OBJECTIVE: To compare the diagnostic accuracy of supraspinatus muscle outlet X-ray film, oblique sagittal multislice helical CT (MSCT), and oblique sagittal MRI in the diagnosis of subacromial impingement syndrome (SIS). METHODS: A retrospective analysis was conducted on the imaging data of 106 patients diagnosed with SIS between January 2023 and December 2024. The cohort consisted of 32 males and 74 females, with ages ranging from 43 to 70 years (mean, 60.19 years). All patients underwent supraspinatus muscle outlet X-ray film, MSCT, and MRI scans, with MSCT further subjected to three-dimensional reconstruction. Two experienced radiologists independently evaluated the acromion morphology in each imaging modality using the Bigliani classification system. Inter-observer reliability was assessed via Kappa statistics. The CT three-dimensional reconstructions were used as the "gold standard". The overall consistency, Kappa values, sensitivity, and specificity of the three imaging modalities were calculated. Receiver operating characteristic (ROC) curves were plotted, and the area under the curve (AUC) was computed. RESULTS: The inter-observer reliability for supraspinatus muscle outlet X-ray film, oblique sagittal MSCT, and oblique sagittal MRI was moderate, with Kappa values of 0.62, 0.63, and 0.55, respectively. When compared to the CT three-dimensional reconstructions as the "gold standard", the overall consistency was 88.7% (94/106), 62.3% (66/106), and 58.5% (62/106), respectively. The supraspinatus muscle outlet X-ray film showed excellent consistency (Kappa=0.77), whereas the consistency of MSCT and MRI was lower (Kappa=0.34 and 0.29, respectively). In terms of diagnostic sensitivity and specificity, the supraspinatus muscle outlet X-ray film outperformed oblique sagittal MSCT and oblique sagittal MRI in distinguishing various acromion types. ROC analysis demonstrated that the AUC for the supraspinatus muscle outlet X-ray film was consistently higher than for oblique sagittal MSCT and oblique sagittal MRI, with the highest diagnostic performance observed for type Ⅲ hooked acromion (AUC=0.939). CONCLUSION Supraspinatus muscle outlet X-ray film provides the highest diagnostic accuracy for acromion classification in SIS patients, particularly in identifying type Ⅲ hooked acromion, which is strongly associated with SIS. Given its superior sensitivity and consistency, it should be considered the primary screening tool. MSCT and MRI serve as valuable supplementary modalities for complex cases and preoperative evaluation.
Humans ; Middle Aged ; Male ; Female ; Shoulder Impingement Syndrome/diagnostic imaging* ; Magnetic Resonance Imaging/methods* ; Retrospective Studies ; Aged ; Adult ; Imaging, Three-Dimensional ; Sensitivity and Specificity ; Tomography, Spiral Computed/methods* ; Multidetector Computed Tomography/methods* ; Reproducibility of Results

BACKGROUND:The clinical manifestation of acute radiation skin injury is recurrent necrotic ulcers,and its pathogenesis is still not fully understood.The establishment of a suitable animal model will have important clinical implications for the study of its pathogenesis,prevention and treatment. OBJECTIVE:To establish a model of acute β-ray radiation skin injury and to investigate the mechanism of injury. METHODS:Sixty-nine Sprague-Dawley rats were randomly divided into 30,45,60 Gy 32P-β-ray groups(n=21 per group)and control group(n=6).A single local irradiation of the back of the rats was performed using 32P radionuclide.The control group was operated in the same way as the irradiated groups except that it was not irradiated.The body mass and skin appearance of the rats were measured at 7,15,30,45,and 60 days after irradiation.Three rats from each group were selected at each observation time point.The skin injury was observed by hematoxylin-eosin staining,Masson staining,transmission electron microscopy,and TUNEL assay.P53,Bcl-2 and Bax protein levels in the skin were measured by immunohistochemistry and western blot assay. RESULTS AND CONCLUSION:There was no accidental death after irradiation,and the body mass of rats showed a gradual increase.The rats showed different degrees of epidermal necrosis,inflammatory cell infiltration,reduction of hair follicles and appendages,and collagen fibrillation,which were evident at 60 and 45 Gy.The levels of serum inflammatory factors,interleukin-6 and tumor necrosis factor-α,were significantly increased in a dose-dependent manner.Under the electron microscope,there are varying degrees of mitochondrial reduction,vacuolization and nuclear pyknosis in the cells.The degree of cell apoptosis showed a certain dose-dependence.Immunohistochemistry and western blot results showed an increase in the expression of P53 and Bax proteins and a decrease in the expression of Bcl-2 protein in the skin after irradiation.There were significant differences between the 60 Gy group and the 45 Gy and 30 Gy groups(P＜0.05).To conclude,irradiation with 60 Gy and 45 Gy 32P radionuclide on the back of rats could successfully establish a practically pre-clinical animal model,and the mechanism is related to the up-regulation of P53 and Bax and the down-regulation of Bcl-2.This model can provide a reference for the establishment of animal models for the study of the mechanism of radiation skin injury and its prevention and treatment.

OBJECTIVE:Percutaneous sacroiliac screw internal fixation has become the main surgical procedure for the treatment of posterior pelvic ring fractures;however,the unassisted closure operation requires high operator experience and repeated fluoroscopy increases the radiation hazard for patients and medical personnel.This article compares the clinical efficacy of robot-assisted versus unassisted percutaneous sacroiliac screw placement for posterior pelvic ring fractures by meta-analysis. METHODS:Computer searches of CNKI,WanFang,VIP,CBM,PubMed,Embase,Cochrane Library and ClinicalTrials.gov were conducted from the time of database inception to December 2022.The literature on the clinical efficacy of robot-assisted versus freehand percutaneous sacroiliac screw placement in the treatment of posterior pelvic ring fractures was collected in and outside China.The data were independently screened and extracted by two investigators according to the inclusion and exclusion criteria,respectively.The quality of randomized controlled trials was evaluated using Cochrane risk assessment criteria.The quality of included cohort studies was assessed using the Newcastle-Ottawa Scale.Meta-analysis was performed using RevMan 5.4 software for inclusion metrics.Outcome metrics included operative time,intraoperative bleeding,fluoroscopy time,fluoroscopy frequency,number of holes drilled,Majeed postoperative function score,the excellent and good rates of Matta fracture reduction,the excellent and good rates of Gras screw position,fracture healing time and complications. RESULTS:(1)A total of 13 publications were included,2 were randomized controlled trials both referring to randomized methods,11 non-randomized controlled studies were evaluated for quality of literature according to the Newcastle-Ottawa Scale,1 scored 8,9 scored 7;and 1 scored 6;the quality of literature was good.A total of 748 patients were included,including 430 in the robot-assisted group and 318 in the freehand group.(2)The results of the meta-analysis showed that the operative time(MD=-28.30,95%CI:-40.20 to-16.40),intraoperative bleeding(MD=-6.36,95%CI:-10.06 to-2.66),intraoperative fluoroscopy time(MD=-12.13,95%CI:-19.54 to-4.72),intraoperative fluoroscopy frequency(MD=-17.39,95%CI:-29.00 to-5.78),number of intraoperative needle drillings(SMD=-9.50,95%CI:-14.27 to-4.73)and the excellent and good rates of Gras screw position(OR=8.65,95%Cl:3.26-22.92)in the robot-assisted group were significantly better than those in the freehand group(P<0.05).(3)In the robot-assisted group,the overall postoperative complication rate was significantly reduced(OR=0.10,95%Cl:0.02-0.48,P<0.05).(4)No significant difference was detected in fracture healing time(MD=-0.08,95%CI:-0.21,0.06),the excellent and good rates of Matta fracture repositioning rate(OR=2.06,95%Cl:0.97-4.39),and Majeed functional score(MD=0.91,95%CI:-0.31-2.13)between both groups(P>0.05). CONCLUSION:Compared with freehand sacroiliac joint nailing,robotic assistance shortens the operative time,reduces intraoperative bleeding,decreases radiation damage to patients and medical staff,improves the excellent and good rate of screw position,and reduces the overall incidence of postoperative complications in patients,but there was no significant improvement in fracture reduction quality,fracture healing time,and postoperative function.In the future,more large-sample,multicenter,and high-quality randomized controlled trials are still needed to verify.

Objective:To explore the clinical efficacy of 125I seeds implantation combined with transcatheter arterial chemoembolization (TACE) in the treatment of primary liver cancer. Methods:A retrospective analysis of data from 40 patients with primary liver cancer at the Northern Theater General Hospital from January 2018 to December 2020 (26 males, 14 females, age 41 to 82 years) was performed. Among them, 21 patients were in treatment group and underwent 125I seeds implantation combined with TACE treatment, while 19 patients were in control group and received TACE treatment. Alpha-fetoprotein (AFP) levels between the two groups were compared, effective rate and disease control rate (DCR) of the two groups were analyzed, and overall survival (OS) and progression-free survival (PFS) were observed. Data were analyzed by using Mann-Whitney U test, χ2 test, Kaplan-Meier method and log-rank test. Results:Two months after 125I seeds implantation, the effective rates of treatment group and control group were 76.19%(16/21) and 8/19, respectively ( χ2=4.83, P=0.028); the DCRs were 90.48%(19/21) and 11/19, respectively ( χ2=4.21, P=0.040). AFP levels in both groups decreased significantly, with treatment group showing a greater decrease rate (0.87(0.84, 0.90) and 0.66(0.65, 0.67); z=5.42, P<0.001). No serious adverse reaction was observed in either group. The median OS of treatment group and control group were 18.2 and 10.6 months, respectively ( χ2=10.98, P=0.037); the median PFS of the two groups were 8.4 and 6.1 months, respectively ( χ2=7.54, P=0.041). Conclusion:125I seeds implantation combined with TACE treatment can exert a synergistic and enhancing effect in the treatment of primary liver cancer.

Atractylodis rhizoma is a perennial herb of the Asteraceae family,which mainly divided into A.chinensis(DC)Koidz and Atractyiodes lancea(Thunb)DC,with the effects of strengthening the spleen,drying dampness,brightening the eyes,etc.Atractylodis rhizoma is mainly used in the clinical treatment of spleen deficiency and dampness,night blindness,eye fatigue and other symptoms.According to the clinical effect,and modern pharmacological researches have confirmed,the Chinese herbal medicine Atractylodis rhizoma contains a variety of active ingredients,such as volatile oils,alkynes,glycosides,etc.In recent years,pharmacological studies on Atractylodis rhizoma have found that atractylodin in polyalkynes has good activity in anti-inflammation,treatment of bacterial resistance,and inhibition of cholangiocarcinoma cell migration,and its high biological activity may be related to the conjugated enyne structure.Therefore,this article summarizes the studies on chemical components and pharmacological effects of polyalkynes in Atractylodis rhizoma that have been published in recent years,and comprehensively expounds the research progress of polyalkynes in Atractylodis rhizoma,so as to provide reference for scientific researchers and promote the in-depth development and utilization of the medicinal value of Atractylodis rhizoma.

Five new spirostanol saponins (1-5) and seven known compounds (6-12) were isolated from the n-butanol fraction of 75% ethanol extract of Allii Macrostemonis Bulbus. The identification and structural elucidation of all the isolates were performed through extensive 1D and 2D NMR experiments, HR-ESI-MS data analysis and comparisons with literature values. Antioxidant evaluation showed that compounds 6-11 exhibited certain scavenging effects on ABTS radical, where compounds 6, 7 and 11 had IC₅₀ values of 0.208, 0.057 and 0.014 mg·mL^-1, respectively.
Saponins/chemistry* ; Drugs, Chinese Herbal/chemistry* ; Magnetic Resonance Spectroscopy ; Antioxidants/pharmacology* ; Molecular Structure

Objective:To evaluate the clinical value of CT-guided 125I seeds implantation combining with 89SrCl 2 to relieve pain after failure of external irradiation in patients with bone metastases from prostate cancer. Methods:Clinical data of 48 patients (age 56-85 years) with bone metastases from prostate cancer admitted to General Hospital of the Northern Theater Command from January 2019 to June 2021 were retrospectively analyzed. Patients were treated with 125I seeds implantation combining with 89SrCl 2 (group A) and 89SrCl 2 alone (group B), respectively. Independent-sample t test and repeated measures analysis of variance were used to evaluate the differences of pain level (most severe pain, least pain, mean pain and current pain) scores and bone pain interference scores between 2 groups before and after treatment (before treatment, 3 d, 4 weeks, 8 weeks and 12 weeks after treatment). Prostate specific antigen (PSA), free PSA (fPSA) and alkaline phosphatase (ALP) 12 weeks after treatment of 2 groups were also compared by using independent-sample t test. Results:In group A, a total of 722 seeds were implanted in 39 bone metastases in 23 patients, and the implantation successful rate was 97.44%(38/39). There were 25 patients in group B. In group A, the most severe pain, mean pain and current pain scores decreased with time ( F values: 3.71-22.47, all P<0.05). Except for the scores at 3 d posttreatment, most severe pain, mean pain, and current pain scores at different times showed significant differences with those before treatment (all P<0.05). There were also differences in the most severe pain, mean pain, and current pain scores in group B before and after treatment ( F values: 2.45-2.52, P values: 0.044-0.049), with scores decreasing first (till 8 weeks after treatment) and increasing later. The most severe pain, mean pain, and current pain scores 8 week after treatment were lower than those before treatment (all P<0.05), but all the four scores at 12 weeks were not significantly different from those before treatment ( P values: 0.057-0.693). At 12 weeks after treatment, the differences in the most severe pain, mean pain and current pain scores between 2 groups were statistically significant ( t values: 2.04-3.41, P values: 0.001-0.047). Bone pain interference scores 12 weeks after treatment in group A were higher than those in group B ( t values: 2.04-3.16, P values: 0.022-0.047), and PSA, fPSA and ALP 12 weeks after treatment in group A were significantly lower than those in group B ( t values: 4.38-6.82, P values: 0.012-0.042). Conclusion:CT-guided 125I seeds implantation combined with 89SrCl 2 is feasible and effective for the treatment of bone pain after failed external irradiation in patients with prostate cancer bone metastases, especially for the combination of fulminant pain.

In recent years, the artificial intelligence machine learning and deep learning technology have made leap progress. Using clinical decision support system for auxiliary diagnosis and treatment is the inevitable developing trend of wisdom medical. Clinicians tend to ignore the interpretability of models while pursuing its high accuracy, which leads to the lack of trust of users and hamper the application of clinical decision support system. From the perspective of explainable artificial intelligence, the authors make some preliminary exploration on the construction of clinical decision support system in the field of liver disease. While pursuing high accuracy of the model, the data governance techniques, intrinsic interpretability models, post-hoc visualization of complex models, design of human-computer interactions, providing knowledge map based on clinical guidelines and data sources are used to endow the system with interpretability.

Bioinformatics is an interdisciplinary science that combines the tools of mathematics, computer science, and biology to clarify and explore the biological implications of large amounts of biological data. With the continuous development of genome sequencing technology, a large number of biological data has been generated, and mining of the biological significance contained in big data has become one of the main tasks that need to be solved urgently. This article summarizes the risk prediction models for hepatocellular carcinoma (HCC) based on feature genes, so as to provide new perspectives for early identification, prognosis, and treatment optimization of HCC.

Deep learning is a process in which machine learning obtains new knowledge and skills by simulating the learning behavior of human brain through massive data training and analysis. With the development of medical technology, a large amount of data has been accumulated in the medical field, and the research on data may help to understand the relationships and rules within data and predict the onset and prognosis of human diseases. Deep learning can find the hidden information in data and has been increasingly used in the medical field. Primary liver cancer is a malignant tumor with high incidence and mortality rates, poor prognosis, and a high recurrence rate, and early diagnosis, timely treatment, and prediction of recurrence have always been the research hotspots in recent years. This article reviews the advances in the application of deep learning in the diagnosis and recurrence of liver cancer from the aspects of risk prediction, postoperative recurrence, and survival risk prediction.