Objective:To explore the clinical efficacy of autologous platelet-rich plasma (PRP) in the treatment of acute injury to the anterior talofibular ligament (ATFL).Methods:A retrospective study was conducted to analyze the data of 96 patients who had been admitted to Department of Orthopedic Trauma Repair, The Nanhua Hospital Affiliated to Hengyang Medical School for acute ATFL injuries of grades Ⅰ & Ⅱ from January 2022 to December 2023. They were divided into 2 groups according to their different treatments. In the PRP group subjected to local PRP injection combined with conservative treatment, there were 49 patients (28 males and 21 females), with an age of (32.5±6.5) years. In the conservative group subjected to traditional conservative treatment, there were 47 patients (24 males and 23 females), with an age of (30.5±5.3) years. The 2 groups were compared in terms of visual analog scale (VAS) pain scores, talar anterior translations, Karlsson scores, American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot scores before and 6 months after treatment.Results:No statistically significant differences were observed in the baseline characteristics between the 2 groups before treatment, indicating comparability ( P>0.05). All patients were followed up for (9.1±1.7) months. In both groups, the VAS pain scores significantly decreased after treatment than the pre-treatment ones, the talar anterior translations significantly reduced after treatment than the pre-treatment ones, and the AOFAS and Karlsson scores significantly increased after treatment than the pre-treatment ones ( P < 0.05). After 6 months of treatment, the talar translation distance [(2.5±0.4) mm], AOFAS ankle hind foot score [(91.7 ± 4.0) points], and Karlsson score [(93.0±3.5) points] in the PRP group were significantly better than those in the conservative group [(6.1±0.9) mm, (87.1±4.3) points, (89.0±4.0) points]( P < 0.05). Conclusion:In the treatment of acute ATFL injury, PRP therapy demonstrates good clinical efficacy, for it can significantly reduce pain, promote functional recovery, and improve joint stability.

Purpose To investigate the predictive value of MRI-based peritumoral edema(PE)of lymph node(LN)metastasis burden in patient with invasive breast cancer.Materials and Methods A total of 213 patients in Sichuan Cancer Hospital with invasive breast cancer confirmed by pathology after surgery were enrolled retrospectively from September 2017 to February 2019.Based on the status and number of LN metastases proved by axillary surgery pathology,all patients were divided into high-burden LN metastasis group(n=47 cases,total number of metastatic LN greater than 2)and low-burden LN metastasis group(n=166 cases,total number of metastatic LN less than or equal to 2).T2WI features,including PE type and PE degree,were analyzed.On DCE-MRI,MRI features of breast cancer were analyzed based on BI-RADS.The predictive value of T2WI features and MRI features for LN metastasis burden was assessed by univariate analysis,and the statistically significant features identified by univariate analysis were further subjected to multivariate Logistic regression analysis to establish a prediction model.The model's performance for LN metastasis burden prediction was evaluated via receiver operating characteristic curve,and the predictive metrics were calculated based on the Youden index.Results The rate of high-burden LN metastasis was 22.1%(47/213).The results of univariate analysis showed that PE degree(OR=18.70,P＜0.001),PE type(OR=16.00,P＜0.001),tumor maximum diameter(OR=1.40,P=0.025),and tumor minimum diameter(OR=2.01,P=0.003)were predictive features for high-burden LN metastasis.The multivariate regression analysis showed that the peritumoral edema features,including PE degree(OR=8.02,P＜0.001)and PE type(OR=5.53,P=0.001)were independent predictive features for high-burden LN metastasis.The area under the curve of the final predictive model was 0.842.The diagnostic sensitivity was 0.766,the specificity was 0.861,the positive predictive value was 0.610,and the negative predictive value was 0.929.Conclusion The PE on preoperative MRI have good predictive performance for LN metastasis burden prediction in patient with invasive breast cancer,particularly for low-burden LN metastasis.

Purpose To investigate the predictive value of MRI-based peritumoral edema(PE)of lymph node(LN)metastasis burden in patient with invasive breast cancer.Materials and Methods A total of 213 patients in Sichuan Cancer Hospital with invasive breast cancer confirmed by pathology after surgery were enrolled retrospectively from September 2017 to February 2019.Based on the status and number of LN metastases proved by axillary surgery pathology,all patients were divided into high-burden LN metastasis group(n=47 cases,total number of metastatic LN greater than 2)and low-burden LN metastasis group(n=166 cases,total number of metastatic LN less than or equal to 2).T2WI features,including PE type and PE degree,were analyzed.On DCE-MRI,MRI features of breast cancer were analyzed based on BI-RADS.The predictive value of T2WI features and MRI features for LN metastasis burden was assessed by univariate analysis,and the statistically significant features identified by univariate analysis were further subjected to multivariate Logistic regression analysis to establish a prediction model.The model's performance for LN metastasis burden prediction was evaluated via receiver operating characteristic curve,and the predictive metrics were calculated based on the Youden index.Results The rate of high-burden LN metastasis was 22.1%(47/213).The results of univariate analysis showed that PE degree(OR=18.70,P＜0.001),PE type(OR=16.00,P＜0.001),tumor maximum diameter(OR=1.40,P=0.025),and tumor minimum diameter(OR=2.01,P=0.003)were predictive features for high-burden LN metastasis.The multivariate regression analysis showed that the peritumoral edema features,including PE degree(OR=8.02,P＜0.001)and PE type(OR=5.53,P=0.001)were independent predictive features for high-burden LN metastasis.The area under the curve of the final predictive model was 0.842.The diagnostic sensitivity was 0.766,the specificity was 0.861,the positive predictive value was 0.610,and the negative predictive value was 0.929.Conclusion The PE on preoperative MRI have good predictive performance for LN metastasis burden prediction in patient with invasive breast cancer,particularly for low-burden LN metastasis.

Objective:To explore the clinical efficacy of autologous platelet-rich plasma (PRP) in the treatment of acute injury to the anterior talofibular ligament (ATFL).Methods:A retrospective study was conducted to analyze the data of 96 patients who had been admitted to Department of Orthopedic Trauma Repair, The Nanhua Hospital Affiliated to Hengyang Medical School for acute ATFL injuries of grades Ⅰ & Ⅱ from January 2022 to December 2023. They were divided into 2 groups according to their different treatments. In the PRP group subjected to local PRP injection combined with conservative treatment, there were 49 patients (28 males and 21 females), with an age of (32.5±6.5) years. In the conservative group subjected to traditional conservative treatment, there were 47 patients (24 males and 23 females), with an age of (30.5±5.3) years. The 2 groups were compared in terms of visual analog scale (VAS) pain scores, talar anterior translations, Karlsson scores, American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot scores before and 6 months after treatment.Results:No statistically significant differences were observed in the baseline characteristics between the 2 groups before treatment, indicating comparability ( P>0.05). All patients were followed up for (9.1±1.7) months. In both groups, the VAS pain scores significantly decreased after treatment than the pre-treatment ones, the talar anterior translations significantly reduced after treatment than the pre-treatment ones, and the AOFAS and Karlsson scores significantly increased after treatment than the pre-treatment ones ( P < 0.05). After 6 months of treatment, the talar translation distance [(2.5±0.4) mm], AOFAS ankle hind foot score [(91.7 ± 4.0) points], and Karlsson score [(93.0±3.5) points] in the PRP group were significantly better than those in the conservative group [(6.1±0.9) mm, (87.1±4.3) points, (89.0±4.0) points]( P < 0.05). Conclusion:In the treatment of acute ATFL injury, PRP therapy demonstrates good clinical efficacy, for it can significantly reduce pain, promote functional recovery, and improve joint stability.

OBJECTIVE To observe the expressions of microribonucleic acid(miR)-155,miR-141,interleukin(IL)-22 and IL-17 in peripheral blood of the chronic renal failure(CRF)and hemodialysis(HD)patients compli-cated with hospital-associated infections and analyze the clinical treatment outcomes.METHODS A total of 561 CRF patients who underwent HD in Wuhan First Hospital from Jun.2022 to Jun.2023 were enrolled in the study and were divided into the infection group with 182 cases and the non-infection group with 379 cases according to the status of hospital-associated infections.The patients of the infection group were divided into the survival group with 138 cases and the death group with 44 cases according to the clinical therapeutic outcomes of a 6-month fol-low-up.The distribution of pathogens isolated from the CRF HD patients with hospital-associated infections was analyzed,the clinical data were compared between the infection group and the non-infection group;the levels of serum miR-155,miR-141,IL-22 and IL-17 were observed and compared among the groups.The values of the se-rologic markers in prediction of the clinical therapeutic outcomes of the CRF HD patients with hospital-associat-ed infections were analyzed by receiver operating characteristic(ROC)curves.RESULTS The proportions of pa-tients with no less than 1 year of hemodialysis,femoral venous catheter indwelling and long-term catheter indwell-ing were higher in the infection group than those in the non-infection group(P＜0.05).Totally 202 strains of pathogens were isolated from the infection group,125(61.88％)of which were gram-negative bacteria.There were significant differences in the levels of serum miR-155,miR-141,IL-22 and IL-17 between the infection group and the no infection group(P＜0.05),the biomarker with the greatest difference value was miR-141(t=37.145,P＜0.001).As compared with the patients with different therapeutic outcomes in the infection group,there were significant differences in the levels of serum miR-155,miR-141,IL-22 and IL-17 between the survival group and the death group(P＜0.05),and the index with the greatest difference value was IL-17(t=35.848,P＜0.001).The values of the four markers in prediction of the therapeutic outcomes of the CRF HD patients compli-cated with hospital-associated infections were analyzed by ROC curves,and the area under the curve(AUC)of the joint detection 0.922 was the highest(P＜0.05).CONCLUSIONS The gram-negative bacteria are dominant among the pathogens isolated from the CRF HD patients complicated with hospital-associated infections.The levels of se-rum miR-155,miR-141,IL-22 and IL-17 are elevated with the incidence of infections and deterioration of progno-sis.The joint detection of the markers has high predictive value.

OBJECTIVE To observe the expressions of microribonucleic acid(miR)-155,miR-141,interleukin(IL)-22 and IL-17 in peripheral blood of the chronic renal failure(CRF)and hemodialysis(HD)patients compli-cated with hospital-associated infections and analyze the clinical treatment outcomes.METHODS A total of 561 CRF patients who underwent HD in Wuhan First Hospital from Jun.2022 to Jun.2023 were enrolled in the study and were divided into the infection group with 182 cases and the non-infection group with 379 cases according to the status of hospital-associated infections.The patients of the infection group were divided into the survival group with 138 cases and the death group with 44 cases according to the clinical therapeutic outcomes of a 6-month fol-low-up.The distribution of pathogens isolated from the CRF HD patients with hospital-associated infections was analyzed,the clinical data were compared between the infection group and the non-infection group;the levels of serum miR-155,miR-141,IL-22 and IL-17 were observed and compared among the groups.The values of the se-rologic markers in prediction of the clinical therapeutic outcomes of the CRF HD patients with hospital-associat-ed infections were analyzed by receiver operating characteristic(ROC)curves.RESULTS The proportions of pa-tients with no less than 1 year of hemodialysis,femoral venous catheter indwelling and long-term catheter indwell-ing were higher in the infection group than those in the non-infection group(P＜0.05).Totally 202 strains of pathogens were isolated from the infection group,125(61.88％)of which were gram-negative bacteria.There were significant differences in the levels of serum miR-155,miR-141,IL-22 and IL-17 between the infection group and the no infection group(P＜0.05),the biomarker with the greatest difference value was miR-141(t=37.145,P＜0.001).As compared with the patients with different therapeutic outcomes in the infection group,there were significant differences in the levels of serum miR-155,miR-141,IL-22 and IL-17 between the survival group and the death group(P＜0.05),and the index with the greatest difference value was IL-17(t=35.848,P＜0.001).The values of the four markers in prediction of the therapeutic outcomes of the CRF HD patients compli-cated with hospital-associated infections were analyzed by ROC curves,and the area under the curve(AUC)of the joint detection 0.922 was the highest(P＜0.05).CONCLUSIONS The gram-negative bacteria are dominant among the pathogens isolated from the CRF HD patients complicated with hospital-associated infections.The levels of se-rum miR-155,miR-141,IL-22 and IL-17 are elevated with the incidence of infections and deterioration of progno-sis.The joint detection of the markers has high predictive value.

A lightweight residual attention enhanced Unet(LRAE-Unet)is designed for the fully automatic brain tumor segmentation.LRAE-Unet uses lightweight residual module to solve the problems of gradient disappearance and network degradation when the network layers increases,lightweight self-attention module to suppress the irrelevant areas and highlight the significant features of specific local areas,and enhanced average pooling module with a larger field of perception to reduce the space of feature map,save computing resources and avoid over-fitting.The experiment on BraTS 2019 dataset shows that the proposed method has a Dice similarity coefficient of 91.24%,88.64%and 88.32%in the segmentations of the whole tumor,tumor core and enhanced tumor,which proves its feasibility and effectiveness for brain tumor segmentation.

Objective By population survey,to explore the epidemiological characteristics of gastric precancerous lesions in Lishui District of Nanjing and provide objective basis for the prevention and treatment of early gastric cancer.Methods From July 2021 to December 2022,21 977 patients who received endoscopy and/or 13C-UBT in Lishui District People's Hospital and 6 medical community units in Nanjing City were retrospectively analyzed for demography characteristics,detection rate of gastric precancerous lesions,and H.Pylori infection rate.Results(1)590 cases of gastric precancerous lesions were detected(detection rate 2.68%);(2)The total detection rate of precancerous lesions and three pathological types in males were all higher than those in females(all P<0.001);(3)The minimum age for the total detection rate of precancerous lesions in males and the mini-mum age for each pathological type were lower than in females(P<0.001,0.009,0.005,0.002);(4)The popu-lation total H.pylori infection rate was 23.10%,the H.pylori infection rate in patients with precancerous lesions was higher than that in non-precancerous lesions(P<0.001),both H.pylori infection rate of male and female in precancerous lesions were all higher than those of non-precancerous lesions of the same sex(all P<0.001),in addition,the H.pylori infection rate of male whether in precancerous or non-precancerous lesions was higher than that of female(all P<0.001);(5)The precancerous lesions detection rate in male,female,and the overall age range of 20～29 to 70～79 years is positively correlated with age growth(P<0.001),and rapidly decreases after the age of 79,the of H.pylori infection rate was also positively correlated with age growth(P<0.001),and the trend of age change(P<0.001)was parallel to the precancerous lesions detection rate.Conclusions The detec-tion rate of gastric precancerous lesions in this region is above the average level in China;the total H.pylori infec-tion rate is at a relatively low level in China;the H.pylori infection rate is parallel to the age trend of the detection rate of gastric precancerous lesions,and increases with age.

Objective:To investigate the clinical outcome of endovascular treatment vs. drug treatment in patients with symptomatic non-acute long-segment occlusion of the internal carotid artery. Methods:Based on prospective cohort registration research data, patients with symptomatic non-acute long-segment occlusion of internal carotid artery were retrospectively included. They were divided into a drug treatment group and an endovascular treatment group according to the actual treatment received. The latter was further divided into a successful recanalization group and an unsuccessful recanalization group. The endpoint events included ipsilateral ischemic stroke, any stroke, and all-cause death. Multivariate logistic regression analysis was used to compare the endpoint events between groups during the perioprocedural period (within 30 days), and multivariate Cox proportional hazards model was use to compare the endpoint events between the groups during the long-term follow-up. Results:A total of 684 patients were included, of which 570 (83.33%) were male, median aged 63 years (interquartile range, 56-70 years). Three hundred and fifty-three patients (51.6%) received drug treatment; 331 (48.4%) received endovascular treatment, of which 161 (48.6%) had successful recanalization. The median follow-up time was 1 223 days (interquartile range, 646.5-2 082 days), with 109 patients (15.9%) experiencing stroke recurrence events (including 87 ipsilateral ischemic stroke) and 78 (11.4%) experiencing all-cause mortality. The risk of any stroke during the perioprocedural period in the successful recanalization group was significantly higher than that in the drug treatment group (odds ratio 3.679, 95% confidence interval 1.038-13.036; P=0.044), but the risk of ipsilateral ischemic stroke recurrence (risk ratio 0.347, 95% confidence interval 0.152-0.791; P=0.012) and all-cause mortality (risk ratio 0.239, 95% confidence interval 0.093-0.618; P=0.003) during the long-term follow-up were significantly lower than those in the drug treatment group. Conclusions:In patients with symptomatic non-acute long-segment occlusion of the internal carotid artery, endovascular treatment can increase the risk of stroke recurrence within 30 days, but successful recanalization can reduce the risks of long-term ipsilateral ischemic stroke recurrence and all-cause mortality.