Objective:To analyze transcranial sonography（TCS）imaging characteristics of rats with 6-hydroxydopamine hydrochloride（6-OHDA）and explore the correlations between the imaging characteristics with motor deficits and pathological changes.Methods:Twenty-nine male SD rats were divided into 3 groups：8 in the no-treatment control（NC）group，10 in the Sham group and 11 in the 6-OHDA group. The model for Sham/Parkinson's disease（PD）was established by stereotacticly injecting saline/6-OHDA containing ascorbic acid to bilateral substantia nigra pars compacta（SNpc）. After three weeks，the models were stable. At the fourth week and seventh week，the behavioral testing was accomplished. The TCS examination was performed weekly at the same time for four weeks. At the eighth week，the rats were sacrificed for pathology.Results:①Behavioral testing：6-OHDA group showed asymmetric motor deficits and the difference was significant compared with the NC group and Sham group（both P<0.001）. ②TCS examination：compared with the NC and Sham group，there were asymmetric substantia nigra hyperechogenicity（SNH）in 6-OHDA group（both P<0.05）；meanwhile the area of SNH in the left was significantly larger in the right side（ P<0.05）.No significant change in SNH area was found during the continuous observation period of weeks 4-7. For 6-OHDA group，the area of SNH was negatively correlated with the number of forelimb wall-touches（ r=-0.825， P＜0.001）. ③Pathological examination：compared with NC group and sham group，the substantia nigra（SN）of 6-OHDA group showed a series of pathological events，including dopaminergic（DA）neurons asymmetrically decreasing，asymmetric ironion deposition and the number of active microglia increasing（all P＜0.05）. Correlation analysis showed that the area of SNH was negatively correlated with the number of DA neurons survivors（ r=-0.689， P=0.013），while the activation of microglial and the deposition of iron were positively correlated with the area of SNH（ r=0.915，0.735；all P＜0.001）. Conclusions:Asymmetric SNH of 6-OHDA PD rats is a representation of asymmetric motor deficits，and the mechanism is related to a catalogue of asymmetric pathological changes in SN，which comprise DA neurons decreasing，asymmetric iron ions deposition，microglial activating.

OBJECTIVE:To compare the clinical efficacy and radiological results of arthroscopic all-inside technique and traditional technique in anterior cruciate ligament reconstruction.METHODS:Databases such as CNKI,WanFang,VIP,PubMed,Web of Science,Embase,and Cochrane Library were searched for literature on all-inside technique and traditional technique in anterior cruciate ligament reconstruction.The search time was from the establishment of each database to September 2024.Meta-analysis was conducted on the included literature.RESULTS:(1)A total of 17 articles were included in the meta-analysis,with 631 patients in the all-inside technique reconstruction group and 626 patients in the traditional technique reconstruction group.The earliest time for the last follow-up was half a year after surgery,and the latest was 5 years after surgery.Most follow-up period was 2 years.(2)Meta-analysis results showed that compared with traditional anterior cruciate ligament reconstruction,the all-inside technique had a thicker graft during anterior cruciate ligament reconstruction[mean difference(MD)=0.20,95％confidence interval(CI)(0.09,0.31),P=0.000 5],smaller postoperative maximum diameter[standardized mean difference(SMD)=-3.64,95％CI(-6.00,-1.28),P=0.002]and volume[SMD=-3.69,95％CI(-5.37,-2.00),P＜0.000 1]of the tibial tunnel,and higher International Knee Documentation Committee subjective scores[MD=2.41,95％CI(0.49,4.32),P=0.01]and Lysholm scores[MD=1.11,95％CI(0.42,1.8),P=0.002]2 years after surgery.However,the operation time was relatively longer[MD=10.06,95％CI(4.71,15.4),P=0.000 2],and the knee stability was poorer after 2 years[SMD=0.3,95％CI(0.04,0.55),P=0.02].No significant differences were found between the two groups in the following aspects:the subjective scores of the International Knee Documentation Committee at 6 months and 1 year postoperatively[MD=-0.05,95％CI(-1.96,1.83),P=0.96;MD=0.51,95％CI(-1.17,2.19),P=0.55];the difference in anterior laxity of bilateral knees at 1 year postoperatively[SMD=-0.02,95％CI(-0.3,0.27),P=0.9];the Lysholm score at 6 months postoperatively[MD=0.87,95％CI(-0.15,1.89),P=0.09];the objective score of the International Knee Documentation Committee at the last follow-up[RR=0.95,95％CI(0.86,1.06),P=0.37];the American Knee Society Score at the last follow-up[MD=0.33,95％CI(-0.55,1.21),P=0.47];the Tegner score at the last follow-up[MD=0.05,95％CI(-0.11,0.22),P=0.53];the negative rate of the pivot shift test at the last follow-up[RR=0.92,95％CI(0.83,1.01),P=0.09];the postoperative revision rate at the last follow-up[RR=2.2,95％CI(0.98,4.92),P=0.05];and the result of the single-leg hop test at the last follow-up[MD=-0.06,95％CI(-4.99,4.86),P=0.98].CONCLUSION:There were no significant differences in most functional outcome scores and the position of the tibial tunnel between the all-inside technique and the traditional technique after anterior cruciate ligament reconstruction.The all-inside technique was more favorable in terms of subjective International Knee Documentation Committee scores and Lysholm scores at 2 years postoperatively.Meanwhile,the knee joint was more stable 2 years after anterior cruciate ligament reconstruction using the traditional technique.In addition,it was found that the graft was thicker during the all-inside technique,while the diameter and volume of the tibial tunnel were smaller postoperatively,with more bone tissue preserved.Nevertheless,the operation time of the all-inside technique was longer.

OBJECTIVE:To compare the clinical efficacy and radiological results of arthroscopic all-inside technique and traditional technique in anterior cruciate ligament reconstruction.METHODS:Databases such as CNKI,WanFang,VIP,PubMed,Web of Science,Embase,and Cochrane Library were searched for literature on all-inside technique and traditional technique in anterior cruciate ligament reconstruction.The search time was from the establishment of each database to September 2024.Meta-analysis was conducted on the included literature.RESULTS:(1)A total of 17 articles were included in the meta-analysis,with 631 patients in the all-inside technique reconstruction group and 626 patients in the traditional technique reconstruction group.The earliest time for the last follow-up was half a year after surgery,and the latest was 5 years after surgery.Most follow-up period was 2 years.(2)Meta-analysis results showed that compared with traditional anterior cruciate ligament reconstruction,the all-inside technique had a thicker graft during anterior cruciate ligament reconstruction[mean difference(MD)=0.20,95％confidence interval(CI)(0.09,0.31),P=0.000 5],smaller postoperative maximum diameter[standardized mean difference(SMD)=-3.64,95％CI(-6.00,-1.28),P=0.002]and volume[SMD=-3.69,95％CI(-5.37,-2.00),P＜0.000 1]of the tibial tunnel,and higher International Knee Documentation Committee subjective scores[MD=2.41,95％CI(0.49,4.32),P=0.01]and Lysholm scores[MD=1.11,95％CI(0.42,1.8),P=0.002]2 years after surgery.However,the operation time was relatively longer[MD=10.06,95％CI(4.71,15.4),P=0.000 2],and the knee stability was poorer after 2 years[SMD=0.3,95％CI(0.04,0.55),P=0.02].No significant differences were found between the two groups in the following aspects:the subjective scores of the International Knee Documentation Committee at 6 months and 1 year postoperatively[MD=-0.05,95％CI(-1.96,1.83),P=0.96;MD=0.51,95％CI(-1.17,2.19),P=0.55];the difference in anterior laxity of bilateral knees at 1 year postoperatively[SMD=-0.02,95％CI(-0.3,0.27),P=0.9];the Lysholm score at 6 months postoperatively[MD=0.87,95％CI(-0.15,1.89),P=0.09];the objective score of the International Knee Documentation Committee at the last follow-up[RR=0.95,95％CI(0.86,1.06),P=0.37];the American Knee Society Score at the last follow-up[MD=0.33,95％CI(-0.55,1.21),P=0.47];the Tegner score at the last follow-up[MD=0.05,95％CI(-0.11,0.22),P=0.53];the negative rate of the pivot shift test at the last follow-up[RR=0.92,95％CI(0.83,1.01),P=0.09];the postoperative revision rate at the last follow-up[RR=2.2,95％CI(0.98,4.92),P=0.05];and the result of the single-leg hop test at the last follow-up[MD=-0.06,95％CI(-4.99,4.86),P=0.98].CONCLUSION:There were no significant differences in most functional outcome scores and the position of the tibial tunnel between the all-inside technique and the traditional technique after anterior cruciate ligament reconstruction.The all-inside technique was more favorable in terms of subjective International Knee Documentation Committee scores and Lysholm scores at 2 years postoperatively.Meanwhile,the knee joint was more stable 2 years after anterior cruciate ligament reconstruction using the traditional technique.In addition,it was found that the graft was thicker during the all-inside technique,while the diameter and volume of the tibial tunnel were smaller postoperatively,with more bone tissue preserved.Nevertheless,the operation time of the all-inside technique was longer.

OBJECTIVE:Anterior cervical decompression and fusion is a classic surgical method for the treatment of degenerative cervical spondylosis.The use of nail plates increases the fusion rate and stability and indirectly leads to adjacent vertebral degeneration and postoperative dysphagia.In this paper,the clinical results and complications of ROI-CTM self-locking system and traditional cage combined with screw-plate internal fixation in the treatment of degenerative cervical spondylosis were compared by meta-analysis to provide evidence-based support for the selection of internal fixation methods in anterior cervical decompression and fusion. METHODS:CNKI,WanFang,VIP,PubMed,Cochrane Library,Web of Science,and Embase databases were searched for Chinese and English literature on the application of ROI-CTM self-locking system and fusion cage combined with screw plate internal fixation in the treatment of degenerative cervical spondylosis.The retrieval time range was from inception to July 2023.Two researchers selected the literature strictly according to the inclusion and exclusion criteria.The Cochrane bias risk tool was used to evaluate the quality of randomized controlled trials.Newcastle-Ottawa Scale was used to assess the quality of cohort studies.Meta-analysis was performed using RevMan 5.4 software.Outcome indicators included operation time,intraoperative blood loss,Japanese Orthopaedic Association score,Neck Disability Index,C2-C7 Cobb angle,fusion rate,incidence of adjacent vertebral degeneration,cage subsidence rate,and incidence of dysphagia. RESULTS:Thirteen articles were included,including eleven retrospective cohort studies and two randomized controlled trials,with 1 136 patients,569 in the ROI-C group,and 567 in the cage combined with the nail plate group.Meta-analysis results showed that the operation time(MD=-15.52,95%CI:-18.62 to-12.42,P<0.000 01)and intraoperative blood loss(MD=-24.53,95%CI:-32.46 to-16.61,P<0.000 01)in the ROI-C group and the fusion device combined with nail plate group.Postoperative adjacent segment degeneration rate(RR=0.40,95%CI:0.27-0.60,P<0.000 01)and postoperative total dysphagia rate(RR=0.18,95%CI:0.13-0.26),P<0.000 01)were statistically different.The two groups had no significant difference in Japanese Orthopaedic Association score,Neck Disability Index,C2-C7 Cobb angle,fusion rate,or cage subsidence rate(P≥0.05). CONCLUSION:Applying an ROI-CTM self-locking system and traditional cage combined with plate internal fixation in anterior cervical decompression and fusion can achieve satisfactory clinical results in treating degenerative cervical spondylosis.The operation of the ROI-CTM self-locking system is more straightforward.Compared with a cage combined with plate internal fixation,the ROI-CTM self-locking system can significantly reduce the operation time and intraoperative blood loss and has obvious advantages in reducing the incidence of postoperative dysphagia and adjacent segment degeneration.The ROI-CTM self-locking system is recommended for patients with skip cervical spondylosis and adjacent vertebral disease.However,given its possible high settlement rate,using a fusion cage combined with screw-plate internal fixation is still recommended for patients with degenerative cervical spondylosis with multiple segments and high-risk factors of fusion cage settlement,such as osteoporosis and vertebral endplate damage.

Objective:To investigate the training mode of outstanding talents in medical imaging in the context of "new medicine".Methods:Aiming at the 138 undergraduate students of medical imaging in the class of 2019, this study proposed a new model of "1+Medicine+X" based on "emphasis on ideology and politics", "strengthening practice", and "interdisciplinary training", which targeted the problems in the traditional teaching process, and the methods such as self-made course satisfaction questionnaires and achievements data collection were used to evaluate the effectiveness of teaching reform.Results:Through five years of reform practice, landmark accomplishments had been achieved in the construction of majors and courses (national and provincial first-class undergraduate majors), with significant improvements in the comprehensive ability and teaching satisfaction of students (process evaluation increased to 50.00%, teaching satisfaction increased to 96.20%), and the teaching reform had been widely recognized by the society.Conclusions:The "1+Medicine+X" model can effectively improve the training quality of medical imaging talents and thus provides a new paradigm for the disciplinary development of imaging and the cultivation of outstanding talents in the context of new medicine.

Objective This study aimed to investigate the regulatory effect of electroacupuncture(EA)intervention on the protein kinase B(Akt)/mammalian target of rapamycin(mTOR)/hypoxia-inducible factor 1α(HIF-1α)signaling pathway in the hippocampal tissue of Alzheimer's disease(AD)model mice and its effect on astrocytic glycolytic function,further exploring how EA ameliorates AD-related cognitive impairment.Methods Eighteen APP/PS1 mice were randomly divided into model,EA,and sham EA groups(n=6)using the random number table method.Six wild-type C57BL/6J mice served as the control group.The EA group received EA stimulation at acupoints"Shenshu"(BL23),"Baihui"(GV20),and"Zusanli"(ST36)(administered every other day,20 min per session,for 4 weeks).The sham EA group received identical needle insertions at the same acupoints without electrical stimulation.The control and model groups were only restrained.Cognitive function was assessed using the Morris water maze and Y-maze spontaneous alternation tests.Hippocampal morphology was observed via hematoxylin and eosin staining.Hippocampal β-amyloid peptide 1-42(Aβ1-42)deposition was detected using immunohistochemistry.HIF-1α protein expression,the p-Akt/Akt,and p-mTOR/mTOR ratios were measured using Western blotting.Pyruvate kinase M2(PKM2)and lactate dehydrogenase A(LDHA)activities were quantified using enzyme-linked immunosorbent assay.Hexokinase(HK)activity and L-lactate content were determined using a colorimetric assay.Co-localization of LDHA with the astrocyte marker glial fibrillary acidic protein was quantitatively analyzed using immunofluorescence double-labeling combined with Pearson's correlation coefficient.Results Compared with the control group,the model group mice exhibited cognitive decline,as shown by prolonged escape latency(P<0.01),reduced number of platform crossings,lower time spent in the target quadrant,and decreased spontaneous alternation accuracy(P<0.01).The hippocampal neurons showed cell body swelling,deeper nuclear staining,enlarged intercellular spaces,and increased average optical density of Aβ1-42(P<0.01).The p-Akt/Akt and p-mTOR/mTOR ratios,as well as HIF-1α protein expression,were elevated(P<0.01).PKM2,LDHA,HK,and L-lactic acid levels were significantly increased(P<0.01),and the co-localization coefficient of LDHA with astrocytes was enhanced.Compared to the model group,the EA group of mice showed improved cognitive function.The hippocampal neurons had more intact structures,with a more uniform cell distribution.The average optical density of Aβ1-42 decreased(P<0.01),and the p-Akt/Akt and p-mTOR/mTOR ratios,as well as HIF-1α protein expression,decreased(P<0.01).PKM2,LDHA,HK,and L-lactic acid levels decreased(P<0.05),and the co-localization coefficient of LDHA with astrocytes significantly decreased(P<0.01).No significant improvement was observed in any of the indicators in the sham EA group compared with the EA group.Conclusion EA at"Shenshu"(BL23),"Baihui"(GV20),and"Zusanli"(ST36)ameliorates cognitive dysfunction in AD model mice.The underlying mechanism may involve suppressing the overactivation of the hippocampal Akt/mTOR/HIF-1α signaling pathway,thereby downregulating key glycolytic enzyme activities and reducing abnormal lactate accumulation.Furthermore,the astrocytic glycolytic metabolic pathway may constitute a key therapeutic target for this intervention.

Objective To explore the prediction efficiency of Ki-67 expression status in pituitary adenoma(PA)based on a joint model of siamese network and transfer learning.Methods The preoperative MR T1WI enhanced sequence images of 370 patients with PA diagnosed by surgery and pathology were retrospectively collected.According to the results of immunohistochemical,all patients were divided into high proliferation index group(Ki-67≥3,n=97)and low proliferation index group(Ki-67＜3,n=273),and all the sample data were randomly divided into training set and test set according to the ratio of 7∶3.Two single predictive models,ResNet-50 and VGGNet-16 and combined them with the siamese network and transfer learning were built.The prediction efficiency of different models were evaluated via accuracy rate,precision rate,recall rate,F1 score and receiver operating characteristic(ROC)curve as the main criteria.Results Compared with a single predictive model,the model combined with siamese network and transfer learning showed a better performance for predicting the Ki-67 of PA.Additionally,the ResNet-50 joint model exhibited the superior predictive performance.The accuracy rate was 0.872 7,the precision rate was 0.812 5,the recall rate was 0.764 7,the F1 score was 0.787 9,and the area under the curve(AUC)was 0.841 6.Conclusion The joint model based on siamese network and transfer learning exhibits a higher efficiency for predicting the Ki-67 expression status in PA,which can help the clinicians to formulate more personalized treatment for the patients.

Objective To analyze the clinical characteristics and treatments of children with myocarditis,and to investigate the relation-ship between arrhythmia and prognosis.Methods A total of 244 patients diagnosed with myocarditis from January 2012 to December 2023 were included and retrospectively analyzed.The patients were divided into three groups:fulminant myocarditis(FMC),myocarditis(MC),and suspected myocarditis(SMC).The data included the clinical characteristics at disease onset,the treatment,and the relationship between different arrhythmias and the prognosis among the three groups.Results Among the 244 children with FMC/MC/SMC,132/244(54.1％)developed arrhythmia,ventricular arrhythmia was observed in 83/132(62.9％),and 86/105(81.9％)showed no persistent arrhythmia.The proportion of children in the FMC group who presented with palpitations,cardio-cerebral syndrome,cardiogenic shock,cardiac insufficiency,and death was significantly higher than that in the MC and SMC groups(P＜0.01).Five children with third-degree(Ⅲ°)atrioventricular block(AVB)recovered after controlling their ventricular rate without a temporary pacemaker.Conclusion Most children with FMC/MC/SMC have different types of arrhythmias,of which ventricular arrhythmias are the most common,and rarely persist.FMC has severe clinical symptoms and the highest mortality rate.Ventricular tachycardia usually occurs during the administration of vaso-active drugs in patients with Ⅲ ° AVB;if the ventricular rate can be controlled promptly,these patients have a good prognosis.

Objective To investigate the correlation between dual-energy computed tomography angiography(CTA)parameters of carotid plaques and acute stroke events.Methods A retrospective analysis was conducted on the clinical and imaging data of patients who underwent dual-energy head and neck CTA and brain MRI scans.Utilizing the Siemens workstation(Syngo.Via VB40B),region of interest(ROI)were placed on the thickest slice of the carotid plaque in the axial plane to obtain parameters such as fat fraction(FF),virtual non-contrast(VNC)value,iodine concentration(IC),electron density(Rho),effective atomic number(Zeff),dual energy index(DEI),spectral curve,and corresponding CT values at 40 keV(40 keVHU)and 90 keV(90 keVHU).The slope of the energy spectrum curve(λ)was calculated within the 40 keV-90 keV range.Patients with acute cerebral infarction(ACI)in the ipsilateral anterior circulation territory were classified into the ACI group,while those without were classified into the non-acute cerebral infarction(NACI)(NACI group).Qualitative data were analyzed using the x2 test,and quantitative data were analyzed using the t-test.The predictive performance was assessed using the area under the curve(AUC)of the receiver operating characteristic(ROC)curve,and the differences between different ROC curves were compared using the DeLong test.Results A total of 72 patients were included,with 21 in the ACI group and 51 in the NACI group.The mean values of FF,Zeff,and 40 keVHU in the ACI group were greater than those in the NACI group.Statistically significant differences were observed between the groups for Zeff,DEI,40 keVHU,and λ(P＜0.05).40 keVHU demonstrated the highest predictive performance,and the AUC,sensitivity,and specificity was 0.789,81.0％,and 74.5％,respectively.A combined variable constructed through logistic regression analysis yielded an AUC,sensitivity,and specificity of 0.796,85.7％,and 70.6％,respectively,with no significant statistical differences compared to single factor variables.Conclusion Dual-energy CTA parameters of carotid plaques may aid in predicting intraplaque hemorrhage(IPH)and the occurrence of acute stroke events.

Objective To construct a clinical-radiological nomo-gram model for severe mycoplasma pneumoniae pneumonia coinfec-tion with other pathogens(Co-SMPP)in children.Methods The clinical and radiological data of children with severe mycoplasma pneumoniae pneumonia(SMPP)who underwent nucleic acid testing or bronchoalveolar lavage(BAL)were analyzed retrospectively.The data analysis were performed by using SPSS 27.0 software.The group comparison between simple SMPP and Co-SMPP children was conducted by using t-tests,Mann-Whitney U tests,or chi-square tests.Nomogram analysis was performed by using R software and rms packages.The predictive performance of the model was evaluated by using the receiver operating characteristic(ROC)curve.Results A total of 194 SMPP children were included in the study,including 136 cases(70.1％)with simple SMPP,58 cases(29.9％)with Co-SMPP.The fibrinogen and albumin levels were lower in Co-SMPP children[(3.53±0.85)g/L,41.00(39.03,43.68)g/L]than in simple SMPP children[(3.79±0.80)g/L,42.80(41.00,44.40)g/L],with P values of 0.047 and 0.036,respec-tively.The probability of bronchial stenosis and grid shadow were higher in Co-SMPP children than in simple SMPP children,and there were significant differences between the two groups(P＜0.001,P=0.010).The odds ratio of bronchial stenosis in predicting Co-SMPP children was 14.085.The clinical-radiological nomogram model had an area under the curve(AUC)of 0.840,with sensi-tivity and specificity of 0.756 and 0.848,respectively.Conclusion The nomogram model based on clinical-radiological features can effectively predict Co-SMPP.