Objective To investigate the risk of thoracoabdominal injuries in six-year-old child occupants in a reclined seating posture during frontal collisions,and provide a reference for developing child restraint systems(CRS).Methods Three validated biomechanical models of six-year-old child occupants in different seating postures with detailed anatomical structures were used.The acceleration curve from a sport utility vehicle crash test was applied to analyze the effects of seating posture on thoracic motion trajectory,chest acceleration,thoracoabdominal compression,viscous criterion(VC)of the chest and abdomen,internal organ strain,and spinal stress.Results Thoracic motion trajectories varied in the Z-direction under three seating postures.As the upper torso angle increased,thoracoabdominal kinematic injury parameters showed an upward trend.The thoracic and abdominal VC under 120° and 135° posture increased by 67％and 113％,10.7％and 25％compared with that under 105° standard sitting posture.The risk of thoracic internal organ injury was inversely related to the seating angle,while the risk of abdominal internal organ injury was positively related to the seating angle.The primary spinal injury mechanism was compression-flexion.Conclusions CRS protection evaluation should comprehensively consider thoracoabdominal kinematic parameters,internal organ biomechanics,and spinal injury risk.These findings have important implications for CRS development in intelligent driving systems and occupant protection strategy formulation.

Objective To investigate the risk of thoracoabdominal injuries in six-year-old child occupants in a reclined seating posture during frontal collisions,and provide a reference for developing child restraint systems(CRS).Methods Three validated biomechanical models of six-year-old child occupants in different seating postures with detailed anatomical structures were used.The acceleration curve from a sport utility vehicle crash test was applied to analyze the effects of seating posture on thoracic motion trajectory,chest acceleration,thoracoabdominal compression,viscous criterion(VC)of the chest and abdomen,internal organ strain,and spinal stress.Results Thoracic motion trajectories varied in the Z-direction under three seating postures.As the upper torso angle increased,thoracoabdominal kinematic injury parameters showed an upward trend.The thoracic and abdominal VC under 120° and 135° posture increased by 67％and 113％,10.7％and 25％compared with that under 105° standard sitting posture.The risk of thoracic internal organ injury was inversely related to the seating angle,while the risk of abdominal internal organ injury was positively related to the seating angle.The primary spinal injury mechanism was compression-flexion.Conclusions CRS protection evaluation should comprehensively consider thoracoabdominal kinematic parameters,internal organ biomechanics,and spinal injury risk.These findings have important implications for CRS development in intelligent driving systems and occupant protection strategy formulation.

Based on CT scan data,a bionic model of lumbar spine injuries with high biofidelity is developed and validated through cadaver experiments.Decoupling the constraint system that affects occupants during collisions due to inertial forces and the subsequent pressure exerted by the seat upon returning to position,a simulated fall experiment is designed.The simulated outcomes are trained and predicted using deep learning algorithms,and the accuracy of the trained neural network prediction model is verified.Key parameters are analyzed for correlation using principal component analysis and cross-reverse methods.The results shows that the predicted lumbar spine injury model obtained from training has high reliability(R2>0.9).Comprehensive analysis reveals that after experiencing axial impact,the L4 vertebral body bears the highest impact load and can be used as a representative measure of lumbar spine injury.Among the environmental variables,the axial force on the L4 lumbar spine is mainly affected by torso mass and fall height,both of which have positive correlations.Torso mass,fall height,and posture angle all have positive effects on internal energy.Conversely,torso mass and fall height have negative correlations with stress.These research findings provide a scientific basis for further elucidating lumbar spine injury mechanisms in intelligent cockpit environments,devising corresponding safety protection measures,and evaluating occupant safety in automobiles.

Based on CT scan data,a bionic model of lumbar spine injuries with high biofidelity is developed and validated through cadaver experiments.Decoupling the constraint system that affects occupants during collisions due to inertial forces and the subsequent pressure exerted by the seat upon returning to position,a simulated fall experiment is designed.The simulated outcomes are trained and predicted using deep learning algorithms,and the accuracy of the trained neural network prediction model is verified.Key parameters are analyzed for correlation using principal component analysis and cross-reverse methods.The results shows that the predicted lumbar spine injury model obtained from training has high reliability(R2>0.9).Comprehensive analysis reveals that after experiencing axial impact,the L4 vertebral body bears the highest impact load and can be used as a representative measure of lumbar spine injury.Among the environmental variables,the axial force on the L4 lumbar spine is mainly affected by torso mass and fall height,both of which have positive correlations.Torso mass,fall height,and posture angle all have positive effects on internal energy.Conversely,torso mass and fall height have negative correlations with stress.These research findings provide a scientific basis for further elucidating lumbar spine injury mechanisms in intelligent cockpit environments,devising corresponding safety protection measures,and evaluating occupant safety in automobiles.

Objective Based on U.S.Food and Drug Administration Adverse Event Reporting System(FAERS)database,the signal mining of tizanidine adverse drug events(ADEs)was conducted to explore the occurrence characteristics of ADE,hoping to provide references for the safe clinical application of tizanidine.Methods The reporting odds ratio(ROR)and medicines and healthcare products regulatory agency methods(MHRA)were used to analyse the ADE of tizanidine using FAERS registration data from the first quarter of 2004 to the second quarter of 2022.After valid signals were obtained,the MedDRA was used for translation and system organ classification.Results A total of 7 135 reports of tizanidine ADE were obtained,including 1 732 patients,1 304 ADE types were involved.According to the results of 2 ADE signal mining methods,at the preferred term(PT)level,177 signals were detected.There were 32 PT signals not included in the drug instructions,including potassium wasting nephropathy,cardio-respiratory arrest,and foetal growth restriction etc.In 1 732 patients,the number of ADE cases of female was 2.37 times that in male(1 057 vs.446),and the age group between 40 and 64 accounted for a large proportion(36.03％).The highest proportion(32.79％)reported by consumers.The system organ class involved mainly included various neurological diseases and psychosis.The median time to onset of tizanidine-related ADEs was 75 d(interquartile range:28-223 d),but it was necessary to be vigilant that ADE may still occur 1 year after starting the drug(13.38％).Conclusion This study aims to suggest that clinical application of tizanidin-related ADE should be paid full attention to the occurrence of ADE such as potassium-wasting nephropathy and suicidally completed,as well as key populations such as women and patients of 40-64 years old.

Injury biomechanics is an interdisciplinary field that studies the biomechanical responses and injury mechanisms of the human body under external loads.The goal is to provide scientific foundations for the prevention,diagnosis,and treatment of human injuries.This field is widely applied in clinical medicine,sports science,rehabilitation engineering,traffic safety,aerospace,and other domains.In this review,the research progress in injury biomechanics in the year 2023 is summarized,focusing on in-depth analysis of injury mechanisms,innovations in injury prediction and protective countermeasure,and the latest applications of injury diagnosis and rehabilitation technologies.By systematically reviewing the research advancements,this review aims to offer new directions and ideas to the continued development of injury biomechanics and promote interdisciplinary collaboration and technological innovation.

Injury biomechanics is an interdisciplinary field that studies the biomechanical responses and injury mechanisms of the human body under external loads.The goal is to provide scientific foundations for the prevention,diagnosis,and treatment of human injuries.This field is widely applied in clinical medicine,sports science,rehabilitation engineering,traffic safety,aerospace,and other domains.In this review,the research progress in injury biomechanics in the year 2023 is summarized,focusing on in-depth analysis of injury mechanisms,innovations in injury prediction and protective countermeasure,and the latest applications of injury diagnosis and rehabilitation technologies.By systematically reviewing the research advancements,this review aims to offer new directions and ideas to the continued development of injury biomechanics and promote interdisciplinary collaboration and technological innovation.

Objective:To investigate the methylation status of SDC2, PPP2R5C and ADHFE1 genes in stool and their values in the screening of colorectal cancer and precancerous lesions.Methods:From August 2020 to March 2021, 64 patients with colorectal cancer, 72 patients with adenoma, 33 patients with hyperplastic polyps and 59 healthy people were recruited from Qingdao Central Hospital Affiliated to Qingdao University, and the morning stool samples were collected from the research subjects. The genomic DNA was extracted and modified with sulfite. The methylation status of SDC2, PPP2R5C and ADHFE1 genes were detected by methylation specific polymerase chain reaction (MSP), and the fecal occult blood test (FOBT) was performed. Taking the pathological results as the gold standard, receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to compare the effect of combined detection of methylation of three genes and FOBT in predicting colorectal cancer and precancerous lesions. R-Studio software was used to construct a nomogram for the prediction of colorectal cancer with combined detection of gene methylation in stool and other clinical features, and the calibration and validation were performed.Results:The positive rates of combined detection of methylation of SDC2, PPP2R5C and ADHFE1 genes in stool were higher than those of FOBT in colorectal cancer+adenoma [74.3% (101/136) vs. 47.1% (64/136), χ2 = 23.20, P = 0.001], colorectal cancer [90.6% (58/64) vs. 70.3% (45/64), χ2 = 8.91, P = 0.003] and adenoma [59.7% (43/72) vs. 26.4% (19/72), χ2 = 14.43, P = 0.002]. There was no significant difference in the positive rates in hyperplastic polyps [21.2% (7/33) vs. 6.1% (2/33), χ2 = 0.12, P = 0.125] and healthy controls [10.2% (6/59) vs. 8.5% (5/59), χ2 = 4.01, P = 1.000]. The combined detection of gene methylation was better than FOBT in the prediction of colorectal cancer + adenoma [AUC: 0.85 (95% CI 0.80-0.91) vs. 0.71 (95% CI 0.64-0.78), P < 0.05], especially in the prediction of adenoma [AUC: 0.82 (95% CI 0.74-0.89) vs 0.64 (95% CI 0.57-0.69), P < 0.001]. The sensitivity and specificity of ADHFE1 gene methylation status in predicting colorectal cancer were high (90.6% and 96.6%). In colorectal cancer patients over 50 years old, the positive rate of combined detection of gene methylation was higher than that of FOBT [90.2% (55/61) vs. 68.9% (42/61), P < 0.05]. The nomogram calibration curve for predicting colorectal cancer constructed based on the combined detection of gene methylation and each clinical feature showed a high degree of concordance between the predicted and observed diagnostic performance of colorectal cancer. Conclusions:The methylation levels of SDC2, PPP2R5C AND ADHFE1 genes in stool are increased in patients with colorectal cancer or adenoma. The combined detection of gene methylation is expected to be a non-invasive method for the screening of colorectal cancer and precancerous lesions.

Objective? To compare predicted incidence of chemotherapy induced nausea and vomiting (CINV) by doctors, nurses and patients with its actual incidence. Methods? We used the prospective paired design to select 320 patients with the induced vomiting plan of medicine department at Peking Union Medical College Cancer Hospital by convenience sampling, and we allocated 72 doctors and 48 responsibility nurses for patients. The predicted chemotherapy induced nausea and vomiting scale was filled in by doctors, nurses and patients as required to understand the incidence of CINV predicted by them. After patients completed their chemotherapy, the Chinese version of MASCC antiemesis tool (MAT) was filled out by nurses to investigate the actual incidence of CINV. Results? The paired chi-square test showed that the incidence of acute and delayed CINV were 38.75% and 61.25% respectively. There was no statistical difference between the incidence of acute CINV predicted by doctors, nurses as well as patients and the actual incidence (P＞0.05). There was also no statistical difference between the incidence of delayed CINV predicted by nurses and the actual incidence (P＞0.05). Doctors and patients all underestimated the incidence of delayed CINV with a statistical difference (P＜0.05). The consistency between the incidence of acute as well as delayed CINV predicted by doctors, nurses, patients and the actual incidence was poor with Kappa value ranging from 0.02 to 0.34. A total of 54.93% to 57.77% of doctors and nurses predicted that CINV could be controlled well lower than that (about 70%) of patients with statistical differences (P＜0.05). Conclusions? There is still much improvement space for control of delayed CINV. Medical staff should take effective measures to improve the level of estimate and the level of CINV symptom management, and to improve the quality of life among patients.

Objective To explore the clinical symptom clusters in breast cancer patients with anthracycline treatment, which could provide evidence for prevention. Methods The M.D.Anderson Symptom Inventory of Chinese version (MDASI-C) was applied to assess clinical symptoms in 506 breast cancer patients received anthracycline therapy during their 1stto 4thcycle chemotherapy.Thirteen symptoms were analyzed using main-component analysis and variance orthogonal rotation. The exploratory factor analysis was conducted to find factors value greater than 1. Results The number of symptoms with incidence rate more than 50% was 5, 6, 7 and 9 during the 1stto the 4thcycle, respectively. Fatigue, poor appetite, and nausea were the most common symptoms, and the incidence of these symptoms were 92.5% to 97.1% ,84.8% to 95.1% and 81.1% to 91.3% with the increasing cycle of chemotherapy.Three factors value greater than 1 were detected during the 1stto 2ndcycle chemotherapy by exploratory factor analysis.The cumulative variance contribution rates were 63.233% and 61.434% in the 1stand 2ndcycle, respectively. The main symptom clusters concentrate on fatigue and digestive tract symptoms, including fatigue, sleep disturbance, hypersomnia, nausea, vomit, poor appetite, dry mouth. Two factors value greater than 1 were detected during 3rdto4thcycle in chemotherapy. The cumulative variance contribution rates were 62.660% and 61.148% in the 3rdand 4thcycle, respectively. The main symptom clusters concentrate on psychological and nervous system symptoms including sadness, pain, dry mouth, numbness, hypersomnia, shortness of breath, amnesia and so on. The Cronbach α of cluster symptoms from the 1stto the 4thcycle chemotherapy was between 0.829 to 0.911. Conclusions Symptom clusters vary with the cycles of chemotherapy in breast cancer patients treated with anthracycline. Nurses should provide targeted intervention measures to improve symptom and enhance quality of life, according to specific situation.