Objective To observe the value of deep learning(DL)models for automatic classification of echocardiographic views.Methods Totally 100 patients after heart transplantation were retrospectively enrolled and divided into training set,validation set and test set at a ratio of 7∶2∶1.ResNet18,ResNet34,Swin Transformer and Swin Transformer V2 models were established based on 2D apical two chamber view,2D apical three chamber view,2D apical four chamber view,2D subcostal view,parasternal long-axis view of left ventricle,short-axis view of great arteries,short-axis view of apex of left ventricle,short-axis view of papillary muscle of left ventricle,short-axis view of mitral valve of left ventricle,also 3D and CDFI views of echocardiography.The accuracy,precision,recall,F1 score and confusion matrix were used to evaluate the performance of each model for automatically classifying echocardiographic views.The interactive interface was designed based on Qt Designer software and deployed on the desktop.Results The performance of models for automatically classifying echocardiographic views in test set were all good,with relatively poor performance for 2D short-axis view of left ventricle and superior performance for 3D and CDFI views.Swin Transformer V2 was the optimal model for automatically classifying echocardiographic views,with high accuracy,precision,recall and F1 score was 92.56％,89.01％,89.97％and 89.31％,respectively,which also had the highest diagonal value in confusion matrix and showed the best classification effect on various views in t-SNE figure.Conclusion DL model had good performance for automatically classifying echocardiographic views,especially Swin Transformer V2 model had the best performance.Using interactive classification interface could improve the interpretability of prediction results to some extent.

Taking chronic atrophic gastritis （CAG） as an example， the frontier technologies in data science have been introduced into the inheritance， innovation and development of traditional Chinese medicine （TCM）， providing reference for conducting real-world clinical research on specialized diseases of TCM. This paper put forward the construction of CAG data science system by elaborating the connotation of data science and its application value in TCM， and discussed the path to build CAG data science system， namely through "data acquisition-knowledge expression-knowledge reasoning" to establish CAG database， knowledge base and develop diagnosis platform differentiating diseases and syndromes. Besides， this paper analyzed the prospects of CAG data science in improving data governance ability and knowledge discovery efficiency， deepening the level of knowledge sharing， promoting interdisciplinary integration， and strengthening the integration process of industry， academia and research.

ObjectiveTo construct traditional Chinese medicine （TCM） diagnostic scale of turbid toxin syndrome in order to provide corresponding reference for the standardization of TCM syndromes and studies. MethodsWe systematically searched the Chinese Medical Dictionary （CMD）， China Knowledge Network （CNKI）， Wanfang Data Knowledge Service Platform （WF） and VIP database for TCM classics and modern literature on turbid toxin syndrome， and initially screened the four diagnosis information of turbid toxin syndrome， established a pool of information entries， and conducted a cross-sectional clinical survey. Discrete trend method， correlation coefficient method， Cronbach's coefficient method， and factor analysis method were applied to objectively screen the entries. The diagnostic scale of turbid toxin syndrome were constructed through three rounds of Delphi method expert survey to determine the scale entries， using hierarchical analysis to get the judgement matrix scores and relative weight of each entry， after passing consistency test and then isometric expansion of the relative weight of the entries to get the weight of each entry and assign the value. ResultsA total of 35 articles were included， 45 entries were obtained after the initial screening. After the clinical investigation， 12 entries were not suitable by the discrete trend method， 23 entries not suitable by correlation coefficient method， 13 entries by the internal consistency screening were removed with the Cronbach's alpha coefficient rising， and 10 entries not suitable by the factor analysis method. Twenty-two entries were retained after objective screening by the combined use of the four statistical methods. The positive coefficients of experts in the three rounds of Delphi method of expert consultation were 96.67%， the coefficients of expert authority were 0.834， 0.856， and 0.867， and the coefficients of co-ordination were 0.126， 0.326， and 0.312， respectively. After consulting with clinical experts， and three rounds of Delphi method survey and hierarchical analysis method weight assignment， the diagnostic scale entries of turbid toxin syndrome were finally established. Primary symptoms： dark red or purple and dusky tongue， yellowish greasy or dry coating （10 points）； sticky and unpleasant stools （8 points）； disharmony of tastes including halitosis， sticky and greasy taste in the mouth， dry mouth and bitter taste in the mouth （6 points）； unfavourable or yellowish or red urination （5 points）； and dark complexion （4 points）. Secondary symptoms： heavy body （3 points）； dizziness （3 points）； profuse， sticky， foul-smelling secretions （2 points）； wiry and slippery， or slippery， or slippery and rapid pulse （2 points）； feeling of hardness in the abdomen （1 point）. ConclusionUsing Delphi method combined with the hierarchical analysis method， combining qualitative and quantitative study， a diagnostic scale of turbid toxin syndrome was initially developed.

Objective:To explore the diagnostic value of high frequency ultrasound in the diagnosis of closed penile cavernous rupture.Methods:The ultrasonic examination data of 8 patients with closed penile cavernous rupture treated in Union Medical College Affiliated to Tongji Medical College of Huazhong University of Science and Technology from August 2016 to May 2021 were retrospectively analyzed, and the high-frequency ultrasonic image features were analyzed.Results:Among the 8 patients with closed penile cavernous rupture, 6 were located at the distal end of the corpus cavernosum, one was located at the middle of the corpus cavernosum, and one was located at the proximal end of the corpus cavernosum. All of them were unilateral penile cavernosum rupture, 3 on the left side and 5 on the right side. In all 8 cases, the white membrane of the corpus cavernosum of the penis was continuously interrupted, and the broken end could be clearly displayed. The largest white membrane breach was 16.1 mm, and the smallest was 2.1 mm. Hematoma formed around the rupture of the tunica albuginea of the penis corpus cavernosum, and the maximum range of hematoma was 40.3 mm×15.4 mm, the minimum range of hematoma was 7.9 mm×5.6 mm.Conclusions:High frequency ultrasound is convenient, rapid and accurate, and can be used as the first choice of auxiliary examination for closed penile cavernous rupture.

Objective:To investigate the effect of preoperative pulmonary hypertension (PH) on right ventricular function in patients with heart transplantation(HTx) one year after surgery.Methods:A total of 120 patients who underwent HTx in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 2017 to January 2020 were retrospectively recruited.According to the mean pulmonary arterial pressure (mPAP) obtained by preoperative right heart catheterization, the research subjects were divided into the pulmonary hypertension group (PH group, n=81) and without pulmonary hypertension group (NPH group, n=39). Conventional echocardiographic indices of right ventricular function such as right ventricular area change (RV-FAC), tricuspid annular plane systolic excursion (TAPSE), tricuspid lateral annular systolic velocity (S′), and two-dimensional speckle tracking imaging (2D-STI) strain parameters including right ventricular global longitudinal strain (RV-GLS), right ventricular free wall longitudinal strain (RV-FWLS) were obtained to assess the right ventricular function of grafted hearts. The echocardiographic parameters one year after the operation of the two groups were analyzed to compare the differences in right ventricular function and their correlation with preoperative mPAP. Results:The grafted heart RV-GLS and RV-FWLS were significantly decreased in the PH group (all P<0.01), while RV-FAC, TAPSE, and S′ were similar between the two groups (all P>0.05). RV-FWLS and RV-GLS correlated with preoperative hemodynamic parameter mPAP( rs=-0.46, -0.54; all P<0.05)while RV-FAC, TAPSE, and S′ were not significantly correlated with mPAP (all P>0.05). Conclusions:Preoperative PH correlates with right ventricular function in HTx patients 1 year after the operation. The absolute values of RV-FWLS and RV-GLS in HTx patients with preoperative PH decrease 1 year after the operation. 2D-STI is more sensitive than conventional echocardiography to monitor the changes in right ventricular function in HTx patients after the operation.

Objective:To evaluate the efficacy of the domestic D-Shant device for the treatment of patients with chronic heart failure (CHF) using echocardiography.Methods:Twenty-four CHF patients who were treated with domestic D-Shant device in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from September 2020 to December 2021 were enrolled in the study. Pulmonary capillary wedge pressure (PCWP)/ left atrial pressure (LAP), right atrial pressure (RAP), pulmonary artery pressure, interatrial septal gradient pressure, cardiac index and pulmonary/systemic blood flow ratio (Qp/Qs) were measured before and after implantation using right heart catheterization.Left atrial end-diastolic area index (LAEDAI), left atrial end-diastolic volume index (LAEDVI), left ventricular end-diastolic volume index (LVEDVI), left ventricular end-systolic volume index (LVESVI), left ventricular ejection fraction (LVEF), right atrial end-diastolic diameter, right ventricular end-diastolic diameter, tricuspid annular plane systolic excursion (TAPSE), right ventricular tractional area change (RVFAC), device shunt aperture, velocity and pressure, together with mitral and tricuspid regurgitation severity were measured using echocardiography before, and 1 month as well as 3 months after D-Shant device implantation. Clinical data were collected and analyzed including 6-minute walking test (6MWT), New York Heart Association (NYHA) classification and the Kansas City Cardiomyopathy Questionnaire (KCCQ). Spearman correlation analysis was used to determine the relation between the changes in PCWP/LAP as well as echocardiographic parameters before and 3 months after implantation and NYHA classification. Binary Logistic regression analysis was performed to determine the predictive factors of NYHA classification improvement at 3-month follow-up after D-Shant device implantation.Results:①D-Shant devices were successfully implanted in all patients. ②Compared with preoperative values, invasive PCWP/LAP systolic, diastolic and mean pressures, transatrial septal gradient, and pulmonary systolic, diastolic and mean pressures decreased significantly after implantation(all P<0.001); Qp/Qs increased significantly after implantation( P<0.001). ③Compared with preoperative values, TAPSE, RVFAC and pulmonary artery flow velocity increased at 1 month after implantation(all P<0.05), whereas a significant reduction in mitral regurgitation grade, and an increase in LVEF and pulmonary artery flow velocity at 3 months after implantation(all P<0.05). Right atrial end-diastolic diameter, right ventricular end-diastolic diameter, LAEDAI, LAEDVI, LVEDVI, LVESVI, ratio of early to late diastolic peak velocities of mitral inflow(E/A), systolic peak velocity of mitral annulus at septal site(S′), ratio of early diastolic peak velocity of mitral inflow to diastolic peak velocity of mitral annulus(E/e′), pulmonary artery diameter, inferior vena cava diameter and degree of tricuspid regurgitation did not change among before, and 1 month as well as 3 months after implantation. There were no significant changes in the device shunt aperture, velocity and pressure between 1 month and 3 months after implantation(all P>0.05). ④The significant improvements in NYHA classification, KCCQ scores and 6MWT were observed at 1 and 3 months after implantation compared with preoperative values (all P<0.01). ⑤NYHA classification at 3 months after implantation was correlated with LVEF pre-post, PCWP/LAP pre-post, TAPSE pre-post and RVFAC pre-post ( rs=0.738, -0.730, 0.738, 0.723; all P<0.001). Logistic regression analysis showed that LVEF pre-post was an independent predictor for NYHA classification improvement at 3 months after implantation ( OR=0.687, 95% CI=0.475-0.992, P=0.045) . Conclusions:Domestic D-Shant device can effectively improve the cardiac function and clinical symptoms in patients with CHF. Echocardiography is a feasible and effective method to evaluate the benefits of domestic D-Shant device for the treatment of CHF.

In recent years, ultrasound elastography, as a new technique for evaluating soft tissue elasticity, has been progressively used in musculoskeletal system. Shear-wave elastography (SWE) is considered to be more objective, quantitative, and reproducible than other ultrasonic elastography techniques with increasing applications to the musculoskeletal system. A number of studies have shown that SWE has high application value in determining severity and prognosis of the musculoskeletal tissue diseases (including tendons, muscles, nerves and ligaments). This article describes the applications of SWE in the evaluation of musculoskeletal system.

Objective:To investigate the clinical value of conventional ultrasound combined with contrast-enhanced ultrasound (CEUS) in diagnosis of chromophobe renal cell carcinoma (ChRCC).Methods:We retrospectively analyzed the ultrasound features of 40 cases with ChRCC which were confirmed by operation and pathology from January 2012 to January 2018 in our hospital. The site, shape, size, capsule, internal echo and blood supply of the lesions were observed by routine ultrasound. Then CEUS showed the modality of enhancement, including the arrival time, peak time, peak intensity, distribution and the washout time.Results:Among the 40 cases, 38 cases were single, 2 cases were multiple, 17 cases were left kidney, 22 cases were right kidney, 1 case was double kidney. The tumors were located in the upper part of the kidney in 8 cases (20.0%), the lower part of the kidney in 9 cases (22.5%), and the middle part of the kidney in 23 cases (57.5%). One of the tumors was located in the right renal pelvis, and the lesion invaded the renal capsule in 11 cases (27.5%). The tumor was round, quasi round or oval, with clear boundary in 35 cases (87.5%), unclear boundary in 5 cases (12.5%), and the maximum diameter was 2.0-11.2 (5.1±0.8)cm. The lesions were hypoechoic in 23 cases (57.5%), isoechoic in 7 cases (17.5%), slightly hyperechoic in 7 cases (17.5%), cystic and solid mixed echo in 3 cases (7.5%), homogeneous echo in 23 cases (57.5%), heterogeneous echo in 17 cases (42.5%), and calcification in 5 cases (12.5%). Color Doppler flow imaging (CDFI) showed that blood vessels could be seen around the lesions, and no obvious blood flow signal was detected in 15 cases (37.5%) of the lesions; few star shaped blood flow signals could be detected in 12 cases (30%) of the lesions, short strip shaped blood flow signals could be detected in 7 cases (17.5%) of the lesions, and abundant blood flow signals could be seen in 6 cases (15%) of the lesions. Four patients underwent contrast-enhanced ultrasound examination at the same time. The lesions began to strengthen rapidly and evenly at the same time in the renal cortex, showing slightly low enhancement, and disappeared earlier than the renal cortex, showing a " fast forward and fast backward" perfusion mode. No tumor thrombus in draining vein, perirenal tissue and lymph node metastasis were found in all cases.Conclusions:Conventional ultrasound show ChRCC to be poor blood supply of solid tumors in the renal parenchyma, most of which are hypoechoic or isoechoic, with clear boundaries. CEUS show the lesions taking on high wash-in and wash-out, low enhancement than the surrounding renal cortex. These features are helpful for preoperative ultrasound diagnosis of ChRCC.

Objective:To investigate the values of right ventricular free wall longitudinal strain (RVFWLS) by three-dimensional speckle tracking echocardiography (3D-STE) in predicting the degree of RV myocardial fibrosis (MF) in patients with end-stage heart failure (HF).Methods:A total of 102 consecutive patients with end-stage HF undergoing heart transplantation were enrolled in the Union Hospital of Tongji Medical College, Huazhong University of Science and Technology from June 2018 to December 2019. Echocardiographic examinations were performed in these patients before heart transplantation. The conventional RV function parameters were obtained, including fractional area change, tricuspid annular plane systolic excursion(TAPSE), myocardial performance index, tricuspid lateral annular systolic velocity(Tricuspid s′). Two-dimensional (2D) RVFWLS was calculated by two-dimensional speckle tracking echocardiography (2D-STE). Right ventricular (RV) end-diastolic volume (RVEDV), RV end-systolic volume (RVESV), RV stroke volume (RVSV), RV ejection fraction (RVEF) and 3D-RVFWLS were measured by 3D-STE. The degree of MF was quantified using Masson′s trichrome stain in RV myocardial samples after heart transplantation. Patients were divided into mild, moderate, and severe groups according to the degree of MF on histology, then echocardiographic parameters were compared among the 3 groups. Pearson correlation analysis and the multiple linear regression analysis between echocardiographic parameters and RV MF were analyzed.Results:Compared with patients with mild and moderate MF, 3D-RVFWLS, 2D-RVFWLS and conventional parameters of RV function were significantly decreased in patients with severe MF.RV MF strongly correlated with 3D-RVFWLS ( r=-0.71, P<0.01), modestly correlated with 2D-RVFWLS ( r=-0.53, P<0.01), and weakly correlated with RVFAC, TAPSE, RVEF, Tricuspid s′, RVSV ( r=-0.47, -0.44, -0.35, -0.29, -0.38; all P<0.01). 3D-RVFWLS correlated best with the degree of MF compared with 2D-RVFWLS and conventional RV function parameters ( r=-0.71 vs r=-0.29~-0.53, all P<0.05). A stepwise multivariate analysis showed that 3D-RVFWLS was independently associated with RV MF (β=1.554, P<0.01, adjusted R2=0.539). Conclusions:3D-RVFWLS can provide an important imaging reference for detecting the degree of RV MF in patients with end-stage HF.

Drug-associated reward memories are conducive to intense craving and often trigger relapse. Simvastatin has been shown to regulate lipids that are involved in memory formation but its influence on other cognitive processes is elusive. Here, we used a mass spectrometry-based lipidomic method to evaluate the impact of simvastatin on the mouse brain in a cocaine-induced reinstatement paradigm. We found that simvastatin blocked the reinstatement of cocaine-induced conditioned place preference (CPP) without affecting CPP acquisition. Specifically, only simvastatin administered during extinction prevented cocaine-primed reinstatement. Global lipidome analysis showed that the nucleus accumbens was the region with the greatest degree of change caused by simvastatin. The metabolism of fatty-acids, phospholipids, and triacylglycerol was profoundly affected. Simvastatin reversed most of the effects on phospholipids induced by cocaine. The correlation matrix showed that cocaine and simvastatin significantly reshaped the lipid metabolic pathways in specific brain regions. Furthermore, simvastatin almost reversed all changes in the fatty acyl profile and unsaturation caused by cocaine. In summary, pre-extinction treatment with simvastatin facilitates cocaine extinction and prevents cocaine relapse with brain lipidome remodeling.
Animals ; Brain ; Cocaine ; Conditioning, Operant ; Extinction, Psychological ; Lipidomics ; Male ; Mice ; Simvastatin/therapeutic use*