Objective To observe the value of multiparametric MRI-based radiomics model and deep learning(DL)model for distinguishing benign and malignant myxoid soft tissue tumors(MSTT).Methods A total of 141 MSTT patients confirmed with pathology were retrospectively collected.The patients were randomly divided into training set(n=98,including 51 cases of malignant MSTT and 47 cases of benign MSTT)and test set(n=43,including 22 cases of malignant MSTT and 21 cases of benign MSTT)at the ratio of 7∶3.Based on T1WI and fat suppression(FS)-T2WI in training set,radiomics features and DL features were extracted and selected,then a radiomics model and a DL model were constructed,respectively.Receiver operating characteristic(ROC)curves,calibration curves and decision curves were drawn,and the discrimination,calibration and net benefit of these 2 models were compared.Results In training set,the radiomics model for differentiating benign and malignant MSTT was constructed according to 9 optimal radiomics features,including 2 first order features,1 shape feature,3 gray level co-occurrence matrix features,1 gray level dependence matrix feature and 2 gray level size zone matrix features,while DL model was built based on 7 optimal DL features.In test set,the area under the ROC curve of radiomics model and DL model was 0.758 and 0.911,respectively,the latter was higher than the former(P=0.017).Both models had good calibration,and DL model had higher overall net benefit.Conclusion Compared with radiomics model,DL model based on MRI had better ability to differentiating benign and malignant MSTT,also higher overall net benefit.

Objective:To explore the clinical efficacy of DELTA endoscopic lumbar interbody fusion for the treatment of mild to moderate, single segment lumbar spondylolisthesis.Methods:A retrospective analysis was conducted on the clinical data of 48 surgical cases of grade Ⅰ to Ⅱ lumbar spondylolisthesis admitted to the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine from February 2020 to March 2022. Among them, 24 cases treated with DELTA endoscopic lumbar interbody fusion surgery were classified as the DELTA group, and 24 cases treated with traditional minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) surgery were classified as the MIS-TLIF group. Two groups of patients were compared in terms of perioperative indicators (surgical time, postoperative drainage volume, incision length, hospital stay), clinical efficacy [Visual Analogue Scale (VAS) score for low back and leg pain, lumbar Japanese Orthopaedic Association Scores (JOA), improved MacNab standard excellence rate], and lumbar fusion rate (Bridwell intervertebral fusion grade).Results:The DELTA group had longer surgical time than the MIS-TLIF group, and the postoperative drainage volume, incision length, and hospital stay were all lower than the MIS-TLIF group, with statistically significant differences (all P<0.05). The VAS score of lower back and leg pain and lumbar JOA score of the two groups of patients at 1 week, 3 months, and the last follow-up were significantly improved compared to those before surgery (all P<0.01), and the DELTA group had better VAS score of lower back and leg pain and lumbar JOA score at all time points after surgery than the MIS-TLIF group, with statistically significant differences (all P<0.05). The improved MacNab standard was used to evaluate the efficacy of the two groups of patients at the last follow-up after surgery, and there was no statistically significant difference in the excellent and good rates ( P>0.05); There was no statistically significant difference ( P>0.05) in the fusion rate between the two groups. Conclusions:DELTA endoscopic lumbar interbody fusion has a significant therapeutic effect on lumbar spondylolisthesis, with the advantages of small surgical incision and fast recovery; After crossing the DELTA endoscopic learning curve and optimizing surgical procedures, this technology can become an alternative to MIS-TLIF technology.

Objective: To analyze the factors affecting the dropping-out from methadone maintenance treatment (MMT) in Hangzhou City, so as to provide the evidence for improving the compliance to MMT. Methods: One MMT clinic was sampled from each of the eight districts in Hangzhou City using a cluster random sampling method, and patients that received MMT and were at ages of 18 years and older and registered during the period from December 2020 through June 2021 were recruited. Participants' basic characteristics, illegality and crime within 6 months prior to MMT and family and social relationships were collected through questionnaire surveys, and factors affecting the dropping-out from MMT were identified using a multivariable logistic regression model. Results: A total of 315 outpatients were included from MMT clinics. The participants had a mean age of (45.33±7.63) years, and included 245 men (77.78%) and 70 women (22.22%), with a dropping-out rate of 65.71%. Multivariable logistic regression analysis showed a low likelihood of dropping-out from MMT among patients at ages of 60 years and older (OR=0.080, 95%CI: 0.018-0.350), employees (OR=0.415, 95%CI: 0.236-0.727), patients without drug-related infectious diseases (OR=0.411, 95%CI: 0.231-0.731), patients with per dossing of 60 mL and higher (OR=0.431, 95%CI: 0.236-0.787) and patients without contact with drug-using friends (OR=0.328, 95%CI: 0.185-0.582), and a high possibility of dropping-out from MMT among patients with poor relationship with family members (OR=2.905, 95%CI: 1.127-7.488). Conclusion Age, working status, drug-related infectious diseases, dosing, relationship with family members and contact with drug-using friends affected the dropping-out from MTT in Hangzhou City.

Objective To explore the clinical efficacy of Delta endoscopic lumbar decompression fusion for the treatment of giant lumbar disc herniation(GILDH).Method A retrospective analysis was performed on 36 cases of GILDH from April 2020 to May 2022,including 18 cases in the Delta group and 18 cases in the open group.There was no statistically significant difference in gender,age,and responsible section between the two groups of patients.Compare the surgical time,perioperative indicators,and clinical efficacy between the two groups.Results The intraoperative bleeding and drainage volume in the Delta group were lower than those in the open group,the incision length and hospital stay were shorter than those in the open group,the degree of paraspinal muscle injury was lighter than that in the open group,and the surgical time was longer than that in the open group,with statistical significance(P＜0.05);The lumbago visual analogue scale(VAS)of the two groups of patients at each postoperative period was significantly reduced compared to preoperative,and the lumbar spine function score of the Japanese Orthopaedic Association(JOA)was significantly increased compared to preoperative,with statistical significance(P＜0.05);The lumbago VAS of the Delta group was significantly lower than that of the open group at all postoperative stages,and the lumbar spine function JOA score was significantly higher than that of the open group,with statistical significance(P＜0.05);There was no statistically significant difference in the modified MacNab score between the two groups of patients at the last follow-up after surgery(P＞0.05).Conclusion Delta endoscopic lumbar decompression fusion for GILDH has significant therapeutic effects,with advantages such as less bleeding,small surgical incision,and fast postoperative recovery;After crossing the Delta endoscopic learning curve and optimizing the surgical process,this technology can become an alternative to conventional open surgery.

Objective To study the effects of endophytic fungus Epichloë bromicola SH09 on the plant growth and accumulation of active components in Salvia miltiorrhiza, and improve the quality of medicinal plant S. miltiorrhiza. Methods E. bromicola SH09 solid bacterial fertilizer was prepared and co-cultured with S. miltiorrhiza for 60 d and 120 d. Four morphological indexes, fresh weight of roots, dry weight of roots, and the contents of four tanshinones and two phenolic acids in the roots of S. miltiorrhiza from treated group and control group were assayed, respectively. Results After 60 d and 120 d co-culture, E. Bromicola SH09 significantly increased the tiller number, plant height, leaf number, leaf area, fresh weight of roots, dry weight of roots, and the content of tanshinones and phenolic acids in S. miltiorrhiz. Conclusion The endophytic fungus E. bromicola SH09 can effectively promote the plant growth and improve the accumulation of active components in S. miltiorrhiza, which not only broadens the new ecological functions of endophytic fungi, but also improves the quality of medicinal plant S. miltiorrhiza.

Lower extremity deep vein thrombosis (DVT) is one of the main complications in patients with traumatic fractures, and for severe patients, the DVT can even affect arterial blood supply, resulting in insufficient limb blood supply. If the thrombus breaks off, pulmonary embolism may occur, with a high mortality. The treatment and rehabilitation strategies of thrombosis in patients with lower extremity fractures have its particularity. DVT in traumatic fractures patients has attracted extensive attention and been largely studied, and the measures for prevention and treatment of DVT are constantly developing. In recent years, a series of thrombosis prevention and treatment guidelines have been updated at home and abroad, but there are still many doubts about the prevention and treatment of DVT in patients with different traumatic fractures. Accordingly, on the basis of summarizing the latest evidence-based medical evidence at home and abroad and the clinical experience of the majority of experts, the authors summarize the clinical treatment and prevention protocols for DVT in patients with traumatic fractures, and make this consensus on the examination and assessment, treatment, prevention and preventive measures for DVT in patients with different fractures so as to provide a practicable approach suitable for China ′s national conditions and improve the prognosis and the life quality of patients.

Objective:To explore the effect of self-made dynamic cardiovascular three-dimensional model combined with CBL (case-based learning) teaching method in the clerkship of valvular heart disease for medical students.Methods:Sixty five-year clinical medical undergraduates from Nanjing Medical University (Batch 2016) were randomly divided into experimental group and control group. The experimental group received dynamic cardiovascular 3D model combined with CBL teaching method, while the control group received traditional model combined with CBL teaching method. After the course, the teaching effect was evaluated by examination and questionnaire. SPSS 19.0 was used for independent sample t test and chi-square test. Results:Compared with the control group, the students in experimental group had higher scores of basic theoretical knowledge [(43.10±3.51) vs. (40.87±3.19)] and clinical thinking ability [(42.20±3.15) vs. (40.20±3.81)], with significant differences ( P<0.05). Furthermore, they showed higher evaluation and satisfaction to learning initiative and enthusiasm, mastery of theoretical knowledge, clinical thinking ability, classroom learning interest, classroom activity and clarity of knowledge teaching, with significant differences ( P<0.05). Conclusion:In the teaching of valvular heart disease clerkship, the application of self-made dynamic cardiovascular three-dimensional model combined with CBL teaching method, can cultivate students' clinical diagnostic thinking ability and improve teaching quality.