Objective To explore the regular progressive pattern of nontraumatic osteonecrosis of the femoral head (ONFH) in order to establish the reliable and convenient new classification of ONFH.Methods The coronal section of the femoral head was divided into three pillars (medial,central and lateral).The mid-coronal section of the femoral head on MRI was selected.The China-Japan Friendship Hospital (CJFH)classification of ONFH was established according to the site of necrotic focus in three pillars.A total of 153hips with ONFH were classified according to CJFH classification and Japanese Investigation Committee (JIC)classification,respectively.The collapse rate was observed and compared between both classifications of ONFH.Results The CJFH classification for ONFH consists of 3 types:type A,the medial pillar was involved; type B,the medial and central pillars were involved; type C,the lateral pillar was involved.According to site of necrosis focus in the lateral pillar,the type C was divided into 3 types:C1,there pillars were involved but there still was some normal tissue in lateral pillar;,C2,partial central pillar and all lateral pillar were involved; C3,the whole femoral head was involved.The natural history of the ONFH showed the collapse rate of type C2 and C3 in CJFH classification (95.3％) was higher than that (72.3％) of type C2 in JIC classification.Conclusion The CJFH classification of ONFH based on three pillars is more sensitive than JIC classification in predicting collapse of the femoral head.Moreover,the CJFH classification is convenient to use.

OBJECTIVETo describe the epidemiological characteristics of nonfatal child pedestrian injuries and provide information to help understand an important public-health problem.

METHODSThis was a school-based, cross-sectional questionnaire survey. The sample (42 750 children) was obtained from two urban cities of Guangdong Province, China, using multi-stage randomized sampling. Information was collected by the respondents self-reporting in the classroom.

RESULTSThe incidence rate of nonfatal child pedestrian injuries in the cities was 2.0%. Boys had a higher incidence rate (2.6%) than girls (1.4%). Compared to other children, those aged 10 years are at the highest risk. The primary places of occurrence were sidewalks, residential roads, and crosswalks. High-risk behavior of the children immediately prior to injury included mid-block crossings, playing on roads, and crossing on red lights. The major vehicles that caused pedestrian injuries were bicycles, car or vans, and motorcycles. Bruises, fractures, and injuries to the internal organs were the top three types of injuries. Almost 40% of victims were hospitalized, and nearly 30% of the victims suffered long-term disabilities.

CONCLUSIONThis study shows that nonfatal child pedestrian injuries are a very serious public-health problem in the urban cities of Guangdong. Based on the epidemiological characteristics, prevention strategies and further research should be carried out to reduce the occurrence of injuries.

Accident Prevention ; methods ; Accidents, Traffic ; prevention & control ; statistics & numerical data ; Animals ; Child ; China ; epidemiology ; Cross-Sectional Studies ; Data Collection ; Female ; Humans ; Incidence ; Male ; Motor Vehicles ; Surveys and Questionnaires ; Urban Population ; statistics & numerical data ; Wounds and Injuries ; epidemiology

Objective To establish a quick and accurate method for detection of tree shrew adenovirus(TAV) using TaqMan real-time fluorescence quantitative PCR. Methods Based on the published TAV genome sequence, a 3' conserved sequence was used to design specific probe primers. A standard curve was prepared using a recombinant plasmid containing the target gene fragment. A real-time fluorescence quantitative PCR method was established for detecting TAV based on TaqMan probe. Results The detection method was specific and was not cross-reactive with other common pathogens. The detection limit of the method was 3.7 copies/μL,showing a high sensitivity. The correlation coefficient was 0.998, and the efficiency was 95.7%. The amplification result showed a fine linear relationship,and the repeatability test effect was good. Conclusions The TAV real-time quantitative PCR detection method based on TaqMan probe has been successfully established. It has high sensitivity and reproducibility and can be applied to early detection of TAV infection.

Objective:To formulate surgical strategies and guide the implementation of laparoscopic anatomical hepatectomy with preoperative simulative resection.Methods:Twenty-two cases of hepatocellular carcinoma undergoing laparoscopic lobe, segment, subsegment and combined segment liver resection following preoperative simulative resection from Sep 2020 to Jan 2022 were enrolled in this study retrospectively.We observed and analyzed the operation time,intraoperative blood loss,postoperative hospital stay and postoperative complication.Results:All patients underwent laparoscopic hepatectomy successfully according to the preoperative simulative resection plan without conversion, some of them adjusted plan according to preoperative simulative resection. The median operation time was 170.0 min, the median intraoperative blood loss was 150.0 ml, the median times of pringle maneuver was done on 4 episodes, and the median postoperative hospital stay was 6.5 days. There were no severe postoperative complications in all cases.Conclusion:Preoperative simulative resection can plan the range of surgical resection accurately by visualizing important anatomical structures,greatly helping the actual surgical hepatectomy.

Photoplethysmography (PPG) is often affected by interference, which could lead to incorrect judgment of physiological information. Therefore, performing a quality assessment before extracting physiological information is crucial. This paper proposed a new PPG signal quality assessment by fusing multi-class features with multi-scale series information to address the problems of traditional machine learning methods with low accuracy and deep learning methods requiring a large number of samples for training. The multi-class features were extracted to reduce the dependence on the number of samples, and the multi-scale series information was extracted by a multi-scale convolutional neural network and bidirectional long short-term memory to improve the accuracy. The proposed method obtained the highest accuracy of 94.21%. It showed the best performance in all sensitivity, specificity, precision, and F1-score metrics, compared with 6 quality assessment methods on 14 700 samples from 7 experiments. This paper provides a new method for quality assessment in small samples of PPG signals and quality information mining, which is expected to be used for accurate extraction and monitoring of clinical and daily PPG physiological information.
Photoplethysmography ; Machine Learning ; Neural Networks, Computer

The extraction of pulse rate variability(PRV) in daily life is often affected by exercise and blood perfusion. Therefore, this paper proposes a method of detecting pulse signal and extracting PRV in post-ear, which could improve the accuracy and stability of PRV in daily life. First, the post-ear pulse signal detection system suitable for daily use was developed, which can transmit data to an Android phone by Bluetooth for daily PRV extraction. Then, according to the state of daily life, nine experiments were designed under the situation of static, motion, chewing, and talking states, respectively. Based on the results of these experiments, synchronous data acquisition of the single-lead electrocardiogram (ECG) signal and the pulse signal collected by the commercial pulse sensor on the finger were compared with the post-auricular pulse signal. According to the results of signal wave, amplitude and frequency-amplitude characteristic, the post-ear pulse signal was significantly steady and had more information than finger pulse signal in the traditional way. The PRV extracted from post-ear pulse signal has high accuracy, and the accuracy of the nine experiments is higher than 98.000%. The method of PRV extraction from post-ear has the characteristics of high accuracy, good stability and easy use in daily life, which can provide new ideas and ways for accurate extraction of PRV under unsupervised conditions.
Ear ; Electrocardiography, Ambulatory ; Fingers ; Heart Rate ; Humans ; Monitoring, Ambulatory ; Motion ; Pulse

OBJECTIVE To establish the project approval evaluation system for traditional Chinese medicine （TCM） preparations in medical institutions guided by new drug conversion， to improve the success rate of approval for TCM preparations in medical institutions and lay the foundation for the later drug conversion. METHODS Research and development team used the literature research method and brainstorming method to list and organize relevant elements of project evaluation and determine the initial indicator system. Experts were consulted using the Delphi method to confirm the evaluation index. The weights were calculated based on the proportion of importance scores for each indicator and assigned specific scores to each item. The indicator system was used to evaluate 31 TCM preparations applied for filing by various departments of our hospital from April to July 2023. RESULTS After two rounds of 17 experts’ consultation， the final TCM preparation system included five primary indicators， i.e. theoretical basis， clinical research foundation， pharmaceutical foundation， prescription， and clinical value， as well as 17 secondary indicators including prescription source， traditional Chinese medicine theory， clinical positioning and so on. Human experience was considered as the item which would be rejected as one vote. Based on the above indicator system， our hospital further improved the filing and project approval process for TCM preparations in medical institutions. Among the 31 TCM preparations applied for filing by various departments from April to July 2023， 8 TCM preparations with a score ≥65 were selected for development. CONCLUSIONS The evaluation system is objective， comprehensive， and highly operable. It is suitable for the selection of TCM preparations in medical institutions before research and development.

OBJECTIVE To investigate the intervention effect and potential mechanism of breviscapine on hepatic fibrosis （HF） in rats based on the transforming growth factor-β（1 TGF-β1）/Smad2/extracellular signal-regulated protein kinase 1（ERK1） and Kelch-like epichlorohydrin-associated protein 1（Keap1）/nuclear factor-erythroid 2-related factor 2（Nrf2）/heme oxygenase-1（HO-1） pathways. METHODS Totally 60 rats were randomly divided into normal control group， model group， breviscapine low-dose， medium-dose and high-dose groups （5.4， 10.8， 21.6 mg/kg）， and colchicine group （positive control， 0.45 mg/kg）， with 10 rats in each group， half male and half female. Except for the normal control group， HF model of the other groups was induced by carbon tetrachloride. Subsequently， each drug group was given corresponding medicine by gavage once a day for 28 days. The liver appearance of rats in each group was observed and their liver coefficients were calculated. The levels of alanineaminotransferase （ALT） and aspartate aminotransferase （AST）in serum， those of ALT， AST， superoxide dismutase （SOD），malondialdehyde （MDA） and glutathione peroxidase （GSH- Px） in liver tissue were detected. The liver tissue inflammatory and fibrotic changes were observed. The protein and mRNA expressions of TGF-β1， Smad2， ERK1， Nrf2， Keap1 and HO-in liver tissue were detected. RESULTS Compared with the normal control group， the model group showed large areas of white nodular lesions in the liver， obvious inflammatory cell infiltration and collagen fiber deposition. The body weight， the levels of SOD and GSH-Px in liver tissue， the protein and mRNA expressions of Nrf2 and HO-1 were significantly lowered in the model group （P＜0.05）； the liver coefficient， the percentage of Masson staining positive area， ALT and AST levels of serum and liver tissue， MDA level of liver tissue， the protein and mRNA expressions of TGF-β1， Smad2， ERK1 and Keap1 were significantly increased （P＜0.05）. Compared with the model group， the liver lesions of rats in each drug group were improved， and the above quantitative indexes were generally reversed （P＜0.05）. CONCLUSIONS Breviscapine has a good intervention effect on HF rats， which may be related to inhibiting TGF-β1/Smad2/ERK1 pathway for anti-fibrosis and regulating Keap1/Nrf2/HO-1 pathway to inhibit oxidative stress.