Objective:To explore the clinical application value of a combined model based on the radiomics features of magnetic resonance imaging(MRI)and MRI signs in predicting recurrence after radical resection for hepatocellular carcinoma(HCC).Methods:A retrospective analysis was conducted on the imaging data of 100 patients with radical resection for HCC who admitted to Zibo 148 Hospital from May 2016 to May 2020.All patients underwent abdominal enhanced MRI examination before surgery,and they were followed up for at least 2 years after the surgery.They were randomly divided into training group(70 cases)and verification group(30 cases)as a ratio of 7:3.According to the postoperative follow-up results,the training group existed 12 cases of recurrence and 58 cases without recurrence,and the verification group existed 5 cases of recurrence and 25 cases without recurrence.The 3D-slicer software was used to extract radiomics features of preoperative MRI images of each HCC patient.The intra-group correlation coefficient(ICC)of the extracted imaging features of the observers was calculated.The maximum related minimum redundancy(mRMR)algorithm and LASSO regression were selected to analyze the established radiomics labels after dimensionality reduction and screening.Univariate and multivariate logistic regression analysis were used to screen the independent risk factors of predicting recurrence in MRI signs,and they were used respectively to construct radiomics models with the radiomics labels of plain scan,arterial phase,portal phase and hepatobiliary phase.The receiver operating characteristic(ROC)curve was used to assess the diagnostic efficacy of each radiomics model in predicting recurrence.Results:The ICC range of two physicians in selecting radiomics features from the MRI images of all patients were between 0.903 and 0.957,which consistency was favorable(ICC≥0.9).Compared with other predictive models,the highest area under curve(AUC)values of ROC curve of the radiomics model of plain scan of training group[0.951(95%CI:0.901-1.000)]and verification group[0.968(95%CI:0.917-1.000)]were respectively 0.951 and 0.968 in predicting recurrence after radical resection for liver cancer.Conclusion:The combined model that is constructed on the basis of MRI radiomics features has favorable predictive value for the recurrence of patients after radical resection for HCC.Among of them,the radiomics model of plain scan has a certain guiding role in the clinical implementation of personalized treatment plans under the absence of enhancement,and in underdeveloped areas.

Objective:To explore the clinical application value of a combined model based on the radiomics features of magnetic resonance imaging(MRI)and MRI signs in predicting recurrence after radical resection for hepatocellular carcinoma(HCC).Methods:A retrospective analysis was conducted on the imaging data of 100 patients with radical resection for HCC who admitted to Zibo 148 Hospital from May 2016 to May 2020.All patients underwent abdominal enhanced MRI examination before surgery,and they were followed up for at least 2 years after the surgery.They were randomly divided into training group(70 cases)and verification group(30 cases)as a ratio of 7:3.According to the postoperative follow-up results,the training group existed 12 cases of recurrence and 58 cases without recurrence,and the verification group existed 5 cases of recurrence and 25 cases without recurrence.The 3D-slicer software was used to extract radiomics features of preoperative MRI images of each HCC patient.The intra-group correlation coefficient(ICC)of the extracted imaging features of the observers was calculated.The maximum related minimum redundancy(mRMR)algorithm and LASSO regression were selected to analyze the established radiomics labels after dimensionality reduction and screening.Univariate and multivariate logistic regression analysis were used to screen the independent risk factors of predicting recurrence in MRI signs,and they were used respectively to construct radiomics models with the radiomics labels of plain scan,arterial phase,portal phase and hepatobiliary phase.The receiver operating characteristic(ROC)curve was used to assess the diagnostic efficacy of each radiomics model in predicting recurrence.Results:The ICC range of two physicians in selecting radiomics features from the MRI images of all patients were between 0.903 and 0.957,which consistency was favorable(ICC≥0.9).Compared with other predictive models,the highest area under curve(AUC)values of ROC curve of the radiomics model of plain scan of training group[0.951(95%CI:0.901-1.000)]and verification group[0.968(95%CI:0.917-1.000)]were respectively 0.951 and 0.968 in predicting recurrence after radical resection for liver cancer.Conclusion:The combined model that is constructed on the basis of MRI radiomics features has favorable predictive value for the recurrence of patients after radical resection for HCC.Among of them,the radiomics model of plain scan has a certain guiding role in the clinical implementation of personalized treatment plans under the absence of enhancement,and in underdeveloped areas.

Objective:To compare the performance and surgical outcomes of domestic single-use digital flexible ureteroscopes with reusable digital flexible ureteroscopes in treatment of upper urinary stones.Methods:A prospective, single-blind, multicenter and randomized controlled study was performed from September 2018 to June 2019. Eligible patients were randomly assigned, in a ratio of 1∶1, to either experimental group or control group. The inclusion criteria for the study were: aged 18-75 years, solitary upper urinary stone with stone size between 0.8 and 2.0 cm and CT value less than 1 400 HU, negative preoperative urine culture and normal renal function. Exclusion criteria included: patients with acute urinary tract infection, intransitable urethral strictures, impassable ureteropelvic junction obstructions, systemic hemorrhagic disease, coagulation function abnormalities or bleeding tendency, severe hypertension or cardiopulmonary insufficiency, severe hip malformation and difficulty in meeting the demand of operation position and pregnant and lactation women. The device used in the experimental group was a domestic single-use digital flexible ureteroscope, and the device used in the control group was an imported Olympus digital flexible ureteroscope. The qualified rate of clinical comprehensive evaluation (including image quality and operational performance), the rate of device failure, the stone-free rate and the occurrence rate of adverse events (including increase in urine red blood cell and white blood cell counts, postoperative hematuria, nausea, vomiting, dizziness, and fever) in the two groups were recorded.Results:A total of 186 eligible study cases were collected from the People's Hospital of Wuhan University, the First Affiliated Hospital of Xiamen University, and the First Affiliated Hospital of Guangzhou Medical University. 90 cases in the final experimental group and 88 cases in the control group completed the trial and were included in the evaluation. There were no statistically significant differences among age [(48.40±11.36) vs. (47.40±12.53)years old, P=0.594], male to female ratio (62/28 vs. 56/32, P =0.874), BMI [(24.8±2.1) kg/m 2 vs. (25.1±2.0)kg/m 2,P =0.331], hydronephrosis (no/slight vs. mild/severe) (62/28 vs. 65/23, P =0.874), stone location and stone size [(12.8±4.7) mm vs. (11.9±5.2) mm, P =0.227]. There were no significant differences in terms of qualified rate of clinical comprehensive evaluation [98.9% (89/90) vs. 100.0% (88/88), P =0.991], lithotripsy success rate [84.4% (76/90) vs. 84.1% (74/88), P =0.888], device failure/defect rate (both 0%), and the incidence of adverse events [50.0% (45/90) vs. 52.0% (51/88), P =0.894]. The highest incidence of adverse events in two groups was the increase of red blood cells and white blood cells of routine urine after operation. There was no serious adverse event in the experimental group and 1 serious adverse event in the control group. Conclusions:There was no significant difference in image quality, device failure/defect rate, lithotripsy success rate, and adverse event rate between single-use digital flexible ureteroscopes and reusable digital flexible ureteroscopes for lithotripsy of upper ureteral and pelvic stones. Domestic single-use digital flexible ureteroscopes have good safety and effectiveness in the treatment and microscopy of upper urinary tract stones.

Objective To investigate the effects of chronic fluoride and arsenic co-exposure on bone morphogenetic proteins 2 (BMP-2) and runt-related transcription factor 2 (Runx2) gene expressions of bone tissue in rats. Methods One hundred and sixty 8-week-old clean-grade Wistar rats weighting (200 ± 50) g were randomly divided into 16 groups by weight via the random number table method of 10 rats in each group by 2 × 4 factorial experimental design (half female and half male), and treated with different doses of fluoride, arsenite and fluoride plus arsenite in deionized water (untreated control group with 0.0 mg/kg fluoride and 0.0 mg/kg arsenite; low-, moderate- and high-fluoride groups were supplemented with 5.0, 10.0 and 20.0 mg/kg fluoride and 2.5, 5.0 and 10.0 mg/kg arsenite) for 6 months. Rats were divided into control (F0.0As0.0), low fluorine (F5.0As0.0), moderate fluorine (F10.0As0.0), high fluorine (F20.0As0.0), low arsenic (F0.0As2.5), moderate arsenic (F0.0As5.0), high arsenic (F0.0As10.0), low fluorine and low arsenic (F5.0As2.5), low fluorine and moderate arsenic (F5.0As5.0), low fluorine and high arsenic (F5.0As10.0), moderate fluorine and low arsenic (F10.0As2.5), moderate fluorine and moderate arsenic (F10.0As5.0), moderate fluorine and high arsenic (F10.0As10.0), high fluorine and low arsenic (F20.0As2.5), high fluorine and moderate arsenic (F20.0As5.0), high fluorine and high arsenic (F20.0As10.0) groups. The concentrations of urinary fluoride (UF) and urinary arsenic (UAs) were determined as exposure biomarkers via the fluoride ion selective electrode method and the flame atomic fluorescence method. The mRNA expressions of BMP-2 and Runx2 were measured with quantitive real-time PCR. Results There were no dental fluorosis found in F0.0As0.0, F0.0As2.5, F0.0As5.0 and F0.0As10.0 groups, and there was a dose-response relationship between the occurrence of dental fluorosis and fluoride doses. Under exposure of fluorine and arsenic combined with high dose of fluorine (20.0 mg/kg), with increasing of arsenic exposure doses, the degree of injury of dental fluorosis increased (χ2 = 9.124, P < 0.05). Compared with F0.0As0.0 (0.99 ± 0.08, 0.99 ± 0.07), the mRNA expressions of BMP-2 (1.01 ± 0.07, 1.06 ± 0.06, 1.21 ± 0.05) and Runx2 (1.03 ± 0.04, 1.24 ± 0.03, 1.33 ± 0.10) in F5.0As0.0, F10.0As0.0, F20.0As0.0 groups were increased with increasing of fluoride doses. Fluoride had a significant effect on mRNA expressions of BMP-2 and Runx2 (F=3.067, 2.927, P<0.05). There was a significant interaction between fluoride and arsenic combination and BMP-2 and Runx2 mRNA expression levels (F = 3.817, 4.802, P < 0.05). Conclusion When rat is co-exposed to fluorine and arsenic, fluorine plays a leading role on BMP-2 and Runx2 mRNA expressions, and arsenic is indirectly involved in fluoride-induced bone toxicity; fluorine and arsenic has a antagonistic effect on BMP-2 and Runx2 mRNA expressions.

Diffuse axonal injury (DAI) is a common primary brain injury.The main mechanism of DAI is the relative displacement of brain tissue junction caused by shearing force during cranial rotation.The pathological changes are the deformation and rupture of white matter nerve fiber bundles.The mechanism of injury and recovery is still unclear,and unified diagnostic criteria are also lacking.Apolipoprotein E (APOE) gene polymorphisms are associated with nervous system development,injury,and repair process.The APOE gene contains six genotypes by the combination among three genes and synthesizes three proteins including apoE2,apoE3 and apoE4.The abnormal spatial structure of apoE4 decreases its ability of transporting lipids,resulting in reduced repair ability after nerve injury.The molecular mechanism of ApoE in the development of axonal injury is complicated.apoE protein can bind to receptor proteins such as low density lipoprotein receptor related protein 1 (LRP1) and heparan sulfate proteoglycan (HSPG) to mediate axonal repair,and it can also damage nerves by influencing calcium influx and producing toxic fragments through hydrolysis.Correcting the abnormal structure of apoE4 is helpful to nerve repair,and apoE analogues also have certain neuroprotective effects.This article reviews the injury characteristics,pathological characteristics,APOE gene polymorphisms,and the role of apoE synthesis in DAI,to provide new insights for elucidation of mechanism of DAI and related clinical application.

Objective To investigate the relationship between spina bifida occulta in lumbasacral portion and functional defe-cation abnormality among middle-aged and elderly people.Methods The cross-sectional and cluster random sampling survey meth-od was adopted to select the residents aged 45-90 years old in 7 communities of Zhengzhou City as the respondents.All respond-ents underwent the physical examination and lumbosacral digital radiography(DR)examination in the physical examination center of the First Affiliated Hospital of Zhengzhou University,and filled the related questionnaire about defecation abnormality.The rela-tionship between SBO and functional defecation abnormality among middle-aged and elderly people was studied by diagnosing and analyzing the functional constipation(FC)and functional incontinence(FC).Results The effective sample amounts were 1 057 ca-ses,including 497 males and 560 females,167 cases of SBO(86 males and 81 females).The morbidity rate of functional defecation abnormality was 26.02%(275/1 057),23.34%(116/497)in males and 28.39%(159/560)in females.Among 275 cases of functional defecation abnormality,there were 72 cases of complicating SBO.The Logistic regression analysis results showed that age,SOB,physical activity status,diet and living habits,education level and psychological factors were the risk factors for functional defecation abnormality (P<0.05),while there was no relationship between between past-history of stroke and functional defecation abnormality(P>0.05).Con-clusion SBO may be one of risk factors for functional defecation abnormality among middle-aged and elderly people.

Objective To investigate the genotype of M.tuberculosis in He'nan Province.Methods A total of 668 M.tuberculosis clinical strains collected in difference regions of He'nan Province during 2015 were genotyped by two standard methods,including classical 24-locus mycobacterium interspersed repetitive unit variable-number tandem-repeat (MIRU-VNTR) typing and spoligotyping.Results The 668 isolates were divided into 11 clusters and 35 patterns by spoligotyping.Among the 558 Beijing strains,546 were typical Beijing strains and the other 12 were atypical Beijing strains.Among the 110 non-Beijing strains,eight were new strains and the remaining 102 non-Beijing strains were divided into 10 families.There were 76 isolates belonging to T family,including 59 of T1 families,7 of T2 families,and 10 of T3 families.The 668 strains were divided into 550 gene patterns by standard 24-locus VNTR,including 508 un-clustered patterns and 160 clustered into 42 clusters.The largest cluster contained 21 strains,the other clusters contained 2-20 strains.Conclusion Beijing strain is still the most prevalent M.tuberculosis in He'nan Province.

Objective To observe the effects of high fat diet on ulcerative colitis(UC)and atypical hyperplasia in different periods induced by azoxymethane(AOM)/dextran sodium sulfate(DSS)and the changes of interleukin-6(IL-6)level in blood. Methods The mice in DSS,DSS+AOM,DSS+high fat diet,and DSS+AOM+high fat diet groups were given DSS for 3 days and sterilization water for 4 days as one cycle for 9 cycles, and the mice in normal control group were given sterilization water(n=12 in each group). The mice in DSS+AOM and DSS+AOM+high fat diet groups received intraperitoneal injection of AOM(10 mg/kg)in the every first day of the first 3 cycles. The mice in each group were sacrificed at different time points,and the disease activity index and pathohistological index were used to determine the degree of inflammation. ELISA method was used for the detection of serum IL-6 level. Results Simple administration of DSS could induce UC in the mouse model. After 9 circles of treatment,atypical hyperplasia was not found in normal control and DSS groups,and the rate of atypical hyperplasia was 25%(1/4)in DSS+high fat diet group,50%(2/4)in DSS+AOM group,and 75%(3/4)in DSS+AOM+high fat diet group. However,there were no significant differences in the rate of atypical hyperplasia between DSS and DSS+AOM groups ,DSS+high fat diet and DSS+AOM+high fat diet groups ,DSS and DSS+high fat diet groups,and DSS+AOM and DSS+AOM+high fat diet groups(all P>0.05). The histopathological score and the disease activity index in DSS+high fat diet and DSS+AOM+high fat diet groups were higher than those in DSS and DSS+AOM groups(P<0.05). The IL-6 level in DSS+high fat diet and DSS+AOM+high fat diet groups was higher than that in DSS and DSS+AOM groups ,but the difference was not statistically signifi-cant(P>0.05). Conclusion High fat diet may be one of the stimulating factors of UC and atypical hyperplasia.

ObjectiveTo evaluate the clinical efficiency and safety of cefmetazon in the prevention Department of General Surgery,First People's Hospital,Shanghai Jiaotong University,Shanghai 200080,Chinaand or treatment of infections in general surgery. MethodsA multicenter,prospective and open-labeled trial was conducted. In the prevention group,1700 patients were enrolled in clean-infection surgery,cefmetazon was given 1 g iv half an hour before the surgery started,and 1 g iv twice daily after the surgery for 3 days.Clinical response was evaluated in terms of both cure ( disappearance of pre treatment symptoms)and pathogen. In the treatment group,897 patients were diagnosed as peritonitis, cholecystitis and cholangitis,the patients were given cefmetazon 2 g iv twice a day for 7 - 14 days,clinical response and microbiological efficacy were assessed.ResultsIn prophylactic group,1449 patients were finally included.The clinical efficacy was 100％ (1449/1449).In the treatment group,a total of 897 patients were enrolled,and 110 patients failed for assessment of clinical efficacy,787 patients were included in the PPS population,the clinical efficacy was 90.7％ (714/787); Bacterial eradication rate was 92％ (46/50).Adverse reaction rates in prevention group and treatment group were 1.3％ (22/1700) and 1.2％ (11/897),including mild nausea and vomitting.ConclusionsCefmetazon is effective and safe in prevention and treatment of Postoperative infections in general surgery.

Objective To observe the steps of vascular smooth muscle cells (VSMCs) calcification induced by high phosphate enviroment in vitro. Methods VSMCs were incubated with high phosphate (2.5 mmol/L or 3.5 mmool/L) medium for different times. Expression of core binding factor α1(Cbfα1), osteopontin(OP), collagen type Ⅰ(Col Ⅰ), osteocalcin(OC) and α-smooth muscle actin (α-SMA) was investigated by Western blot, immunofluorcscencc staining and real time PCR. Mineral deposition was assessed by von Kossa aad Alizarin red staining. Ultrastructure of VSMCs calcification was observed by electron microscopy (EM). Results Up-regulated expression of osteoblast-specific transcription factor Cbfα1 in the nuclei oceured at as early as 12 hours. The protein of Col Ⅰ and OP was up-regalated when VSMCs were incubated in high phosphate medium for 3 days, and content of OC increased at the time of 6 days. When cultured in 2.5 mmol/L phosphate medium for 15 days, VSMCs lost their lineage marker α-SMA, developed granular calcium deposits. Moreover, the results of real time PCR indicated mRNA level of OP and Col Ⅰ increased at day 1, OC increased at day 5 and α-SMA level decreased at day 10, respectively. Ultrastructural analysis also confirmed the presence of collagen and matrix vesicles in the cells. Conclusion VSMCs phenotype transformation induced by high phosphate enviroment is an orchestrated, highly regulated process.