Wavelet transform is internationally recognized a good tool for time-frequency analysis. This paper presents a novel speckle suppression method for medical B-Scan images. The speckle is produced by scattering echoed signals in different phases because of wave interference. The software MATLAB is used as operating platform meanwhile the wavelet is used to eliminate the noise. The ultrasound image is processed by adaptive method and then the selected sym8 wavelet is used in the multiresolution analysis of the ultrasound image. The result shows that this method can effectively reduce the speckle noise.

Objective Assessment of short?term and mid?term changes of knee cartilage in non?professional long?distance runners before and after marathon using T2 mapping imaging. Methods Twenty?four knee joints of 12 healthy volunteers (5 males and 7 females) who participated in the marathon were examined by 3.0 T MRI one week before the race, within 12 hours after the race and two months after the race, respectively. The age ranged from 21.0 to 37.0 years. Athletes run more than three times a week, and each time was about 30 minutes. From T2 mapping we can obtain T2 value of 6 cartilage subregions of knee joint. Paired t?test was used to compare the T2 values of cartilage before and after the marathon. The comparison between the superficial and deep T2 values of cartilage was performed by independent sample t test. Results T2 mapping imaging showed that the T2 value of the superficial articular cartilage was higher than that of deep articular cartilage in pre?competition, within 12 hours after competition and 2 months follow?up, respectively (t=11.095, 10.385 and 10.102, P<0.01). The T2 value of superficial articular cartilage decreased after the competition compared with that of pre?competition (t=2.18,P<0.05), while the T2 value of deep articular cartilage showed no significant difference compared with that of pre?competition (t=1.832, P> 0.05). Except for the MTP?DZ, the T2 value of the remaining cartilage subregions showed a trend of decrease within 12 hours after the competition. There were significant differences in the subregion of MFC?DZ (t=2.110,P<0.05). At the follow?up of 2 months, cartilage T2 values of the MTP?SZ,LTP?SZ,LTP?DZ,MFC?DZ, Patella?SZ, Patella?DZ, Trochlea?SZ, Trochlea?DZ subregions showed a trend of recovery, and there was no significant difference compared with pre?competition(t=0.857,0.573, 0.146, 0.510,-0.594,-1.135,-0.812,-0.679; P>0.05). The T2 values of the LFC?SZ and LFC?DZ were lower than those before the race, with statistical significance (t=2.378, 3.147,P<0.05). Conclusion T2 value could reflect the change process of articular cartilage tissue composition in marathon runners from T2 mapping imaging. Under stress, the changes of superficial T2 value are more significant. The T2 value of knee cartilage can gradually recover to the pre?run level 2 months after running.

Objective: Assessment of short-term and mid-term changes of knee cartilage in non-professional long-distance runners before and after marathon using T₂ mapping imaging. Methods: Twenty-four knee joints of 12 healthy volunteers (5 males and 7 females) who participated in the marathon were examined by 3.0 T MRI one week before the race, within 12 hours after the race and two months after the race, respectively. The age ranged from 21.0 to 37.0 years. Athletes run more than three times a week, and each time was about 30 minutes. From T₂ mapping we can obtain T₂ value of 6 cartilage subregions of knee joint. Paired t-test was used to compare the T₂ values of cartilage before and after the marathon. The comparison between the superficial and deep T₂ values of cartilage was performed by independent sample t test. Results: T₂ mapping imaging showed that the T₂ value of the superficial articular cartilage was higher than that of deep articular cartilage in pre-competition, within 12 hours after competition and 2 months follow-up, respectively (t=11.095, 10.385 and 10.102, P<0.01). The T₂ value of superficial articular cartilage decreased after the competition compared with that of pre-competition (t=2.18,P<0.05), while the T₂ value of deep articular cartilage showed no significant difference compared with that of pre-competition (t=1.832, P> 0.05). Except for the MTP-DZ, the T₂ value of the remaining cartilage subregions showed a trend of decrease within 12 hours after the competition. There were significant differences in the subregion of MFC-DZ (t=2.110,P<0.05). At the follow-up of 2 months, cartilage T₂ values of the MTP-SZ,LTP-SZ,LTP-DZ,MFC-DZ, Patella-SZ, Patella-DZ, Trochlea-SZ, Trochlea-DZ subregions showed a trend of recovery, and there was no significant difference compared with pre-competition (t=0.857,0.573, 0.146, 0.510, -0.594, -1.135, -0.812, -0.679; P>0.05). The T₂ values of the LFC-SZ and LFC-DZ were lower than those before the race, with statistical significance (t=2.378, 3.147,P<0.05). Conclusion T₂ value could reflect the change process of articular cartilage tissue composition in marathon runners from T₂ mapping imaging. Under stress, the changes of superficial T₂ value are more significant. The T₂ value of knee cartilage can gradually recover to the pre-run level 2 months after running.

Objective:To evaluate the effect of verbascoside on cold ischemia-reperfusion injury following heterotopic heart transplantation in mice and the relationship with nuclear factor kappa B (NF-κB)/nucleotide-binding oligomerization domain-like receptor containing pyrin domain 3 (NLRP3) signaling pathway.Methods:This experiment was performed in two parts. Part Ⅰ animal experiment Eighteen SPF healthy male C57BL/6 mice, aged 6-8 weeks, weighing 24-28 g, were divided into 3 groups ( n=6 each) by the random number table method: control group (C group), cold ischemia-reperfusion (I/R) group (I/R group) and cold I/R + verbascoside group (I/R+ VB group). Cold I/R injury model of mouse heart transplantation was prepared by neck heterotopic heart transplantation using the modified non-suture cuff technique. The donor heart in group C was immediately transplanted to the recipient after removal, while the donor heart in group I/R was stored in the 4 ℃ University of Wisconsin solution for 8 h before transplantation to the recipient, and verbascoside 20 mg/kg was intraperitoneally injected at 3 days before surgery in donor and recipient mice in I/R+ VB group. At the end of reperfusion, the myocardial tissue of the transplanted heart was obtained after assessing the beating score for determination of malondialdehyde (MDA) content and superoxide dismutase (SOD) activity by enzyme-linked immunosorbent assay. Part of the donor myocardium was taken for examination of the pathological results. The expression of NF-κB, p-NF-κB, NOD-like receptor protein 3 (NLRP3), ACS and caspase-1 was detected by Western blot. The expression of IL-1β, TNF-α and IL-6 mRNA was detected by real-time polymerase chain reaction. Part Ⅱ cell experiment Rat cardiomyocyte H9c2 cold hypoxia-reoxygenation model was developed, and the cells were divided into 3 groups ( n=24 each) by the random number table method: control group (C group), cold hypoxia-reoxygenation group (H/R group), and cold hypoxia-reoxygenation+ verbascoside group (H/R+ VB group). The cells were exposed to hypoxia for 18 h at 10 ℃ followed by restoration of reoxygenation for 24 h at 37 ℃ to develop the cold hypoxia-reoxygenation model. The cell viability and LDH activity were determined. The expression of NF-κB and NLRP3 was detected by Western blot, and the expression of phosphorylated NF-κB (p-NF-κB) was detected by immunofluorescence staining. Results:Part Ⅰanimal experiment Compared with C group, the MDA content was significantly increased, the beating score of grafts and SOD activity were decreased, and the expression of p-NF-κB, NLRP3, ACS and caspase-1 and IL-1β, TNF-α and IL-6 mRNA was up-regulated ( P<0.05), and myocardial histopathological injury was aggravated in I/R group. Compared with I/R group, the content of MDA was significantly decreased, the beating score of grafts and SOD activity were increased, the expression of p-NF-κB, NLRP3, ACS and caspase-1 and IL-1β, TNF-α and IL-6 mRNA was down-regulated ( P<0.05), and the myocardial histopathological injury was alleviated in I/R+ VB group. Part Ⅱ cell experiment Compared with C group, the cell viability was significantly decreased, the activity of LDH was increased, and the expression of p-NF-κB, NLRP3, ACS, caspase-1 and p-NF-κB was up-regulated in H/R group ( P<0.05). Compared with H/R group, the cell viability was significantly increased, the activity of LDH was decreased, and the expression of p-NF-κB, NLRP3, ACS, caspase-1 and p-NF-κB was down-regulated in H/R+ VB group ( P<0.05). Conclusions:Verbascoside can alleviate cold I/R injury following heterotopic heart transplantation in mice, and the mechanism may be related to inhibition of activation of NF-κB/NLRP3 signaling pathway.

Objective:To evaluate the role of ferroptosis in hypoxia-reoxygenation (H/R) injury in cardiomyocytes cultured in high-fat high-glucose (HFHG) medium.Methods:Cardiomyocytes H9c2 cells were commonly cultured and divided into 3 groups ( n=20 each) using a random number table method: control group (C group), HFHG-H/R group and Ferrostatin-1 (Fer-1) plus HFHG-H/R group (Fer-1+ HFHG+ H/R group). H9c2 cells were cultured in a HFHG medium for 12 h and then exposed to 1%O 2-5%CO 2-94%N 2 for 4 h, followed by 2 h reoxygenation in a cell incubator.Fer-1 at a final concentration of 10 μmol/L was added while the cells were cultured in the HFHG medium in group Fer-1+ HFHG+ H/R.At 2 h of reoxygenation, the cell viability was measured using CCK-8 assay, the activity of lactate dehydrogenase (LDH) in the supernatant was measured using 2, 4-dinitrophenylhydrazine color method, the activity of reactive oxygen species (ROS) was measured by fluorescent probe DCFH-DA flow cytometry, and the expression of acyl-CoA synthetase long-chain family member 4 (ACSL4), nuclear receptor coactivator 4 (NCOA4), and glutathione peroxidase 4 (GPX4) was detected by Western blot. Results:Compared with group C, the cell viability was significantly decreased, the activities of LDH release and ROS were increased, and the expression of ACSL4 and NCOA4 was up-regulated ( P<0.05), and no significant change was found in the expression of GPX4 in group HFHG+ H/R ( P>0.05). Compared with group HFHG+ H/R, the cell activity was significantly increased, the activities of LDH and ROS were decreased, and the expression of ACSL4 and NCOA4 was down-regulated ( P<0.05), and no significant change was found in the expression of GPX4 in Fer-1+ HFHG+ H/R group ( P>0.05). Conclusions:Ferroptosis is involved in the process of H/R injury in cardiomyocytes cultured in HFHG medium.

Objective:To evaluate the role of bilateral superior cervical sympathetic ganglia (SCG) in myocardial ischemia-reperfusion (I/R) injury in mice and the relationship with NOD-like receptor protein 3 (NLRP3) inflammasomes.Methods:Thirty-two healthy SPF male C57BL mice, aged 8-10 weeks, weighing 25-30 g, were divided into 4 groups ( n=8 each) by the random number table method: sham operation group (NS group), myocardial I/R group (NIR group), bilateral SCG excision group (SCGx group) and bilateral SCG excision + myocardial I/R group (SCGx+ IR group). The myocardial I/R injury model was prepared by ligating the anterior descending branch of the left coronary artery for 30 min followed by 24 h reperfusion in isoflurane-anesthetized mice. Bilateral superior cervical sympathectomy was performed at 3 days before reperfusion. Blood samples were collected from the inferior vena cava at 24 h of reperfusion for examination of pathological changes (by HE and WGA staining) and for measurement of serum creatine kinase isoenzymes (CK-MB) activity, cardiac troponin I (cTnI) concentration, norepinephrine (NE) concentration and lactic dehydrogenase (LDH) activity (by enzyme-linked immunosorbent assay), superoxide dismutase (SOD) activity (by colorimetric method), myocardial reactive oxygen species (ROS) level (by DHE method), myocardial infarct size(by TTC method), and expression of interleukin-1beta (IL-1β), IL-6, IL-10, tumor necrosis factor-alpha (TNF-α), NLRP3 mRNA (by quantitativepolymerase chain reaction ), and expression of tyrosine hydroxylase (TH), IL-1β, TNF-α, NLRP3, atrial natriuretic peptide (ANP)and brain natriuretic peptide (BNP) (by Western blot). Results:Compared with NS group, the NE concentration was significantly decreased, and TH expression was down-regulated in SCGx group, and the serum CK-MB activity, concentrations of cTnI and NE, LDH activity and myocardial ROS level were significantly increased, SOD activity was decreased, the expression of IL-1β, TNF-α, NLRP3, ANP and BNP was up-regulated, and the expression of IL-1β, IL-6, TNF-α and NLPR3 mRNA was up-regulated in NIR group ( P<0.05). Compared with SCGx group, the serum CK-MB activity, concentrations of cTnI and NE, LDH activity and myocardial ROS levels were significamtly increased, SOD activity was decreased, the expression of IL-1β, TNF-α, NLRP3, ANP and BNP was up-regulated, and the expression of IL-1β, IL-6, TNF-α and NLPR3 mRNA was up-regulated in SCGx+ NIR group ( P<0.05). Compared with NIR group, the serum CK-MB activity, cTnI concentration, LDH activity and myocardial ROS level were significantly decreased, SOD activity was increased, the expression of IL-1β, TNF-α, NLRP3, ANP and BNP was down-regulated, the expression of IL-1β, IL-6, TNF-α and NLPR3 mRNA was down-regulated, and myocardial infarct size was decreased in SCGx+ NIR group ( P<0.05). Conclusions:The mechanism by which bilateral SCG excision attenuates myocardial I/R injury is associated with decreased NLRP3 inflammatory inflammasome activation and inhibition of inflammatory responses in mice.

Objective This study was performed to explore the use of intramuscular low-dose Zoletil(1.5 mg/kg)combined with isoflurane inhalation for tracheal intubation in miniature pigs while preserving spontaneous respiration by determining the 50％and 95％minimum alveolar concentrations effective inhaled(MAC EI50 and MAC EI95).The goal was to establish a safe anesthetic method for tracheal intubation in miniature pigs in which intubation is difficult.Methods Forty-four Bama miniature pigs underwent general anesthesia.Following sedation with an intramuscular injection of sufentanil,anesthetic induction was performed using mask inhalation of isoflurane with monitoring of the heart rate,blood pressure,respiration,body temperature,oxygen saturation,end-tidal carbon dioxide concentration,and end-tidal isoflurane concentration.The initial end-tidal isoflurane concentration was set at 2.0％.The tracheal intubation conditions and outcomes were evaluated using Cooper's scoring system,and the dose-response relationship was calculated using Dixon's up-and-down method.Probit regression was employed to calculate the MAC EI50 and MAC EI95 along with their 95％confidence intervals(CI).Results In tracheal intubation using direct laryngoscopy with induction by low-dose sufentanil combined with isoflurane inhalation in miniature pigs,the MAC EI50 was 3.10％(95％CI,2.79％～3.56％)and the MAC EI95 was 3.77％(95％CI,3.41％～6.42％).With proper monitoring and airway management planning in place,alveolar isoflurane concentrations ranging from 3.10％to 3.75％were able to maintain stable vital signs in the miniature pigs.Conclusions The use of Zoletil combined with isoflurane inhalation for tracheal intubation in miniature pigs,aimed at preserving spontaneous breathing,is a preferable and safe anesthetic method for oral airway management in miniature pigs with significant potential for widespread application.

Objective:To analyze the clinical characteristics of necrotizing otitis externa(NOE) and to discuss its clinical staging and treatment.Methods:A retrospective case series study was conducted in the Otorhinolaryngology Head and Neck Surgery Center of Beijing Friendship Hospital. Patients hospitalized in our department with diagnosis of NOE between June 2015 to December 2021 were included. There were 23 patients (23 affected ears), with 19 males and 4 females, aged 32-85 years (the median age was 68 years old). We analyzed and summarized the main symptoms and signs, laboratory examinations, imaging examinations, treatments and prognosis of the patients, and established a database for data collection and sorting.Results:All the 23 patients had various complications. There were 19 cases of type 2 diabetes, 5 cases of anemia, 3 cases of hypoalbuminemia, 2 cases of chronic renal insufficiency, and 1 case of uremia. The main symptoms on admission were otalgia, otorrhea, hearing loss, angular deviation, limited mouth opening, dysphagia and hoarseness. Physical examination showed swelling of the external ear canal (EEC), granulation tissue of the EEC, thin purulent secretion of the EEC, facial paralysis, restricted mouth opening, and decreased vocal cord movement. Etiological results showed 15 cases of Pseudomonas aeruginosa, 5 cases of Staphylococci and 3 cases of Aspergillus fumigatus. Imaging mainly showed abnormal soft tissue shadows of the EEC and middle ear, and temporomandibular joint, parapharyngeal space, skull base, intracranial and other adjacent structures were involved according to the different invasion directions of the lesions. According to the characteristics of these patients, we summarized a diagnostic criteria and clinical staging. All patients received systematic anti-infection, surgery and symptomatic support treatment. Until January 30, 2022, 4 patients died, including 1 case of extensive intracranial infection caused by NOE, and 3 cases of other systemic diseases after the affected ears were recovered and discharged from hospital. The other 19 patients′ ears were cured, the symptoms of otalgia and otorrhea disappeared, and the epithelization of the surgical cavity was good. Conclusion:The clinical manifestations of NOE lack specificity, and the diagnosis should be made according to the medical history, physical examination and auxiliary examination. According to different clinical stages, corresponding treatment measures should be formulated. The treatment is based on multidisciplinary comprehensive treatment, mainly surgical treatment. Early intervention has a good prognosis, otherwise, multiple-group of cranial nerve injury or intracranial infection implies poor prognosis.

Objective:To investigate the hemodynamic characteristics of transverse sinus with sigmoid sinus wall dehiscence (SSWD) of pulsatile tinnitus (PT) based on 4D flow MRI.Methods:Retrospective analysis was performed on all patients admitted to Beijing Friendship Hospital, Capital Medical University from January 2019 to January 2021 for dehiscent sigmoid plate pulsatile tinnitus. A total of 26 patients (sides) who met the criteria and underwent 4D flow MRI were included. A total of 26 subjects (46 sides), matched 1∶1 according to gender and age, were included in the normal healthy control group. Nonparametric rank sum test, Student′s t test, and ANOVA were performed by SPSS 19.0 software. Binary Logistic regression was applied to the data with statistical significance. Results:There were more patients with dominant drainage on the affected side in PT group than in control group (73.1% vs. 42.3%). The incidence of transverse with a focal intraluminal filling defect and tapered stenosis was higher than that in control group (21.7% vs. 69.2%; 17.4% vs. 42.3%). Average through-plane velocity and maximum through-plane velocity in PT group were higher than those in control group [(33.75±13.88) cm/s vs. (15.84±7.21) cm/s; (93.19±33.55) cm/s vs. (40.40±14.40) cm/s]. The middle part and proximal end of Flow avg (ml/s) in PT group were larger than those in control group [4.69 (2.87; 5.62) ml/s vs. 2.76 (1.67; 4.99) ml/s; 3.41 (2.16; 5.47) ml/s vs. 2.67 (1.68; 4.41) ml/s]. In control group, the velocity of transverse sinus changed relatively gently, while in PT group, the velocity of proximal sinus increased significantly. Binary Logistic regression showed that SSWD PT was independently correlated with proximal maximum flow velocity [ OR=1.086(1.029-1.146), P=0.003]. Conclusion:4D flow MRI showed that the dominant drainage and higher velocity at the proximal end of the transverse sinus might be an important hemodynamic characteristics of dehiscent sigmoid plate pulsatile tinnitus.

Objective:To retrospectively analyze the treatment status of tyrosine kinase inhibitors (TKI) in newly diagnosed patients with chronic myeloid leukemia (CML) in China.Methods:Data of chronic phase (CP) and accelerated phase (AP) CML patients diagnosed from January 2006 to December 2022 from 77 centers, ≥18 years old, and receiving initial imatinib, nilotinib, dasatinib or flumatinib-therapy within 6 months after diagnosis in China with complete data were retrospectively interrogated. The choice of initial TKI, current TKI medications, treatment switch and reasons, treatment responses and outcomes as well as the variables associated with them were analyzed.Results:6 893 patients in CP ( n=6 453, 93.6%) or AP ( n=440, 6.4%) receiving initial imatinib ( n=4 906, 71.2%), nilotinib ( n=1 157, 16.8%), dasatinib ( n=298, 4.3%) or flumatinib ( n=532, 7.2%) -therapy. With the median follow-up of 43 ( IQR 22-75) months, 1 581 (22.9%) patients switched TKI due to resistance ( n=1 055, 15.3%), intolerance ( n=248, 3.6%), pursuit of better efficacy ( n=168, 2.4%), economic or other reasons ( n=110, 1.6%). The frequency of switching TKI in AP patients was significantly-higher than that in CP patients (44.1% vs 21.5%, P<0.001), and more AP patients switched TKI due to resistance than CP patients (75.3% vs 66.1%, P=0.011). Multi-variable analyses showed that male, lower HGB concentration and ELTS intermediate/high-risk cohort were associated with lower cytogenetic and molecular responses rate and poor outcomes in CP patients; higher WBC count and initial the second-generation TKI treatment, the higher response rates; Ph + ACA at diagnosis, poor PFS. However, Sokal intermediate/high-risk cohort was only significantly-associated with lower CCyR and MMR rates and the poor PFS. Lower HGB concentration and larger spleen size were significantly-associated with the lower cytogenetic and molecular response rates in AP patients; initial the second-generation TKI treatment, the higher treatment response rates; lower PLT count, higher blasts and Ph + ACA, poorer TFS; Ph + ACA, poorer OS. Conclusion:At present, the vast majority of newly-diagnosed CML-CP or AP patients could benefit from TKI treatment in the long term with the good treatment responses and survival outcomes.