Background::Computer-aided detection (CAD) software has been introduced to automatically interpret digital chest X-rays. This study aimed to evaluate the performance of CAD software (JF CXR-1 v3.0, which was developed by a domestic Hi-tech enterprise) in tuberculosis (TB) case finding in China.Methods::In 2019, we conducted an internal evaluation of the performance of JF CXR-1 v3.0 by reading standard images annotated by a panel of experts. In 2020, using the reading results of chest X-rays by a panel of experts as the reference standard, we conducted an on-site prospective study to evaluate the performance of JF CXR-1 v3.0 and local radiologists in TB case finding in 13 township health centers in Zhongmu County, Henan Province.Results::Internal assessment results based on 277 standard images showed that JF CXR-1 v3.0 had a sensitivity of 85.94% (95% confidence interval [CI]: 77.42%, 94.45%) and a specificity of 74.65% (95% CI: 68.81%, 80.49%) to distinguish active TB from other imaging conditions. In the on-site evaluation phase, images from 3705 outpatients who underwent chest X-ray detection were read by JF CXR-1 v3.0 and local radiologists in parallel. The imaging diagnosis of local radiologists for active TB had a sensitivity of 32.89% (95% CI: 22.33%, 43.46%) and a specificity of 99.28% (95% CI: 99.01%, 99.56%), while JF CXR-1 v3.0 showed a significantly higher sensitivity of 92.11% (95% CI: 86.04%, 98.17%) ( p < 0.05) and maintained high specificity at 94.54% (95% CI: 93.81%, 95.28%). Conclusions::CAD software could play a positive role in improving the TB case finding capability of township health centers.

Background::Computer-aided detection (CAD) software has been introduced to automatically interpret digital chest X-rays. This study aimed to evaluate the performance of CAD software (JF CXR-1 v3.0, which was developed by a domestic Hi-tech enterprise) in tuberculosis (TB) case finding in China.Methods::In 2019, we conducted an internal evaluation of the performance of JF CXR-1 v3.0 by reading standard images annotated by a panel of experts. In 2020, using the reading results of chest X-rays by a panel of experts as the reference standard, we conducted an on-site prospective study to evaluate the performance of JF CXR-1 v3.0 and local radiologists in TB case finding in 13 township health centers in Zhongmu County, Henan Province.Results::Internal assessment results based on 277 standard images showed that JF CXR-1 v3.0 had a sensitivity of 85.94% (95% confidence interval [CI]: 77.42%, 94.45%) and a specificity of 74.65% (95% CI: 68.81%, 80.49%) to distinguish active TB from other imaging conditions. In the on-site evaluation phase, images from 3705 outpatients who underwent chest X-ray detection were read by JF CXR-1 v3.0 and local radiologists in parallel. The imaging diagnosis of local radiologists for active TB had a sensitivity of 32.89% (95% CI: 22.33%, 43.46%) and a specificity of 99.28% (95% CI: 99.01%, 99.56%), while JF CXR-1 v3.0 showed a significantly higher sensitivity of 92.11% (95% CI: 86.04%, 98.17%) ( p < 0.05) and maintained high specificity at 94.54% (95% CI: 93.81%, 95.28%). Conclusions::CAD software could play a positive role in improving the TB case finding capability of township health centers.

BACKGROUND:Unilateral knee osteoarthritis patients experience abnormal alterations in lower extremity gait biomechanics,yet few studies have analyzed changes in gait dynamics and muscle activation in knee osteoarthritis patients from the perspective of gait asymmetry.OBJECTIVE:To explore the effects of unilateral knee osteoarthritis on gait dynamics and muscle activation asymmetry in elderly women.METHODS:Thirty female patients with unilateral knee osteoarthritis attending Beijing Jishuitan Hospital Guizhou Hospital from October 2023 to March 2024 were selected as the knee osteoarthritis group,and 30 healthy elderly females without musculoskeletal disorders from the neighboring community were recruited as the control group.The kinetic and muscle activation levels of the subjects in both groups during walking were synchronously collected by a P-6000 force platform and a Free EMG300 surface EMG device.Kinetic parameters included the first and second peak forces of vertical ground reaction force.Muscle activation indexes included normalized root mean square values of rectus femoris,long head of biceps femoris,and lateral gastrocnemius muscle during the braking and pushing phases.Asymmetry index of the kinetic and muscle activation indexes were calculated separately in patients with K-L grade Ⅱ and Ⅲ knee osteoarthritis and controls and compared between groups by independent samples t-test and one-way analysis of variance.RESULTS AND CONCLUSION:(1)The difference between the second peak of vertical ground reaction force of both limbs in the knee osteoarthritis group was statistically significant(P＜0.05),as well as the difference between the standardized root mean square of rectus femoris in the braking phase and gastrocnemius and biceps femoris in the pushing phase(P＜0.05).(2)In terms of asymmetry index,the difference between the asymmetry index values of the first peak of vertical ground reaction force between the two groups of subjects was not statistically significant(P＞0.05),while the difference between the second peak asymmetry index values was statistically significant(P＜0.05).The difference in asymmetry index values of standardized root mean square of rectus femoris muscle during the braking phase as well as gastrocnemius and biceps femoris muscles during the pushing phase was statistically significant between the two groups of subjects(P＜0.05).(3)The asymmetry index of the standardized root mean square values of the second peak of vertical ground reaction force,rectus femoris in the braking phase,gastrocnemius in the pushing phase,and biceps femoris in the osteoarthritis group of the knee with K-L classification grade Ⅱand Ⅲ were significantly higher than those of the control group(P＜0.05).The asymmetry indices of standardized root mean square values of the second peak of vertical ground reaction force,rectus femoris in the braking phase and biceps femoris in the pushing phase were higher in the osteoarthritis group of the knee with K-L classification Ⅲ than in the osteoarthritis group of the knee with classification Ⅱ(P＜0.05).(4)The asymmetry indices of the second peak of vertical ground reaction,the rectus femoris muscle in the braking phase,and the muscle activation of the biceps femoris and gastrocnemius muscles in the pushing phase can be used as an important index for identifying gait asymmetry in the knee osteoarthritis,which is helpful in providing a theoretical basis for the development of rehabilitation treatment programs.It is also worth noting that extra attention should be paid to patients with higher severity of knee osteoarthritis in the clinical monitoring of gait asymmetry.

BACKGROUND:In recent years,the use of blood flow restriction training in the rehabilitation of ankle injuries has gradually increased,and this technique can improve muscle strength,and can achieve a similar effect of high-load resistance training when combined with low-intensity resistance training. OBJECTIVE:To elucidate the current application status of blood flow restriction training in the prevention and rehabilitation of foot and ankle injuries. METHODS:A literature search was conducted on CNKI,PubMed,and Web of Science databases. The Chinese search terms were "blood flow restriction training,pressure training,ankle,ankle joint," and the English search terms were "blood flow restriction,BFR,KAATSU,ankle,foot." Relevant literature from database inception to July 2023 was retrieved,and 50 articles were ultimately included according to inclusion and exclusion criteria. RESULTS AND CONCLUSION:In foot and ankle applications,blood flow restriction training is primarily used in studies of Achilles tendon thickness and ankle muscle strength in healthy individuals,as well as in chronic ankle instability,after Achilles tendon ruptures,and after external ankle fractures. Single blood flow restriction training can reduce the thickness of Achilles tendon in healthy individuals,while long-term training can make it thicker. Blood flow restriction training can prevent muscle strength decline in healthy individuals,while low-intensity blood flow training can promote ankle muscle strength recovery in injured patients. In current research,few adverse events related to blood flow restriction have been found,and future research should compare the efficacy of different training programs in different populations and optimize the research content.

BACKGROUND:Unilateral knee osteoarthritis patients experience abnormal alterations in lower extremity gait biomechanics,yet few studies have analyzed changes in gait dynamics and muscle activation in knee osteoarthritis patients from the perspective of gait asymmetry.OBJECTIVE:To explore the effects of unilateral knee osteoarthritis on gait dynamics and muscle activation asymmetry in elderly women.METHODS:Thirty female patients with unilateral knee osteoarthritis attending Beijing Jishuitan Hospital Guizhou Hospital from October 2023 to March 2024 were selected as the knee osteoarthritis group,and 30 healthy elderly females without musculoskeletal disorders from the neighboring community were recruited as the control group.The kinetic and muscle activation levels of the subjects in both groups during walking were synchronously collected by a P-6000 force platform and a Free EMG300 surface EMG device.Kinetic parameters included the first and second peak forces of vertical ground reaction force.Muscle activation indexes included normalized root mean square values of rectus femoris,long head of biceps femoris,and lateral gastrocnemius muscle during the braking and pushing phases.Asymmetry index of the kinetic and muscle activation indexes were calculated separately in patients with K-L grade Ⅱ and Ⅲ knee osteoarthritis and controls and compared between groups by independent samples t-test and one-way analysis of variance.RESULTS AND CONCLUSION:(1)The difference between the second peak of vertical ground reaction force of both limbs in the knee osteoarthritis group was statistically significant(P＜0.05),as well as the difference between the standardized root mean square of rectus femoris in the braking phase and gastrocnemius and biceps femoris in the pushing phase(P＜0.05).(2)In terms of asymmetry index,the difference between the asymmetry index values of the first peak of vertical ground reaction force between the two groups of subjects was not statistically significant(P＞0.05),while the difference between the second peak asymmetry index values was statistically significant(P＜0.05).The difference in asymmetry index values of standardized root mean square of rectus femoris muscle during the braking phase as well as gastrocnemius and biceps femoris muscles during the pushing phase was statistically significant between the two groups of subjects(P＜0.05).(3)The asymmetry index of the standardized root mean square values of the second peak of vertical ground reaction force,rectus femoris in the braking phase,gastrocnemius in the pushing phase,and biceps femoris in the osteoarthritis group of the knee with K-L classification grade Ⅱand Ⅲ were significantly higher than those of the control group(P＜0.05).The asymmetry indices of standardized root mean square values of the second peak of vertical ground reaction force,rectus femoris in the braking phase and biceps femoris in the pushing phase were higher in the osteoarthritis group of the knee with K-L classification Ⅲ than in the osteoarthritis group of the knee with classification Ⅱ(P＜0.05).(4)The asymmetry indices of the second peak of vertical ground reaction,the rectus femoris muscle in the braking phase,and the muscle activation of the biceps femoris and gastrocnemius muscles in the pushing phase can be used as an important index for identifying gait asymmetry in the knee osteoarthritis,which is helpful in providing a theoretical basis for the development of rehabilitation treatment programs.It is also worth noting that extra attention should be paid to patients with higher severity of knee osteoarthritis in the clinical monitoring of gait asymmetry.

BACKGROUND:In recent years,the use of blood flow restriction training in the rehabilitation of ankle injuries has gradually increased,and this technique can improve muscle strength,and can achieve a similar effect of high-load resistance training when combined with low-intensity resistance training. OBJECTIVE:To elucidate the current application status of blood flow restriction training in the prevention and rehabilitation of foot and ankle injuries. METHODS:A literature search was conducted on CNKI,PubMed,and Web of Science databases. The Chinese search terms were "blood flow restriction training,pressure training,ankle,ankle joint," and the English search terms were "blood flow restriction,BFR,KAATSU,ankle,foot." Relevant literature from database inception to July 2023 was retrieved,and 50 articles were ultimately included according to inclusion and exclusion criteria. RESULTS AND CONCLUSION:In foot and ankle applications,blood flow restriction training is primarily used in studies of Achilles tendon thickness and ankle muscle strength in healthy individuals,as well as in chronic ankle instability,after Achilles tendon ruptures,and after external ankle fractures. Single blood flow restriction training can reduce the thickness of Achilles tendon in healthy individuals,while long-term training can make it thicker. Blood flow restriction training can prevent muscle strength decline in healthy individuals,while low-intensity blood flow training can promote ankle muscle strength recovery in injured patients. In current research,few adverse events related to blood flow restriction have been found,and future research should compare the efficacy of different training programs in different populations and optimize the research content.

BACKGROUND:Previous studies have shown that knee joint moment changes in patients with knee osteoarthritis,but there are few reports on the correlation of moment changes with knee extensor muscle strength and gait spatiotemporal parameters. OBJECTIVE:To explore the correlation of knee extensor muscle strength and gait spatiotemporal parameters with peak knee flexion moment and knee adduction moment in female patients with knee osteoarthritis. METHODS:Twenty knee osteoarthritis female patients with single knee disease hospitalized in Guizhou Hospital,Beijing Jishuitan Hospital from February to August 2022 were selected as the knee osteoarthritis group,and an additional 20 healthy females without musculoskeletal disease were selected as the control group.The knee extensor force at 60(°)/s was measured with the Biodex isokinetic instrument.The gait spatiotemporal parameters and peak knee flexion moment and knee adduction moment were collected with the Italian BTS infrared motion capture system and force measuring platform.Pearson correlation analysis was used to explore the correlation of muscle strength and gait spatiotemporal parameters with peak knee adduction moment and knee flexion moment,and the variables significantly related to knee joint moment were further included in the multiple stepwise regression analysis. RESULTS AND CONCLUSION:(1)Compared with the control group,the knee osteoarthritis group had significantly lower knee extensor force,step speed,step frequency,step length,step width,peak knee adduction moment and knee flexion moment at 60(°)/s(P<0.05).(2)Pearson correlation analysis showed that the 60(°)/s centripetal extensor force,step speed,step frequency and step length were positively correlated with the peak knee flexion moment,and negatively correlated with the peak knee adduction moment,with a statistically significant difference(P<0.05).(3)The results of multiple stepwise regression showed that step speed and 60(°)/s knee extensor force were the strongest predictors of peak knee flexion moment,and the total R2 value of the two factors was 0.426,indicating that 42.6%of the total variance of this parameter could be explained.Step length and 60(°)/s centripetal extensor force were the strongest predictors of peak knee adduction moment.The total R2 value of the two factors was 0.602,indicating that 60.2%of the total variance of this parameter could be explained.(4)It is concluded that knee extensor strength,step speed and step length are the main variables affecting peak knee adduction moment and knee flexion moment.Therefore,these variables can be used for clinical gait monitoring and guidance to change knee joint load during knee osteoarthritis rehabilitation.

Objective : To investigate the effects of D ⁃allose on the restoration of neurological function , Galectin⁃3 (Gal⁃3) , adenosine monophosphate⁃activated protein kinase/mammalian target of rapamycin (AMPK/mTOR) and the expression of some inflammatory factors in ischemia⁃reperfusion injury ( CIRI) mice . Methods : A total of 50 male mice were randomly divided into control group (Con group) , sham group (Sham group) , cerebral ischemia⁃reperfusion injury group (MCAO group) , cerebral ischemia⁃reperfusion injury + D ⁃alolose group (MCAO + D ⁃allose group) and cerebral ischemia⁃reperfusion injury + modified citrus pectin group (MCAO + MCP group) . The middle cerebral artery occlusion/reperfusion (MCAO/R) model (reperfusion after 2 hours of MCA ischemia) was established by thread embolism . After successful modeling , the neurological function of mice was evaluated Longa score and rotated rod walking . TTC staining was used to observe the volume of cerebral infarction foci . The expression levels of Gal⁃3 and autophagy⁃related molecules were detected by Western blot and RT⁃PCR . Immunofluorescence was applied to detect the distribution of Gal⁃3 in brain tissue , and TNF⁃α , IL⁃8 secretion was detected with ELISA KIT . Results : Compared with Con group and Sham group , the MCAO model represented significant increase in the Longa neurofunction score (P < 0. 01) , cerebral infarction volume ( P < 0. 01) , Gal⁃3 expression and manifasted enhanced autophagy (P < 0. 01) . After treatment with D ⁃allose , it could significantly improve neurological dysfunction , reduce cerebral infarction volume (P < 0. 01) , reduce the expression of Gal⁃3 ( P < 0. 01) , inhibit AMPK phosphorylation , promote mTOR phosphorylation , and inhibit autophagy (P < 0. 01) . The use of the Gal⁃3 inhibitor MCP alone could also achieve the effect of inhibiting autophagy . Conclusion D ⁃allose can effectively promote the recovery of neurological function and reduce the volume of infarct foci in CIRI mice . The mechanism may involve inhibiting excessive cell autophagy by downregulating the expression of Gal⁃3 , and reducing the release of inflammatory factors such as TNF⁃α and IL⁃8 , thereby exerting neuroprotective effects .

Objective To analyze and summarize the experiences in diagnosis and treatment of patients with severe traumatic brain injury (sTBI) so as to increase the cure rate and survival rate. Methods A retrospective study was made on the diagnoses and treatment of 4 462 cases of sTBI inclu-ding 3 298 males (73.9%) and 1 164 females (26.1%). The most frequent cause for injury was traffic accident, accounting for 35.5% (1 583/4 462). Closed bead injury ocurred in 3 654 cases (81.9%) and open head injury in 808 (18.1%). The most commen clinical manifestations included unconscious-ness, changes of pupils and life signs. Of all, 1 158 cases (26.0%) were found with combined injury and 1 356 (30.4%) with complications. Treatment measures included first aid, surgery or conventional treatment. Emphasis was put on the treatment of secondary insults. Results Surgery was performed in 3 023 cases (67.7%) including craniotomy for hematoma clearance in 856 cases and hematoma clearance plus decompression in 2 167, with mortality rate of 17.9%. Conventional treatment was carried out in 1 439 cases (32.3%), with mortality rate of 23.7%. There were 2 462 eases (55.2%) with fair recov-ery, 508 (11.4%) with mild disability, 339 (7.6%) with severe disability, 272 (6.1%) under vege-tative state and 881 (19.7%) deaths on discharge according to the Glasgow Outcome Scale. Conelu-sions Active diagnoses and treatment, strict medication rules and prevention and treatment of secondary insults may be key to higher eure rate as well as lower morbidity and mortality of sTBI.

This study sought to assess the effect of SspA on the formation of Staphylococcus aureus biofilm extending over the surfaces of Cardiovascular Biomaterial Dacron. SspA was extracted from the surface of staphylococcus aureus biofilm, purified, and then used to influence the adhesion of Staphylococcus aureus and the formation of Staphylococcus aureus biofilm on Dacron biomaterial surfaces. The formation of the Staphylococcus aureus biofilm on cardiovascular biomaterial Dacron surfaces under gradient SspA concentrations was evaluated by confocal laser microscopy. The result revealed that SspA inhibited the formation of Staphylococcus aureus biofilms on cardiovascular biomaterials surfaces effectively, and it was dose dependent. This study indicates that SspA is effective for preventing biomaterial centered infection and this method is conducive to clinical applications.
Bacterial Adhesion ; Biocompatible Materials ; chemistry ; Biofilms ; growth & development ; Polyethylene Terephthalates ; Prosthesis-Related Infections ; microbiology ; Serine Endopeptidases ; pharmacology ; Staphylococcus aureus ; pathogenicity ; physiology