Objective To further improve the accuracy of bone age identification using the time of secondary ossification center appearance and epiphyseal fusion of 7 joints to estimate the age of living individuals.Methods DR films were taken from 7 parts including sternal end of clavical and the left side of shoulder,elbow,carpal,hip,knee and ankle joints of 1709 individuals who came from eastern China,central China and southern China,whose ages were between 11.0 and 20.0 years.From those 7 joints 24 osteal loci were selected as bone age indexes,which could better reflect age growth of teenagers.The characteristics of secondary ossification center appearance and epiphyseal fusion were observed,and the mean and age range of secondary ossification center appearance and epiphyseal fusion were calculated.Results The fusion time of the 24 epiphyses were advanced at different degrees,the most obvious epiphyses the sternal end of clavicle,scapular acromial end,distal end of the radius,distal end of the ulna,iliac crest,ischial tuberosity,the upper and lower end of tibia and fibula.The appearance time of sternal end of clavicle,scapular acromial end,iliac crest and ischial tuberosity epiphyses were all found to be after the age of 12,and the female's age,approximately 1year ahead of schedule in comparison with the male's.Conclusion The relevant forensic information and data for bone age identification should be updated every 10-15 years so as to provide accurate and objective evidence for court testimony,conviction and sentencing.

Objective To observe the effect of mouse nerve growth factor (mNGF) on treating herpes zoster.Methods The 64 patients with herpes zoster were divided into treatment group and control group by random digits table with 32 cases each.The control group received only routine treatment,the treatment group based on routine treatment combined with mNGF 30 μ g,both groups were treated 14 days.Pain changes of two groups were observed in once every 5 days,a total of 1 month.Results The times of pain to lessen and the pain to vanish of treatment group were (4.36 ± 2.01) and (12.29 ± 1.98) d,those of control group were (7.23 ±3.57) and (20.36 ±2.24) d,there were significant differences (t =5.21 and 8.37,P ＜0.01).The effective rate of treatment group was significantly higher than that of control group [96.9％(31/32) vs.71.9％(23/32),P＜0.05].Conclusion mNGF combined with routine treatment can significantly shorten the course of nerve injury and improve the prognosis with few adverse reactions.

Objective To explore the correlation between CTvolume rendering (VR) statistics and living age and to build the mathematical models for skeletal age evaluation based on the grow th rules of medi-al clavicular epiphysis of teenagers in China. Methods The thin layer CTscan and VR3D imaging re-construction of both sides of sternal ends of clavicles were exam ined for 684 teenagers aged from 15 to 25 in East and South China. The parameters of sternal end of clavicle including the longest diameter of epiphysis, the longest diameter of metaphysis, their length radio, area of epiphysis, area of meta-physic, their area ratio, and other data were measured and calculated in order to establish mathematical models of skeletal age evaluation. Fifty trained subjects were tested to verify the accuracy of the math-ematical models. Results In the same age group, the length ratio and the area ratio had significant dif-ference in genders (P<0.05). The established mathematical models showed that the grow th rules of medial clavicular epiphysis were highly correlated with the living ages. The accuracies of these models were higher than 70.5% (±1.0 year) and 82.5% (±1.5 year). Conclusion The mathematical models have easy operability and high accuracy. It can be used to confirmand sustain the conclusion of atlas method. M eanw hile, it is of great significance to study the other single skeletal age evaluation in the future.

Objective To explore the role of MKK34 (a peptide spanning a C-terminal α-helical region in TSLP) on airway inflammation and β-catenin of airway epithelium in a HDM-induced mouse asthma.Methods 32 male BALB/c mice were randomly divided into control,MKK34,asthma and MKK34 + HDM groups.The mice in the asthma group were exposed to HDM for five consecutive days and the MKK34 + HDM group was pretreated with MKK34 1 h prior to the HDM intranasally treated.After 8 weeks' treatment,animal lung function test and pathological staining were performed to evaluate the asthma situation,IL-4,IFN-γin bronchoalveolar lavage fluid and IgE in the serum were detected,immunohistochemistry and western blot were used to assess β-catenin and p-ERK,t-ERK levels.Results Airway reactivity,IL-4 and IgE in the asthma group were significantly higher than that in the control group.Treatment with MKK34 significantly decreased airway hyperresponsiveness,IL-4 and IgE.HE staining demonstrated the chronic bronchitic inflammation in the lungs of asthma group.β-catenin in the control group was distributed evenly at the cytomembrane of epithelial cells.In the asthma group,β-catenin was disordered in epithelial cells and its expression was decreased.Treatment with MKK34 ameliorated the damage of β-catenin and chronic bronchitic inflammation.The protein levels of p-ERK1/2 increased obviously in the asthma group.The pretreated group significantly decreased the expression of p-ERK1/2.Conclusions MKK34 can ameliorate the airway inflammation and the destruction of β-catenin of airway epithelium in a HDM-induced mouse asthma.The ERK pathway may play a role in this process.

Objective To realize the autom ated assessm ent of the levels of epiphysis of distal radius and ulna by support vector m achine (SVM). Methods The X-ray film s of the leftwrist jointswere taken from 140 teenagers aged from 11 to 19 years old as training sam ples. The levels of epiphysis of distal radius and ulnawere divided into five developm ental levels. Each level contained 28 sam ples. A nother 35 cas-eswere selected as independent verifying sam ples. SVM classification m odels of the five developm ental levels of epiphysis of distal radius and ulnawere established. The internal cross validationwas m ade by leave one out cross validation (LOOCV ),while the external validationwas m ade by histogram of orient-ed gradient (HOG), and then the accuracy (PA ) of testing resultswas calculated, respectively. Results The PA of SVM, LOOCV and HOG of distal radius epiphyseal levelwere 100%, 78.6%, and 82.8%, respec-tively;whereas the PA of SVM, LOOCV and HOGof distal ulna epiphyseal levelwere 100.0%, 80.0%and 88.6%, respectively. Conclusion The SVM -based autom atic m odels of the growth stage of distal ra-dius and ulna appear to have certain feasibility, and m ay provide a foundation for software developm ent of bone age assessm ent by forensic medicine.

Objective To investigate the impact of 1,25(OH)2D3 on histological changes and activation of STAT3 in BLM?induced pulmonary fibrosis mice. Methods 30 male C57BL/6 mice were randomly divided into control group ,BLM group and BLM+VD group. Mice in BLM group and BLM+VD group received intratracheal injection of BLM(3 U/kg). Control group were intratracheally injected equal volume of sterile saline. From the first day after the surgery,mice in BLM+VD group received intraperitoneal injection of VD (5μg/kg·d). After 21 days, H&E and Masson′s trichrome staining were carried out. Aschroft score were used to evaluate histological changes in lungs. IL?6,IL?4 and INF?γin BALF were assessed by Elisa. p?STAT3,α?SMA and Collagen I were detected by western blot (WB) and immunohistochemistry. Results Fibrosis score and level of α?SMA,Collagen I in BLM group were significantly higher than that in control group (P < 0.05). However ,treatment with VD effectively at?tenuated fibrosis (P<0.05). IL?6 and IL?4 increased while INF?γwas decreased in BALF of BLM group (P<0.05). VD could ameliorate these changes. Upregulation and neuclear translocation of p?STAT3 were observed in BLM group,while VD intervention could inhibit phosphorylation of STAT3. Conclusions VD attenuate BLM?induced pulmonary fibrosis and regulate inflammatory cytokines probably by blocking STAT3 activation.

Objective To investigate the value of ADC histogram of tumor volume measurement in the diagnosis of prostate cancer,and to screen out the best diagnostic parameter value.Methods 31 cases of prostate cancer and 35 cases of benign prostatic hyperplasia confirmed by biopsy or surgical pathology were analyzed retrospectively.DWI examination was performed on all patients before treatment,and b value of 0 and 1500 s/mm2 was selected.The total tumor ADC histogram parameters were measured respectively,including the average value of ADC (ADCmean ),the median ADC (ADCmedian ),the tenth percentile ADC (ADC10th),the twenty-fifth percentile ADC (ADC25th), the fiftieth percentile ADC (ADC50th),the seventy-fifth percentile ADC (ADC75th),the ninetieth percentile ADC (ADC90th), skewness and kurtosis.The histogram parameters of the two groups of patinents and their diagnostic efficacy were analyzed and compared.Results ADCmean ,ADCmedian ,ADC10th,ADC25th,ADC50th,ADC75th and ADC90th in the prostate cancer group were statistically lower than those of benign prostatic hyperplasia group (P <0.01),and there was no significant difference in the skewness and kurtosis between the two groups of diseases (P > 0.05 ).ADCmean ,ADCmedian ,ADC10th,ADC25th,ADC50th,ADC75th and ADC90th diagnosing prostate cancer in the area under ROC curves (AUC)were more than 0.78.ADC10th had the best diagnostic efficacy and its AUC was 0.82, with the optimal cut-off value for 0.27 × 10 -3 mm2/s,with sensitivity and specificity for 78.4％ and 83.3％.Conclusion The ADC histogram of the total tumor volume measurement is of great value in the diagnosis of prostate cancer,among which ADC10th is the most effective parameter.It can accurately distinguish between prostate cancer and prostatic hyperplasia nodules.

Objective:To investigate the level and significance of CD64 index, matrix metalloproteinase-9 (MMP-9) and serum amyloid A (SAA) in peripheral blood of patients with severe carbapenem resistant Enterobacteriaceae (CRE) infection.Methods:A total of 61 patients with severe CRE infection who were admitted to the neurosurgery department of Kashgar First People′s Hospital from January 2019 to January 2022 were selected as the CRE group, and 100 patients with severe carbapenem sensitive Enterobacteriaceae (CSE) infection were selected as the CSE group. The difference in clinical data between the two groups was compared, and the difference in clinical data between the dead and surviving patients in the CRE group was compared. The value of CD64 index, MMP-9 and SAA in differential diagnosis of CRE was analyzed. Logistic regression was used to analyze the influencing factors of prognosis in patients with CRE infection.Results:The age, hypertension, lung disease, liver and kidney disease, comorbidities≥2, antibiotic use≥2 combinations, antibiotic use time>10 days, proportion of carbapenem use, CD64 index, MMP-9, and SAA of the CRE group patients were significantly higher than those of the CSE group patients (all P<0.05). The area under the receiver operating characteristic (ROC) curve for CD64 index, MMP-9, and SAA differential diagnosis of CRE was 0.857, 0.701, and 0.655, respectively (all P<0.05). In the CRE group, the age , the score of Acute Physiological and Chronic Health Status Ⅱ (APACHE Ⅱ) score at admission, diabetes, liver and kidney diseases, comorbidities≥2, the proportion of carbapenems, CD64 index, MMP-9 and SAA of dead patients were significantly higher than those of survivors (all P<0.05). Logistic regression analysis showed that age, APACHE Ⅱ score at admission, comorbidities≥2, CD64 index, MMP-9, and SAA were influencing factors for the prognosis of severe CRE patients (all P<0.05). Conclusions:The peripheral blood CD64 index, MMP-9, and SAA have certain application value in the diagnosis of neurological severe CRE infection, and are also influencing factors for the prognosis of CRE infected patients.

Objective To investigate the effects of continuous positive airway pressure (CPAP) on sleep status,neuropsychological characteristics in patients with stroke combined with obstructive sleep apnea syndrome (OSAHS).Methods Fifty-four patients hospitalized with stroke in Tianjin Medical University General Hospital from May 2014 to January 2016,who were with snoring and met the OSAHS diagnostic criteria,were randomly divided into CPAP combined with drug treatment group (25 cases) and drug treatment alone group (29 cases).The sleep structure and respiratory parameters were evaluated by polysomnography,and the changes of the patients' sleep status was assessed by Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI).The changes of neurocognitive function were assessed by Montreal Cognitive Assessment (MoCA),Digital Span Test (DST) and Hopkins Verbal Learning Testrevised (HVLT),and Patient Health Questionnaire-9 (PHQ9) was used to evaluate the depression mood changes.The changes of sleep status,cognitive function and mood in the CPAP combined with drug treatment group were compared before and three months after CPAP combined with drug treatment,and with the drug treatment alone group.Results Because five cases were dropped off,there were 20 patients in the CPAP combined with drug treatment group and 29 patients in the drug treatment alone group who completed the study.After three months of CPAP combined with drug treatment,the respiratory parameters apnea hypopnea index (AHI) in the CPAP combined with drug treatment group (29.32 ± 16.57) was significantly lower than that before treatment (41.66 ± 21.84;t =3.926,P =0.001),and the minimum blood oxygen saturation (LSaO2;82.11％ ± 5.66％) was significantly higher than that before treatment (76.11％ ± 8.90％;t=-5.054,P=0.000).However,the sleep structure parameters did not show statistically significant changes compared with those before treatment.The ESS,PSQI and PHQ9 scores in the CPAP combined with drug treatment group (4.53 ± 3.86,3.00 ± 2.45,0.00 (0.00,2.00)) were significantly decreased compared with those before treatment (10.58 ± 7.82,7.53 ± 2.87,3.00 (1.00,9.00);t =-3.883,P =0.001;t =-6.522,P =0.000;Z =-3.549,P =0.000),whereas MoCA,HVLT (total scores,recall and recognition) and DST 1,2 scores in the CPAP combined with drug treatment group (23.37 ± 4.75,22.32 ± 6.90,7.47 ± 3.82,7.84 ± 2.59,5.32 ± 2.81) were increased compared with those before treatment (22.16±4.94,19.16 ±7.66,6.68 ±3.74,7.32 ±2.67,5.00 ±3.00;t=-2.773,P=0.013;t=-6.857,P=0.000;t=-2.704,P=0.015;t=-2.249,P=0.037;t=-2.882,P =0.010).The ESS,PSQI and PHQ9 scores were significantly reduced in the CPAP combined with drug treatment group compared with the drug treatment alone group (8.76 ± 6.92,7.59 ± 5.49,5.00 (2.50,9.50);t=-2.711,P=0.009;t=-3.941,P=0.000;Z=-4.555,P=0.000),whereas the DST1 score was significantly increased compared with the drug treatment alone group (6.45 ± 1.43;t =2.144,P =0.042).Conclusions Three-month CPAP combined with drugs mainly improved the daytime sleepiness and depression of patients with stroke combined with OSAHS.Cognition especially in attention was significantly improved,and the degree of low ventilation and hypoxia was alleviated,whereas there was no significant change in sleep structure disorder.

Objective:To analyze the characteristics of gamma oscillation in chronic insomnia patients with anxiety and depression, and to investigate its underlying neural mechanism.Methods:According to the anxiety and depression scores, the subjects with chronic insomnia who met the diagnostic criteria were divided into chronic insomnia with anxiety and depression group ( n=19) and chronic insomnia group ( n=13). Healthy subjects matched with age, gender, and educational background were selected as the normal control group ( n=16). The EEGs from the three groups under resting state and cognitive load state were collected.The relative gamma power was then calculated by fast Fourier transform.The spatial distribution pattern of the gamma oscillation in the three groups was analyzed.Spearman correlation analysis was employed to quantify the correlation between relative gamma powers and sleep scale, anxiety and depression scale scores. Results:In the resting state, the relative gamma power in the chronic insomnia with anxiety and depression, chronic insomnia and normal control group was 0.192 1±0.008 0, 0.210 3±0.009 6, 0.237 3±0.006 4, respectively.In the cognitive load state, the relative gamma power in the three groups increased compared with those in the resting state (0.220 7±0.008 1, 0.249 5±0.009 8, 0.267 7±0.007 2, respectively) (all P<0.05). In the resting state, the relative gamma power (F3, F4, C3, C4, P3, P4, O2, F8, T4) in the chronic insomnia with anxiety and depression group (0.179 9±0.009 7) and the chronic insomnia group (0.194 4±0.010 4) was lower than that in control (0.236 0±0.012 0, P<0.05). In the cognitive load state, the relative gamma power (F3, C3, C4, P3, P4, T4) in the chronic insomnia with anxiety and depression group (0.207 3±0.009 7) was lower than that in control (0.259 1±0.009 4)( P<0.05). There was a significant negative correlation between the relative gamma power in the nodes(F3, C3, P3)and the insomnia, anxiety and depression in the three groups(correlation coefficient r=-0.467--0.274, P<0.05). Conclusion:Chronic insomnia patients with anxiety and depression are often accompanied by cognitive dysfunction.The loss of gamma oscillation in left posterior, left central and left apex may be one of the potential neural mechanisms of cognitive dysfunction in chronic insomnia patients with anxiety and depression.