Objective:To explore the teaching effect of combining diversified teaching modes with individualized teaching methods in musculoskeletal ultrasound training classes compared with traditional teaching modes.Methods:The 109 trainees participated in the muscle and bone ultrasound training classes from June 2020 to June 2022 were included as the research subjects and divided into the observation group ( n=53) and control group ( n=56). The control group received traditional teaching modes, while the observation group received diversified teaching modes in combination with individualized teaching methods. The differences in teaching satisfaction and final exam scores between the two groups were compared after training. Statistical analysis was conducted using the software SPSS 27.0. Categorical data were presented as cases and percentages, while continuous data were presented as mean±standard deviation. The intergroup differences in continuous variables were compared using the t-test, while the intergroup differences in categorical variables were compared using the chi-square test. Results:There were no significant differences in age, sex, education, and professional title between the control group and the observation group ( P>0.05). The comprehensive satisfaction score of ultrasound teaching was (88.08±6.65) in the observation group and (80.71±8.59) in the control group, with a significant difference between the two groups ( χ2=5.02, P<0.01). Before training, the test scores of the control group and the observation group were (62.61±5.39) and (63.87±7.77), respectively, and there was no significant difference between the two groups ( t=0.98, P=0.330). The final scores, theoretical exam, computer operation, and video reading exam scores of the control group were (84.07±1.49), (82.39±1.97), (85.13±2.55), and (86.79±6.06), respectively, while those of the observation group were (90.06±2.17), (88.28±3.19), (88.92±3.23), and (96.23±5.96); there were significant differences between the two groups in these four indicators ( t=16.75, 11.53, 6.79, and 8.20, respectively; P<0.01). The scores were compared for the two groups of trainees classified based on their unit level, professional title, and educational background. Trainees with the same unit level, professional title, and educational background showed no significant differences in test scores between the two groups, though their final scores were significantly different ( P<0.01). Conclusions:The combination of diversified teaching modes and individualized teaching methods can increase the learning enthusiasm of trainees, improve the teaching effect of training classes, and increase the satisfaction of trainees.

Objective:To explore the relationship between neck muscle strength and elastic strain of flying personnel by comparing the changes of neck muscle elastic strain values and neck muscle strength before and after neck muscle training in flying personnel with neck pain.Methods:By using CME-1 neck muscle strength trainer, 56 flying personnel were trained under isometric and changeable velocity and resistant (CVR) training mode for 2 weeks. The neck muscle strength and neck muscle elastic strain values before and after training were compared.Results:The elastic strain values of longus colli, splenius capitis and levator scapula were significantly increased by neck muscle training ( t=4.154, 2.348, 2.745, P<0.001, P=0.040, 0.006). The relative growth rate of the average elastic strain values of longus colli, splenius capitis and levator scapula after training was 13.75%, 4.18% and 2.8%, respectively. After neck muscle training, the average maximum neck muscle strength and average 10 s maximum impulse in the directions of forward flexion, backward extension, left flexion and right flexion were higher than those before training, and the difference was statistically significant ( t=3.364-8.284, all P<0.01); The relative growth rate of the average maximum neck muscle strength in each direction was 39.3%, 34.6%, 35.2% and 28.4%, respectively, and the relative growth rate of the average 10 s maximum impulse was 51.4%, 33.6%, 42.7% and 34.5%, respectively. The elastic strain values of levator scapula and longus colli were negatively correlated with the average maximum muscle strength of anterior flexor ( r=-0.281, -0.387, P=0.036, 0.004). Conclusions:Neck muscle training can effectively improve the strength of neck muscle groups and the elastic strain of some muscle groups. The elastic strain values of levator scapula and longus colli are negatively correlated with the average maximum muscle strength of anterior flexor, those suggesting that neck muscle training has a certain effect on enhancing the activity of anterior flexor muscle groups and maintaining the physiological lordosis of cervical spine.

Objective:To explore the relationship between neck muscle strength and elastic strain of flying personnel by comparing the changes of neck muscle elastic strain values and neck muscle strength before and after neck muscle training in flying personnel with neck pain.Methods:By using CME-1 neck muscle strength trainer, 56 flying personnel were trained under isometric and changeable velocity and resistant (CVR) training mode for 2 weeks. The neck muscle strength and neck muscle elastic strain values before and after training were compared.Results:The elastic strain values of longus colli, splenius capitis and levator scapula were significantly increased by neck muscle training ( t=4.154, 2.348, 2.745, P<0.001, P=0.040, 0.006). The relative growth rate of the average elastic strain values of longus colli, splenius capitis and levator scapula after training was 13.75%, 4.18% and 2.8%, respectively. After neck muscle training, the average maximum neck muscle strength and average 10 s maximum impulse in the directions of forward flexion, backward extension, left flexion and right flexion were higher than those before training, and the difference was statistically significant ( t=3.364-8.284, all P<0.01); The relative growth rate of the average maximum neck muscle strength in each direction was 39.3%, 34.6%, 35.2% and 28.4%, respectively, and the relative growth rate of the average 10 s maximum impulse was 51.4%, 33.6%, 42.7% and 34.5%, respectively. The elastic strain values of levator scapula and longus colli were negatively correlated with the average maximum muscle strength of anterior flexor ( r=-0.281, -0.387, P=0.036, 0.004). Conclusions:Neck muscle training can effectively improve the strength of neck muscle groups and the elastic strain of some muscle groups. The elastic strain values of levator scapula and longus colli are negatively correlated with the average maximum muscle strength of anterior flexor, those suggesting that neck muscle training has a certain effect on enhancing the activity of anterior flexor muscle groups and maintaining the physiological lordosis of cervical spine.

Objective To explore the effect of single level lumbar disc herniation on the morphology and diameter of sciatic nerve,and to identify the correlation between the diameter change in sciatic nerve and severity of clinical symptoms,as well as the prognosis of surgical treatment in patients with lumbar disc herniation.Methods From January 1,2017 to December 31,2017,Seventy lumbar disc herniation (LDH) patients who underwent single-level posterior lumbar spine surgery were recruited in this retrospective analysis study.Specific data including age,gender,the level of a disc herniation,the type of disc herniation,symptomatic side,surgical procedure were recorded respectively.In addition the morphological changes and the diameter of bilateral sciatic nerve were recorded preoperatively and postoperatively by B-mode ultrasound.Furthermore,the pain in patients and neurological function were evaluated by visual analogue scale (VAS,back pain and leg pain),Japanese orthopaedic association scores-lumbar (JOA) and Oswestry disability index (ODI).The correlation between the diameter of sciatic nerve and clinical features,as well as clinical prognosis of patients were identified in the present study.Results For patients with acute lumbar disc herniation,the diameter of sciatic nerve in affected side was 5.19±1.03 ram,which is significantly higher than that in the unaffected side (4.57±0.64 mm,t=6.735,P=0.000).In addition,preoperative ratio of the affected side to the healthy side of the sciatic nerve showed strong correlation with the VAS of leg pain (r=0.838,P=0.001),JOA (r=-0.857,P=0.001),and ODI score(r=0.881,P=0.000),but not with the VAS of back pain (r=-0.061,P=0.614).Three months after surgery,the diameter of sciatic nerve in the affected side decreased to 4.58±0.63 mm (t=6.865,P=0.000),while the unaffected side showed no significant change(t=0.300,P=0.765).Clinical improvement was observed in all the patients postoperatively.The changes in the diameter of sciatic nerve postoperatively in affected side showed strong correlation to the rate of improvement in VAS of leg (r=0.624,P=0.003),JOA(r=0.615,P=0.003) and ODI scores (r=0.722,P=0.002),but not to the rate of improvement in VAS of back (r=-0.025,P=0.836).Conclusion Single root compression in patients with single level disc herniation might cause morphological changes such as thickening and edema in sciatic nerve,which were closely related to the severity of clinical symptoms and the prognosis of surgical treatment.

Objective To evaluate the diagnostic value of gray-scale ultrasound combined with contrast-enhanced ultrasound (CEUS) in thyroid imaging and reporting system ( TI-RADS) 3-5 nodules of American College of Radiology ( ACR) . Methods The 208 patients( 216 nodules) who underwent thyroid contrast-enhanced ultrasound examination from April 2014 to December 2016 were retrospectively analyzed . The ACR TI-RADS classification and contrast-enhanced mode of thyroid ultrasound were evaluated . The benign and malignant thyroid lesions were constructed through the analysis of contrast-enhanced mode of thyroid benign and malignant lesions in the past literature and the preliminary study of our group . Prediction model of gray scale combined with contrast-enhanced ultrasound for lesions were established . Besides ,the sensitivity ,specificity and accuracy of gray scale ultrasound combined with contrast-enhanced ultrasound prediction model for differential diagnosis of benign and malignant thyroid lesions were calculated based on the results of puncture biopsy or surgical pathology as the gold standard . Results Compared with pathological results , the positive predictive value , negative predictive value , accuracy , sensitivity and specificity of gray scale combined with contrast-enhanced ultrasound in evaluating thyroid nodules were 90 .8％ ,93 .3％ ,91 .2％ ,98 .8％ and 62 .2％ ,respectively . Conclusions Gray-scale ultrasound combined with contrast-enhanced ultrasound can provide clinical value in differential diagnosis of benign and malignant TI-RADS 3-5 thyroid nodules .

Objective To explore the effects of manumycin on U937 cells and its mechanisms.Methods Apoptosis was detected by flow cytometry using annexin V and propidium iodide (PI) after treatment with manumycin (2 μmol/L) for different time.The reactive oxygen species (ROS) was detected by flow cytometry using Reactive Oxygen Species Assay Kit.The expressions of PI3K,P-Akt and Akt were detected by Western blotting.Results Compared with the 0 h treatment,manumycin treatment resulted in apoptosis (P ＜ 0.05) and ROS generation (P ＜ 0.05) gradually in U937 cell lines.Furthermore,manumycin also inhibited the activation of phosphatidylinositol-3 kinase (PI3K)/Akt pathway.Moreover,NAC could decrease manumycin-induced ROS generation and inhibit the effects of manumycin on the PI3K/Akt pathway and protect U937 cells from apoptosis induced by manumycin.Conclusion Manumycin induces apoptosis in U937 human leukemia cells through the regulation of the PI3K/Akt pathway and ROS production plays a critical role in the progress.

AIM:Increasing evidence indicates that inflammation contributes to the initiation and perpetuation of atrial fibrillation ( AF) .Al-though tumor necrosis factor ( TNF)-αlevels are increased in patients with AF , the role of TNF-αin the pathogenesis of AF remains unclear.Recent research has revealed that T-type Ca2+currents ( ICa,T ) play an important role in the pathogenesis of AF .METH-ODS:In this study , we used the whole-cell voltage-clamp technique and biochemical assays to explore the role of TNF-αin the regula-tion of ICa,T in atrial myocytes.RESULTS:We found that compared with sinus rhythm (SR) controls, T-type calcium channel (TCC) subunit mRNA levels were decreased , while TNF-αexpression levels were increased , in human atrial tissue from patients with AF .In murine atrial myocyte HL-1 cells, after cultured for 24 h, 12.5, 25 and 50 μg/L TNF-αsignificantly reduced the protein expression levels of the TCC α1G subunit in a concentration-dependent manner .The peak current was reduced by the application of 12.5 or 25μg/L TNF-αin a concentration-dependent manner [from ( -15.08 ±1.11) pA/pF in controls to ( -11.89 ±0.83) pA/pF and (-8.54 ±1.55) pA/pF in 12.5 and 25 μg/L TNF-αgroups, respectively].TNF-αapplication also inhibited voltage-dependent inactivation of ICa,T shifted the inactivation curve to the left .CONCLUSION:These results suggest that TNF-αis involved in the path-ogenesis of AF, probably via decreasing ICa,T function in atrium-derived myocytes through impaired channel function and down -regula-tion of channel protein expression .This pathway thus represents a potential pathogenic mechanism in AF .

AIM:To investigate whether the association of connexin 43 ( Cx43 ) and L-type calcium channel involved in the pathogenesis of atrial fibrillation ( AF) .METHODS:The biochemical assays and whole-cell patch-clamp technique were used to study the expression of Cx43 in human atrial tissue.The co-localization of Cx43 and L-type calcium channel, and the regulation of L-type calcium current in atrial myocytes were investigated.RESULTS:The expression of Cx43 at mRNA and protein levels was decreased in human atrial tissues of AF patients.In cultured atrium-derived myocytes ( HL-1 cells) , knockdown of Cx43 significantly inhibited the mRNA expression of L-type calcium channelα1c subunit, as well as L-type calcium current.Co-localization of Cx43 with L-type calcium channel α1c subunit in mouse atrial myocytes was observed.CONCLUSION:The decrease in Cx43 is involved in the pathogenesis of AF, probably through reducing the L-type calcium current in atrial myoctyes by co-localization with L-type calcium channel, thus representing the potential pathogenesis in atrial fibrillation.

Objective To investigate the clinical value of the echocardiography in the diagnosis of congenital mitral valve malformation and summarize its occurrence and type associated with other cardiac malformations.Methods The echocardiographic image data of 101 patients with congenital mitral valve malformation were retrospectively analyzed,the characteristics of different types were summarized and compared with operation results,CT,cardiac catheterization,transesophageal echocardiography,as well as the data of echocardiographic follow-up.Results Among 101 patients with echocardiographic examination showed mitral valve congenital malformation,63 cases were isolated valve set malformation (62.4％),and multiple valve set malformation were found in 38 cases (32.7％).In another side,39 cases were of single mitral valve malformation (38.6％),while 62 patients combined with other type cardiac malformations (61.4％).No significant difference of dynamic change was shown between patients with solitary and multiple malformation of mitral valve (P ＞0.05).Conclusions Echocardiography can display congenital mitral valve malformation in a fast,robust,real-time way.It has an important clinical value in the diagnosis of congenital mitral valve malformation.

Objective To evaluate the application of high-resolution ultrasonography in the diagnosis of nerve root lesion of cervical vertebra intervertebral foramen part. Methods Twenty-seven patients with root avulsion injury of brachial plexus intervertebral part and 8 patients with schwannoma of brachial plexus root were examined with high-resolution ultrasonography. Thirty healthy volunteers were involved for the sonographic imagings of normal brachial plexus intervertebral part. The ultrasound findings of the patients before operation were compared with surgical outcomes. Results The normal intervertebral part of brachial plexus were shown as hypoechoic tubular strucuture, which could be identified with cervical artery and transverse process used as landmarks for the intervertebral part of brachial plexus root. The detection ratios of normal intervertebral part for C5-C8 and outside part of braehial plexus were 100％. In 27 patients with root avulsion injury of intervertebral brachial plexus, the intervertebral nerve root were enlarged as hypoechoic area, with nerve dissected partly or disappearing, distal nerve parts outside the intervertebral foramen swelling, edema,or cerebrospinal fluid assembling as cystic masses. In 8 patients with schwannoma of brachial plexus root part, the spinal ganglia outside intervertebral foramen were shown as tumor-like hypoechoic mass, with blood supply shown inside. Conclusions High-resolution ultrasonography is of great value for early and convenient diagnosis of root avulsion injury and mass of brachial plexus intervertebral part, especially in community hospitals,which could provide important information for clinical therapy.