97.26％to 99.73％,99.65％,99.77％and 99.71％,respectively,while the overall accuracy for assessing A4C,PLAX and PSAXGV TTE as standard views in test set improved from 89.12％,83.87％and 90.37％to 93.20％,90.32％and 93.33％,respectively.Conclusion The developed DL models semi-automatic training system could improve the efficiency of clinical imaging quality control of TTE and increase iteration speed.