Objective:To explore the efficacy of deep learning-based automatic segmentation technology in the segmentation of hepatocellular carcinoma (HCC) lesions using gadoxetate disodium-enhanced MRI (EOB-MRI), and to investigate the prognostic value of radiomics analysis in predicting patient outcomes.Methods:This was a cross-sectional, retrospective study that collected data from 352 patients with solitary HCC who underwent imaging at the Harbin Medical University Cancer Hospital between June 2015 and May 2023. The patients were randomly divided into a training set ( n=213) and a validation set ( n=139) in a 3∶2 ratio using weighted random sampling. Two radiologists manually annotated the lesions. Hepatobiliary-phase EOB-MRI images were standardized, and six deep learning models,nnU-Net, nnFormer, UnetR, Swin-UnetR, UnetR++ and MedNeXt,were trained for automatic segmentation on the training set. The segmentation performance was evaluated on the validation set, and the segmentation efficacy was assessed using the Dice coefficient and 95% Hausdorff distance (HD 95), identifying of the optimal model. Radiomics features were extracted from both manual and automatic segmentation regions, and the radiomics score (Radscore) was calculated to stratify patients into high-risk and low-risk groups. Kaplan-Meier curves and log-rank tests were used to analyze the differences in relapse-free survival (RFS) and overall survival (OS) between the different stratified groups. Results:Among the automatic segmentation models, the MedNeXt model performed best in the validation set, with a Dice coefficient of 76.0%, HD 95 of 7.2, and a segmentation success rate of 90.6% (126/139). The nnFormer model was the second-best, with a Dice coefficient of 75.3%, HD 95 of 10.1, and a segmentation success rate of 89.9% (125/139). Other models showed Dice coefficients ranging from 66.3% to 74.1%. A MedNext-nnF model was established by combining the MedNeXt and nnFormer models, achieving a Dice coefficient of 78.2%, HD 95 of 5.9, and a segmentation success rate of 92.1% (128/139) in the validation group. After constructing the automatic segmentation radiomics prognostic model, patients were stratified by Radscore. Both manual and automatic segmentation models showed statistically significant differences in RFS and OS between different risk groups ( P<0.001). Conclusions:The Mednext-nnF fusion model enables efficient and automated segmentation of HCC lesions in EOB-MRI. The radiomics model constructed based on the automated segmentation demonstrates strong performance in predicting and stratifying prognostic risk.

Objective:To explore the trajectory and influencing factors of oral frailty in first-onset elderly patients with ischemic stroke.Methods:A total of 240 inpatients from the neurology departments of Wutaishan Hospital and Northern Jiangsu People's Hospital between October 2022 and February 2024 were selected by convenience sampling. Oral frailty scores were assessed dynamically at four time points: 1 day before discharge (T 1) , 1 month after discharge (T 2) , 3 months after discharge (T 3) , and 6 months after discharge (T 4) . Latent growth modeling was used to identify potential trajectory categories and analyze their influencing factors. Results:A total of 240 questionnaires were distributed, with 220 valid responses, yielding a response rate of 91.67%. A total of three trajectory types of oral frailty were identified: non-oral frailty group ( n=92) , low-decline group ( n=66) , and high-decline group ( n=62) . Age, marital status, smoking history, dysphagia, National Institute of Health Stroke Scale score, oral health, nutritional status, oral health-related self-efficacy, monthly per capita household income, polypharmacy, denture use, and cognitive function were influencing factors of oral frailty in first-onset elderly patients with ischemic stroke ( P<0.05) . Conclusions:From 1 day before discharge to 6 months after discharge, there are 3 distinct oral frailty trajectories in first-onset elderly patients with ischemic stroke. Medical staff should implement individualized interventions based on the identified influencing factors.

Objectives: This study evaluates the efficacy of a new temporomandibular joint (TMJ) capsule suspension technique for stabilizing the TMJ after free fibular flap reconstruction of the mandibular condyle. Patients and Methods: Patients undergoing the TMJ capsule suspension technique during free fibular flap reconstruction after mandibulectomy with condylectomy (study group; n=9) were compared with a control group (n=9). Mandibular movement trajectory and surface electromyographic signals of bilateral masseters were recorded. The neocondyle–disc relationship was examined with magnetic resonance imaging (MRI) at 6 months after surgery. Results: Maximal mouth opening and bilateral marginal movement distances were comparable between the two groups (P>0.05). The asymmetry index of the condyle path length was significantly higher in controls (P=0.02). Bilateral mouth opening trajectories were symmetric in 7 patients and deviated to the affected side in 2 patients in the study group; they deviated to the affected side in all controls. The mean electromyographic values of the masseter on the affected side in resting, maximum bite, and chewing states were comparable between the two groups (P=0.13, P=0.65, and P=0.82, respectively). On MRI at 6 months, the thicknesses of the anterior, medial, and posterior bands and TMJ disc length were similar on the affected and normal sides in the study group (P=0.57, P=0.13, P=0.48, and P=0.87, respectively). Conclusion The proposed TMJ capsule suspension technique could improve postoperative TMJ structure and function after fibular free flap reconstruction following mandibulectomy with condylectomy.

Objectives: This study evaluates the efficacy of a new temporomandibular joint (TMJ) capsule suspension technique for stabilizing the TMJ after free fibular flap reconstruction of the mandibular condyle. Patients and Methods: Patients undergoing the TMJ capsule suspension technique during free fibular flap reconstruction after mandibulectomy with condylectomy (study group; n=9) were compared with a control group (n=9). Mandibular movement trajectory and surface electromyographic signals of bilateral masseters were recorded. The neocondyle–disc relationship was examined with magnetic resonance imaging (MRI) at 6 months after surgery. Results: Maximal mouth opening and bilateral marginal movement distances were comparable between the two groups (P>0.05). The asymmetry index of the condyle path length was significantly higher in controls (P=0.02). Bilateral mouth opening trajectories were symmetric in 7 patients and deviated to the affected side in 2 patients in the study group; they deviated to the affected side in all controls. The mean electromyographic values of the masseter on the affected side in resting, maximum bite, and chewing states were comparable between the two groups (P=0.13, P=0.65, and P=0.82, respectively). On MRI at 6 months, the thicknesses of the anterior, medial, and posterior bands and TMJ disc length were similar on the affected and normal sides in the study group (P=0.57, P=0.13, P=0.48, and P=0.87, respectively). Conclusion The proposed TMJ capsule suspension technique could improve postoperative TMJ structure and function after fibular free flap reconstruction following mandibulectomy with condylectomy.

Objectives: This study evaluates the efficacy of a new temporomandibular joint (TMJ) capsule suspension technique for stabilizing the TMJ after free fibular flap reconstruction of the mandibular condyle. Patients and Methods: Patients undergoing the TMJ capsule suspension technique during free fibular flap reconstruction after mandibulectomy with condylectomy (study group; n=9) were compared with a control group (n=9). Mandibular movement trajectory and surface electromyographic signals of bilateral masseters were recorded. The neocondyle–disc relationship was examined with magnetic resonance imaging (MRI) at 6 months after surgery. Results: Maximal mouth opening and bilateral marginal movement distances were comparable between the two groups (P>0.05). The asymmetry index of the condyle path length was significantly higher in controls (P=0.02). Bilateral mouth opening trajectories were symmetric in 7 patients and deviated to the affected side in 2 patients in the study group; they deviated to the affected side in all controls. The mean electromyographic values of the masseter on the affected side in resting, maximum bite, and chewing states were comparable between the two groups (P=0.13, P=0.65, and P=0.82, respectively). On MRI at 6 months, the thicknesses of the anterior, medial, and posterior bands and TMJ disc length were similar on the affected and normal sides in the study group (P=0.57, P=0.13, P=0.48, and P=0.87, respectively). Conclusion The proposed TMJ capsule suspension technique could improve postoperative TMJ structure and function after fibular free flap reconstruction following mandibulectomy with condylectomy.

Objective:To explore the trajectory and influencing factors of oral frailty in first-onset elderly patients with ischemic stroke.Methods:A total of 240 inpatients from the neurology departments of Wutaishan Hospital and Northern Jiangsu People's Hospital between October 2022 and February 2024 were selected by convenience sampling. Oral frailty scores were assessed dynamically at four time points: 1 day before discharge (T 1) , 1 month after discharge (T 2) , 3 months after discharge (T 3) , and 6 months after discharge (T 4) . Latent growth modeling was used to identify potential trajectory categories and analyze their influencing factors. Results:A total of 240 questionnaires were distributed, with 220 valid responses, yielding a response rate of 91.67%. A total of three trajectory types of oral frailty were identified: non-oral frailty group ( n=92) , low-decline group ( n=66) , and high-decline group ( n=62) . Age, marital status, smoking history, dysphagia, National Institute of Health Stroke Scale score, oral health, nutritional status, oral health-related self-efficacy, monthly per capita household income, polypharmacy, denture use, and cognitive function were influencing factors of oral frailty in first-onset elderly patients with ischemic stroke ( P<0.05) . Conclusions:From 1 day before discharge to 6 months after discharge, there are 3 distinct oral frailty trajectories in first-onset elderly patients with ischemic stroke. Medical staff should implement individualized interventions based on the identified influencing factors.

OBJECTIVE: This study reports the first imported case of Lassa fever (LF) in China. Laboratory detection and molecular epidemiological analysis of the Lassa virus (LASV) from this case offer valuable insights for the prevention and control of LF. METHODS: Samples of cerebrospinal fluid (CSF), blood, urine, saliva, and environmental materials were collected from the patient and their close contacts for LASV nucleotide detection. Whole-genome sequencing was performed on positive samples to analyze the genetic characteristics of the virus. RESULTS: LASV was detected in the patient's CSF, blood, and urine, while all samples from close contacts and the environment tested negative. The virus belongs to the lineage IV strain and shares the highest homology with strains from Sierra Leone. The variability in the glycoprotein complex (GPC) among different strains ranged from 3.9% to 15.1%, higher than previously reported for the seven known lineages. Amino acid mutation analysis revealed multiple mutations within the GPC immunogenic epitopes, increasing strain diversity and potentially impacting immune response. CONCLUSION The case was confirmed through nucleotide detection, with no evidence of secondary transmission or viral spread. The LASV strain identified belongs to lineage IV, with broader GPC variability than previously reported. Mutations in the immune-related sites of GPC may affect immune responses, necessitating heightened vigilance regarding the virus.
Humans ; China/epidemiology* ; Genome, Viral ; Lassa Fever/virology* ; Lassa virus/classification* ; Molecular Epidemiology ; Phylogeny

As a mercury-containing elixir， Hongshengdan has been known as a sacred medicine for surgery by ancient medical practitioners because of its precise curative effects. It originated from Yizong Shuoyue in the Qing dynasty， Qing dynasty and modern medical practitioners have adapted and modified its formula for clinical application. Employing bibliometric methods， the authors systematically organized relevant ancient literature of the Qing dynasty and modern literature， and analyzed the composition and dosage， preparation method， and clinical application. Among the 25 ancient books concerning Hongshengdan， a total of 12 medicinal formulas， 15 refining methods and 9 clinical applications were obtained. Research confirms that Hongshengdan consisted of mercury， saltpeter， alum， soap alum， cinnabar and realgar. Using measurement conversion standards of Qing dynasty， the modern single-batch formulation comprised 37.30 g of mercury， 149.20 g of saltpeter， 37.30 g of alum， 22.38 g of soap alum， 18.65 g of cinnabar， and 18.65 g of realgar. In modern refining of Hongshengdan， most medical practitioners take the core medicines， with dosages approximately 30 g of mercury， 30 g of saltpeter， and 30 g of alum. Refining method involves pretreatment stewing the materials during preparation， and alum， soap alum， and saltpeter are first ground together， then combined with mercury， cinnabar， and realgar for grinding until mercury and other drugs grind to the degree of no star points. The mixture is then placed in a pot or vessel by cold-forming method. After covering， the opening is sealed using either raw gypsum salt mud or honey-dipped cotton paper strips. Sand is packed around the vessel and then pressurized. During the calcination process， begin with a low flame（30 min）， then increase to a medium flame（30 min）， followed by a high flame（30 min）， after removing fire toxins， collect the final product. Hongshengdan has the efficacy of lifting the poison， removing the corrosion， producing muscle and dispersing， and is often used in the treatment of surgical sore and carbuncle type of diseases. Modern research indicates that Hongshengdan is commonly used to treat skin system diseases such as ulcers and herpes. The aforementioned findings provide a reference basis for the subsequent refining method and clinical application of Hongshengdan.

Hongsheng Dan, historically referred to as the "surgical sacred medicine", is at risk of losing its refining technology in contemporary times. This study aimed to preserve and innovate this traditional non-heritage refining technology. By utilizing the analytic hierarchy process(AHP) combined with the entropy weight method, this study established the hierarchical structure model of refining process of Hongsheng Dan and conducted a single factor experiment and an L_9(3~4) orthogonal experiment to optimize the refining method of Hongsheng Dan. Additionally, the study employed infrared thermal imaging to monitor temperature variations of Hongsheng Dan during the refining process. The optimized refining parameters for Hongsheng Dan were established as follows: a slow fire temperature of 175 ℃ with a duration of 30 minutes, a strong fire temperature of 270 ℃ with a duration of 60 minutes, and a tail fire temperature of 180 ℃ with a duration of 15 minutes. The stability and feasibility of this optimized process were confirmed through validation tests. The research focused on the material transformation of Hongsheng Dan, starting from the material changes during the refining process of Hongsheng Dan and the synthesis of mercuric oxide from nitric acid. The study investigated elemental transformations, physical phase changes, and alterations in thermal properties. 78.98% of the mercury in Hongsheng Dan and 80.21% of the mercury in mercuric oxide from nitric acid were retained. The diffraction peak intensity of the(011) crystal plane of Hongsheng Dan was highest at approximately 30.07°, indicating that the(011) crystal plane had a preferred crystalline orientation. Furthermore, the temperature range for the alteration in thermal properties during the refining process of Hongsheng Dan was found to be between 80 ℃ and 130 ℃. This research not only optimized the refining technology of Hongsheng Dan but also pioneered the application of infrared thermal imaging to study temperature changes throughout the refining process. By exploring the material transformation patterns of Hongsheng Dan and the synthesis of mercuric oxide from nitric acid, the study provided technical support for the preservation and innovation of Hongsheng Dan.
Drugs, Chinese Herbal/standards* ; Temperature

Compared with matrix-assisted laser desorption ionization mass spectrometry(MALDI-MS)using organic small molecule matrix,surface-assisted laser desorption ionization mass spectrometry(SALDI-MS)based on nanomaterial matrix is more effective in analysis of small molecule compounds.Ion sputtering instruments have obvious advantages for applying inorganic nanomatrix.In this work,the carbon-platinum material was sputtered onto a glass cover slip using an ion sputtering instrument to form a carbon-platinum(C-Pt)composite nanomatrix,and an SALDI-MS analytical method was thus established based on the prefabricated C-Pt composite matrix.The experimental results showed that the C-Pt composite nanomatrix could significantly improve the signal intensity and signal-to-noise ratio of the mass spectrum peaks of the components to be measured.The ratio of carbon to platinum,the duration of ion sputtering,and the laser power in mass spectrometer were investigated to select the optimal C-Pt matrix prefabricated conditions and SALDI-MS experimental conditions.Using the prefabricated C-Pt composite matrix,the melittriose and daidzein sample solution were applied as sample to examine repeatability.The results showed that the intra-point repeatability(RSD)was≤4.8%and the inter-point repeatability(RSD)was≤6.4%.The quercetin and melitriose were applied as model samples,and a linearity between MS peak intensity and respective concentration in the range of 0.05-1.0 mg/mL was found,with linear correlation coefficients(R2)greater than 0.994,showing good potential for quantitative and imaging analysis.Then,the prefabricated C-Pt composite matrix was applied to SALDI-MS analysis of the 50%ethanol extract of soybean,and 15 kinds of compounds including oligosaccharides and triglycerides were identified from the mass spectra.Furthermore,the C-Pt matrix was employed in SALDI-MS imaging for the compositions in corn tissue section,and the results showed that diglycerides and triglycerides were mainly distributed in the corn embryo and around the embryo,and the distribution of oligosaccharides was relatively even.