Objective To investigate the characteristics and rules of tongue image in patients with chronic fatigue syndrome(CFS)with different fatigue degree.Methods Totally 917 patients with severe chronic fatigue syndrome(severe CFS group),351 patients with mild chronic fatigue syndrome(mild CFS group)and 1216 healthy controls(healthy control group)were enrolled in the physical examination center of Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine.The tongue image data of subjects in the three groups were collected using TFDA-1 digital tongue and face diagnostic instrument,and the color space indexes of RGB,HSI,Lab and YCrCb were used to analyze the tongue image differences of CFS people with different fatigue degrees and the tongue image features of CFS patients with liver-qi stagnation syndrome,damp-heat stasis syndrome and spleen deficiency syndrome.Results Compared with the healthy control group,the tongue image indexes TB-R,TB-G,TB-B,TB-I,TB-L,TB-Y,TC-H,TC-I,TC-L and TC-Y increased in the severe CFS group;TB-S,TB-a,TC-S,TC-a,TC-Cr decreased(P<0.05).TB-R,TB-G,TB-B,TB-I,TB-L,TB-Y,TC-R,TC-G,TC-B,TC-I,TC-L and TC-Y increased in severe CFS group compared with mild CFS group.TB-H and TB-b increased in mild CFS group compared with healthy control group.The comparison of syndromes in severe CFS group showed that TB-a,TB-Cr,TC-S,TC-a,TC-Cr and TB-S increased in liver-qi stagnation syndrome compared to damp-heat stasis syndrome;TB-G,TB-B,TB-I,TB-L,TB-Y,TB-b,TB-Cb,TC-G,TC-B,TC-H,TC-I,TC-L,TC-Y and perAll decreased(P<0.05).Compared with spleen deficiency syndrome,TB-a,TB-Cr,TB-CON,TB-ENT,TB-MEAN,TC-a,TC-Cr,TC-CON,TC-ENT,TC-MEAN increased in liver-qi stagnation syndrome;TB-ASM,TC-S and TC-ASM decreased(P<0.05).Compared with spleen deficiency syndrome,TB-a,TB-b,TB-Cr,TB-Cb,TB-CON,TB-ENT,TB-MEAN,TC-G,TC-B,TC-H,TC-I,TC-L,TC-a,TC-Y,TC-Cr,TC-CON,TC-ENT,TC-MEAN,perAll increased;TB-ASM,TC-S and TC-ASM decreased(P<0.05).The comparison of mild CFS syndrome showed that there was no statistical significance between liver-qi stagnation syndrome and spleen deficiency syndrome(P>0.05).TB-Cr,TC-a,TC-Cr and perAll increased and TC-S decreased in damp-heat stasis syndrome compared with spleen deficiency syndrome(P<0.05).TB-S,TB-a,TB-Cr,TC-S,TC-a,TC-Cr increased,and TB-G,TB-B,TB-I,TB-Cb,TB-b,TC-b and TC-Cb decreased(P<0.05)in liver-qi stagnation syndrome compared with damp-heat syndrome.The distribution trend of TC-S was as follows:dampness-heat syndrome

The treatment of ventral and incisional hernias has progressed from simple repair and reinforcement to reconstruction,restoration,and regeneration.There are Onlay,Sublay,preperitoneal,intraperitoneal repair planes,and each plane could be performed via open or laparoscopic surgery.Laparoscopic surgery mainly includes intraperitoneal onlay mesh(IPOM)and minimally invasive non-intraperitoneal mesh(MINIM)repair.Regardless of the technique applied,it is essential to follow the principles of abdominal wall functional reconstruction and minimally invasive features to demonstrate their clinical value.The core of abdominal wall functional reconstruction in laparoscopic surgery for ventral and incisional hernias could be summarized as restoring Anatomical structure,protecting Biomechanics,maintaining Compliance,and providing overall Dynamic support for the body.

Objective To evaluate the acceptability and effectiveness of different doses of midazolam oral solution in sedating infants during echocardiographic studies.Methods Two hundred and fourty patients aged 1 to 3 years who underwent echocardiographic study in sedation in our hospital were enrolled in this study.After recording the baseline data of all infants,they were randomly divided into four groups:0.3 mg·kg-1 midazolam oral solution group(M1 group),0.5 mg·kg-1 midazolam oral solution group(M2 group),0.7 mg·kg-1 midazolam oral solution group(M3 group)and 0.5 mL·kg-1 10%chloral hydrate administrated rectally group(C group),60 case per group,and the sedation was performed in the corresponding method of each group.The 5-point facial hedonic and Ramsay scales were used to evaluate acceptability and effectiveness in sedation.The onset time and duration time of sedation were recorded.Results Compared with the C group,the 5-point facial hedonic scale scores in M1,M2,and M3 groups increased during sedation(F=17.50,P<0.017).The onset time of sedation in the M1 and M2 groups was longer than that in the C group(P<0.017),and the duration time of sedation in the M1 and M2 groups was shorter than that in the C group(P<0.017).There was no significant difference in the onset time(P=0.85)and duration time(P=0.50)of sedation between the M3 and C groups.The onset time of sedation in the M1and M2groups was longer than that in the M3 group(P<0.017),and the duration time of sedation in the M1 and M2 groups were shorter than that in the M3 group(P<0.017).Conclusions The acceptability of infants with midazolam oral solution sedation under echocardiographic study was better than that of 10%chloral hydrate administrated rectally.There were fewer adverse reactions with the midazolam oral solution.The 0.7 mg·kg-1 midazolam oral solution had a rapid onset of sedation and definite effect.

With the rapid development of artificial intelligence technology, its applications in medical imaging have become increasingly extensive. This review aimed to analyze the current development status and future direction of intelligent imaging technology by investigating its application in various medical departments. To achieve this, we conducted a comprehensive search of various data sources up to 2024, including PubMed, Web of Science, and Google Scholar, based on the principle of comprehensive search. A total of 332 articles were screened, and after applying the inclusion and exclusion criteria, 56 articles were selected for this study. According to the findings, intelligent imaging technology exhibits robust image recognition capabilities, making it applicable across diverse medical imaging modalities within hospital departments. This technology offers an efficient solution for the analysis of various medical images by extracting and accurately identifying complex features. Consequently, it significantly aids in the detection and diagnosis of clinical diseases. Its high accuracy, sensitivity, and specificity render it an indispensable tool in clinical diagnostics and related tasks, thereby enhancing the overall quality of healthcare services. The application of intelligent imaging technology in healthcare significantly enhances the efficiency of clinical diagnostics, resulting in more accurate and timely patient assessments. This advanced technology offers a faster and more precise diagnostic approach, ultimately improving patient care and outcomes. This review analyzed the socioeconomic changes brought about by intelligent imaging technology to provide a more comprehensive evaluation. Also, we systematically analyzed the current shortcomings of intelligent imaging technology and its future development directions, to enable future research.
Humans ; Artificial Intelligence ; Diagnostic Imaging/methods* ; Hospitals

Objectives:To investigate the clinical value of a novel non-crosslinked biological mesh in laparoscopic inguinal hernia repair.Methods:The prospective randomized controlled study was conducted. The clinical data of 50 adult patients with unilateral inguinal hernia who were admitted to 3 medical centers, including Ruijin Hospital of Shanghai Jiaotong University School of Medicine et al, from September 2019 to March 2020 were selected. Based on random number table, patients were divided into two groups. Patients using the novel non-crosslinked biological mesh in repair surgery were divided into the experiment group and patients using the lightweight, micro-porous, partially absorbable synthetic mesh in repair surgery were divided into the control group. Observation indicators: (1) grouping situations of the enrolled patients; (2) endpoint of the study. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented as M(range), and comparison between groups was conducted using the non-parameter rank sum test. Count data were described as absolute numbers and (or) persentages, and comparison between groups was conducted using the chi-square test or Fisher exact probability. Comparison of ordinal data was conducted using the non-parameter rank sum test. Repeated measurement data were analyzed using the repeated ANOVA. Taking the recurrence rate of hernia as the basis of efficacy evaluation, according to the intention-to-treat analysis, the confidence interval method (Newcombe Wilson method) was used to conduct non-inferiority statistical analysis of the recurrence rate of hernia between the experiment group and the control group. If the upper limit of 95% confidence interval of the difference of recurrence rate of hernia between the experiment group and the control group is less than 10%, the experiment group is considered to be non-inferior to the control group. Results:(1) Grouping situations of the enrolled patients. A total of 50 adult patients with inguinal hernia were selected for eligibility. There were 44 males and 6 females, aged (60±15)years. All 50 patients were randomly divided into to the experiment group and the control group with 25 cases each. One patient in the control group was not followed up at postoperative month 2, and the rest of 49 patients completed all expected follow-up. No patient in the two groups fell off or were removed. (2) Endpoint of the study. ① The primary endpoint of study. The recurrence rate of hernia was 0 in the experiment group, versus 4%(1/25) in the control group, respectively, showing no significant difference between the two groups ( P>0.05). Results of non-inferiority statistical analysis showed that the 95% confidence interval of the difference of recurrence rate of hernia between the two groups was -19.54% to 9.72%, with the upper limit as 9.72%, which was less than 10%. ② The secondary endpoint of study. There were 2 patients in the control group occurred seroma at postoperative day 14, and none of the rest of patient in the two groups occurred seroma during the follow-up, showing no significant difference in the occurrence of seroma between the two groups ( P>0.05). There was 1 patient in the control group feeling discomfort or foreign body sensation in groin area at postoperative month 2, and none of the rest of patient in the two groups feeling discomfort or foreign body sensation in groin area during the follow-up, showing no significant difference in the feeling discomfort or foreign body sensation in groin area between the two groups ( P>0.05). There was no patient occurred surgical site infection in the experiment group, and there was 1 patient in the control group occurred postoperative skin infection, which had no relationship with mesh. There was no patient in both two groups occurred fever, anaphylaxis and patch related serious adverse reaction during the follow-up. The resting visual analogue scale score, active visual analogue scale score of patients at postoperative 2 days and postoperative 18 months were 0.44±1.00, 1.28±1.46 and 0, 0 in the experiment group, versus 0.40±0.76, 1.28±1.14 and 0.24±1.20, 0.44±1.29 in the control group, respectively. There was a significant difference in the time effect of postoperative active visual analogue scale score of patients between the two groups ( Ftime=10.19, P<0.05). The thickness of the novel non-crosslinked biological mesh before implantation was 0.5?0.7 mm. Two months after operation, results of B-ultrasonic examination in groin area of 10 patients from the experiment group showed a strong echo area at the patch implant area with a thickness as 2 mm. Conclusion:Application of novel non-crosslinked biological mesh in laparoscopic inguinal hernia repair is safe and effective.

The Rives-Stoppa technique was developed by two French surgeons in the 1960s and the plane where they placed the meshes is the plane in Sublay repair which is familiar to modern surgical community. After more than half a century of clinical practice, a large amount of evidence-based medical evidences indicate that the Sublay repair has become the recognized preferred surgical procedure in open repair. The Sublay repair as well as laparoscopic intra-peritoneal onlay mesh repair have become the two dominant procedures for the treatment of abdominal incisional hernia. With the deeply rooted concept of minimally invasive and the increasing integration of laparoscopic technique, the current Sublay repair is constantly deriving multi-dimensional development directions. Integration of laparoscopic technique and Sublay repair has become one of the important exploration directions of minimally invasive non-intraperitoneal mesh repair. The authors comprehensively analyze the research progress at home and abroad, and introduce the history, current status and prospective of Sublay repair.

Objective To evaluate the role of poly( ADP-ribose) polymerase-1 ( PARP-1) in lung ischemia-reperfusion ( I/R ) injury in rats and the relationship with autophagy. Methods Twenty-four clean-grade healthy male Sprague-Dawley rats, aged 8-12 weeks, weighing 200-240 g, were divided into 3 groups (n=8 each) using a random number table method: sham operation group (S group), lung I/R group ( I/R group) and lung I/R plus PARP-1 inhibitor PJ34 group ( I/R+PJ34 group) . The chest was only opened without clamping the left hilum of lung in group S. Lung I/R injury model was established by clam-ping the left hilum of lung for 45 min followed by 120 min reperfusion in I/R and I/R+PJ34 groups. PJ3410 mg/kg was intraperitoneally injected at 30 min before ischemia in group I/R+PJ34, while the equal volume of normal saline was injected in S and I/R groups. The rats were sacrificed at the end of reperfusion, and lungs were removed for microscopic examination of the pathological changes ( with a light microscope) which were scored and for determination of wet to dry weight ratio ( W/D ratio) , cell apoptosis ( by TUNEL) , ex-pression of PARP-1 activity markers ( PAR) , Bcl-2, Bax, microtubule-associated protein 1 light chain 3Ⅰ ( LC3-Ⅰ) , LC3-Ⅱ and Beclin-1 ( using Western blot ) . The apoptosis index, Bcl-2/Bax ratio and LC3-Ⅱ/LC3-Ⅰ ratio were calculated. Results Compared with S group, the W/D ratio, pathological scores, apoptosis index and LC3-Ⅱ/LC3-Ⅰ ratio were significantly increased, the expression of PAR and Beclin-1 was up-regulated, and Bcl-2/Bax ratio was decreased in I/R and I/R+PJ34 groups (P＜0. 05). Compared with I/R group, the W/D ratio, pathological scores, apoptosis index, and LC3-Ⅱ/LC3-Ⅰratio were significantly decreased, the expression of PAR and Beclin-1 was down-regulated, and Bcl-2/Bax ratio was increased in I/R+PJ34 group ( P＜0. 05) . Conclusion PARP-1 activation is involved in lung I/R inju-ry in rats, and the mechanism may be related to increasing autophagy and inducing cell apoptosis.

Objective To explore the effect of video-based education and teach-back method on health literacy and blood pressure control of elderly patients with hypertension. Methods 50 elderly hypertensive patients hospitalized in our hospital during May and December 2016 were enrolled as control group and anther 50 elderly hypertensive patients hospitalized in our hospital during January and May 2017 were assigned as the experimental group.On the basis of routine health education as in the control group,the experimental group was educated by video-based education combined with teach-back method.The health literacy and blood pressure control level of the two groups were compared before and after intervention. Result After intervention,the level of health literacy of the experimental group was significantly better than that of the control group,and the level of blood pressure control was significantly better than that of the control group as well (P<0.001 and P<0.05). Conclusions Video-based education combined with teach-backmethod is an effective way for health education.It has good effect on improving health literacy and blood pressure control level of elderly patients with hypertension.

Laparoscopic inguinal hernia repair (LIHR) is a surgical procedure of preperitoneal repair under laparoscope.It is well suited for young patients due to the advantages of postoperative slighter pain,faster resuming non-restrictive activities and better cosmetic effect.Total extraperitoneal and transabdominal preperitoneal (TAPP) are alternative for experienced surgeons and TAPP is recommended for complicated hernias or beginners.Most of the inguinal hernias in young males are congenital indirect hernias,accompanied with varicocele or cryptorchid.Varicocele can be handled simultaneously during LIHR and treatment scheme for cryptorchid should be formulated before LIHR according to different situations.Cryptorchid located in abdominal cavity or inner mouth can be resected in LIHR for resectable cryptorchid.Incaecerated scrotal hernia is common in young males and can be treated by hybridization technique.Femoral hernia should be paid attention in young females.Femoral hernia of most patients can be excised completely under laparoscope if combined with cyst of uterus round ligament.If possible,young females are suggested to preserve round ligament of uterus.Keyhole surgery and T-dissection are available for selected.

Objective To investigate the clinical efficacy of laparoscopic-assisted linea alba reconstruction for postpartum diastasis recti.Methods The retrospective cross-sectional study was conducted.The clinical data of 14 patients with postpartum diastasis recti who were admitted to Ruijin Hospital of Shanghai Jiaotong University School of Medicine between June 2016 and June 2018 were collected.Patients underwent laparoscopic-assisted linea alba reconstruction.Observation indicators:(1) intra-and post-operative recovery situations;(2) follow-up.Follow-up using outpatient examination and telephone interview was performed to detect postoperative long-term complications,diastasis recti and umbilical hernia recurrence up to September 2018.Measurement data with normal distribution were represented as (x)±s and measurement data with skewed distribution were described as M (P25,P75).Results (1) Intra-and post-operative situations:14 patients underwent successful laparoscopic-assisted linea alba reconstruction and 8 complicated with umbilical hernia area of (6± 3) cm2 were sutured and closed.The mesh area,operation time,visual analogue score for pain at the first day after operation,time of postoperative drainage-tube removal and duration of postoperative hospital stay were respectively (214±26) cm2,(74 ± 14) minutes,3.7 ± 0.6,(3.3 ± 0.7) days and (4.1 ± 1.2) days.No patient required administration of analgesics and had postoperative complication.(2) Follow-up:14 patients were followed up for 17 months (5 months,21 months).During the follow-up,1 patient returned visit at postoperative day 10 due to surgical incision drainage and cured after dressing change.The other patients had no complications,without diastasis recti and umbilical hernia recurrence.Conclusion Laparoscopic-assisted linea alba reconstruction for postpartum diastasis recti is safe and effective.