OBJECTIVES: To construct an intelligent analysis model for classifying fetal orientation during intrapartum ultrasound videos based on multi-feature fusion. METHODS: The proposed model consists of the Input, Backbone Network and Classification Head modules. The Input module carries out data augmentation to improve the sample quality and generalization ability of the model. The Backbone Network was responsible for feature extraction based on Yolov8 combined with CBAM, ECA, PSA attention mechanism and AIFI feature interaction module. The Classification Head consists of a convolutional layer and a softmax function to output the final probability value of each class. The images of the key structures (the eyes, face, head, thalamus, and spine) were annotated with frames by physicians for model training to improve the classification accuracy of the anterior occipital, posterior occipital, and transverse occipital orientations. RESULTS: The experimental results showed that the proposed model had excellent performance in the tire orientation classification task with the classification accuracy reaching 0.984, an area under the PR curve (average accuracy) of 0.993, and area under the ROC curve of 0.984, and a kappa consistency test score of 0.974. The prediction results by the deep learning model were highly consistent with the actual classification results. CONCLUSIONS The multi-feature fusion model proposed in this study can efficiently and accurately classify fetal orientation in intrapartum ultrasound videos.
Humans ; Female ; Ultrasonography, Prenatal/methods* ; Pregnancy ; Fetus/diagnostic imaging* ; Neural Networks, Computer ; Video Recording

Microsurgery is a surgical technique that applies fine instruments to perform precise operations on tiny tissues and organs under optical magnification devices. Digital and intelligent technologies, such as digital imaging, virtual reality (VR), augmented reality (AR), mixed reality (MR), 3D design and reconstruction, 3D printing, digital navigation, mixed perception of multi-source heterogeneous information, automatic control, digital twins, Internet of Things, cloud computing, machine learning, deep learning, large-scale AI models, generative artificial intelligence and so on, have been enabling the innovative development in microsurgery. It will make significant changes in disease diagnosis and monitoring, treatment decision-making and surgical planning, precise and individualised surgery, doctor-patient interaction and healthcare, team collaboration and professional education, and will drive the innovative development in microsurgery.

Standardised emergency management protocols for hand injury in microsurgery is critical, as it directly determines ultimate clinical outcomes. This consensus consolidates expert insights regarding diagnostic and treatment procedure for hand injury in microsurgery, emergency support protocols and key points of emergency workflow optimisation. It summarises the opinions of experts and puts forward standardised recommendations to guide clinical practice in microsurgical treatment process, so as to further improve the quality of treatment for hand injury in microsurgery and maximise the protection of limb function and quality of life of patients.

BACKGROUND:Titanium alloys lack biological activity when used as orthopedic implants,which can lead to implant loosening and periprosthetic infection.Therefore,it is of great significance to study a titanium alloy surface modification method that combines osteogenic and anti-infection functions.OBJECTIVE:To study the physical and chemical properties of titanium alloy modified with copper and strontium binary doped calcium silicate composite coating,and to evaluate its bone-promoting and antibacterial potential.METHODS:Ball milling and granulation methods were used to prepare composite powder containing copper oxide(CuO),strontium oxide(SrO),and calcium silicate(CS).A copper-strontium binary doped calcium silicate composite coating was prepared on the surface of titanium alloy(Ti6Al4V)through atmospheric plasma spraying technology.The composite coating was characterized.The titanium alloy extract,calcium silicate coating modified titanium alloy extract,copper-doped calcium silicate composite coating modified titanium alloy extract,and copper-strontium binary doped calcium silicate composite coating modified titanium alloy extract were co-cultured with MC3T3-E1 cells to detect the biosafety and osteogenic properties of the materials.Staphylococcus aureus(or Escherichia coli)were co-cultured with titanium alloy,calcium silicate coating modified titanium alloy,copper-doped calcium silicate composite coating modified titanium alloy,and copper-strontium binary doped calcium silicate composite coating modified titanium alloy.The in vitro antibacterial properties of the materials were detected by scanning electron microscopy and plate counting method.RESULTS AND CONCLUSION:(1)Scanning electron microscopy showed that a large number of nanostructures existed on the rough surface of the copper-strontium binary doped calcium silicate composite coating.The composite coating was successfully sprayed on the surface of titanium alloy.The composite coating could slowly release Sr2+and Cu2+in vitro.The release concentration of Sr2+was greater than that of Cu2+.(2)CCK-8 assay and cell live/dead staining results showed that the copper-doped calcium silicate composite coating modified titanium alloy had certain cytotoxicity.The calcium silicate coating and the copper-strontium binary doped calcium silicate composite coating modified titanium alloy had good biocompatibility.Alkaline phosphatase and alizarin red staining results showed that compared with titanium alloy and calcium silicate coating modified titanium alloy,copper strontium binary doped calcium silicate composite coating modified titanium alloy showed better osteogenic properties.(3)The results of scanning electron microscopy,bacterial coating,and bacterial counting method showed that compared with titanium alloy and calcium silicate coating modified titanium alloy,copper-doped calcium silicate composite coating and copper strontium binary doped calcium silicate composite coating modified titanium alloy can effectively inhibit the growth of Staphylococcus aureus and Escherichia coli,showing antibacterial potential.(4)The results indicate that copper strontium binary doped calcium silicate composite coating modified titanium sheet has good biocompatibility,osteogenic and antibacterial properties.

BACKGROUND:Titanium alloys lack biological activity when used as orthopedic implants,which can lead to implant loosening and periprosthetic infection.Therefore,it is of great significance to study a titanium alloy surface modification method that combines osteogenic and anti-infection functions.OBJECTIVE:To study the physical and chemical properties of titanium alloy modified with copper and strontium binary doped calcium silicate composite coating,and to evaluate its bone-promoting and antibacterial potential.METHODS:Ball milling and granulation methods were used to prepare composite powder containing copper oxide(CuO),strontium oxide(SrO),and calcium silicate(CS).A copper-strontium binary doped calcium silicate composite coating was prepared on the surface of titanium alloy(Ti6Al4V)through atmospheric plasma spraying technology.The composite coating was characterized.The titanium alloy extract,calcium silicate coating modified titanium alloy extract,copper-doped calcium silicate composite coating modified titanium alloy extract,and copper-strontium binary doped calcium silicate composite coating modified titanium alloy extract were co-cultured with MC3T3-E1 cells to detect the biosafety and osteogenic properties of the materials.Staphylococcus aureus(or Escherichia coli)were co-cultured with titanium alloy,calcium silicate coating modified titanium alloy,copper-doped calcium silicate composite coating modified titanium alloy,and copper-strontium binary doped calcium silicate composite coating modified titanium alloy.The in vitro antibacterial properties of the materials were detected by scanning electron microscopy and plate counting method.RESULTS AND CONCLUSION:(1)Scanning electron microscopy showed that a large number of nanostructures existed on the rough surface of the copper-strontium binary doped calcium silicate composite coating.The composite coating was successfully sprayed on the surface of titanium alloy.The composite coating could slowly release Sr2+and Cu2+in vitro.The release concentration of Sr2+was greater than that of Cu2+.(2)CCK-8 assay and cell live/dead staining results showed that the copper-doped calcium silicate composite coating modified titanium alloy had certain cytotoxicity.The calcium silicate coating and the copper-strontium binary doped calcium silicate composite coating modified titanium alloy had good biocompatibility.Alkaline phosphatase and alizarin red staining results showed that compared with titanium alloy and calcium silicate coating modified titanium alloy,copper strontium binary doped calcium silicate composite coating modified titanium alloy showed better osteogenic properties.(3)The results of scanning electron microscopy,bacterial coating,and bacterial counting method showed that compared with titanium alloy and calcium silicate coating modified titanium alloy,copper-doped calcium silicate composite coating and copper strontium binary doped calcium silicate composite coating modified titanium alloy can effectively inhibit the growth of Staphylococcus aureus and Escherichia coli,showing antibacterial potential.(4)The results indicate that copper strontium binary doped calcium silicate composite coating modified titanium sheet has good biocompatibility,osteogenic and antibacterial properties.

Microsurgery is a surgical technique that applies fine instruments to perform precise operations on tiny tissues and organs under optical magnification devices. Digital and intelligent technologies, such as digital imaging, virtual reality (VR), augmented reality (AR), mixed reality (MR), 3D design and reconstruction, 3D printing, digital navigation, mixed perception of multi-source heterogeneous information, automatic control, digital twins, Internet of Things, cloud computing, machine learning, deep learning, large-scale AI models, generative artificial intelligence and so on, have been enabling the innovative development in microsurgery. It will make significant changes in disease diagnosis and monitoring, treatment decision-making and surgical planning, precise and individualised surgery, doctor-patient interaction and healthcare, team collaboration and professional education, and will drive the innovative development in microsurgery.

Standardised emergency management protocols for hand injury in microsurgery is critical, as it directly determines ultimate clinical outcomes. This consensus consolidates expert insights regarding diagnostic and treatment procedure for hand injury in microsurgery, emergency support protocols and key points of emergency workflow optimisation. It summarises the opinions of experts and puts forward standardised recommendations to guide clinical practice in microsurgical treatment process, so as to further improve the quality of treatment for hand injury in microsurgery and maximise the protection of limb function and quality of life of patients.

The polyfoliate perforator flap is a new type of flap that was developed on the basis of the traditional polyfoliate myocutaneous flap, polyfoliate fascial flap and perforator flap. It overturns the traditional idea that the deep fascial vascular network is the fundamental for a survival of the flap, and enables the flaps to achieve the best profile and function of the recipient areas with minimal damage to the donor area. In order to improve the understanding of the polyfoliate perforator flap and further standardise its clinical application, this paper forms a consensus on the definition, classification, indications, operative points and precautions of the polyfoliate perforator flap, so as to provide references in diagnosis and treatment process and practical application for the surgeons.

OBJECTIVE To analyze and evaluate serious adverse drug reaction(SADR) and drug-drug interactions(DDIs) in the real-world, so as to obtain the clinical evidence of DDIs-related SADR, and to provide a reference for rational clinical use. METHODS The SADR reports reported to the National Adverse Drug Reaction Monitoring Center from January 2011 to December 2020 were collected, and Lexi-Interaction® software in UpToDate was used to analyze ≥2 drugs in SADR to evaluate whether there were potential DDIs. And the possible adverse drug reactions caused by DDIs were statistically analyzed. RESULTS Among the 360 cases of SADR, males were slightly more than females(50.83% vs 49.17%), the mean age was (65.27±14.71) years old, and 56.39% were ≥65 years old. Cardiovascular agents were the most common implicated pharmacological group, and the gastrointestinal system was the most frequently affected system, and aspirin was the most frequently reported drug. Among 150 cases of SADR with at least two suspected drugs, 64 cases had potential DDIs, while 42 cases had clinically significant DDIs, of which only 16 and 2 cases of SADR were caused by actual DDIs in category D and X, respectively. The majority of reports(71.43%) were caused by additive pharmacodynamic interactions. Aspirin was the most common drug in both potential DDIs and actual DDIs, while aspirin and clopidogrel was the most commonly involved drug pair in actual DDIs, with gastrointestinal bleeding being the most common SADR. CONCLUSION Attention should be paid to the influence of drug interactions on SADR, and prescription should be optimized, especially in the elderly population. According to the results of potential DDIs, therapeutic drugs should be rationally selected. Meanwhile, monitoring of cardiovascular drugs and key populations should be strengthened to ensure drug safety.

Microsurgery is not only a technology, but also a science. Microsurgery was enlisted as a tier-three discipline in the Classification of National Clinical Medicine Disciplines (Discipline code 320.2715) in 1992. In the new era, the discipline development of microsurgery should be inherited, innovated, realistic and pragmatic, and it also relies on the other surgical specialties to expand the applications of microsurgery. Microsurgery technology should firmly adhere to its core competitiveness and hold high the banner of microsurgical characteristics by offering the best possible serves to all the clinical surgical disciplines; Pay equal attention to medicine, teaching and scientific researches; Unite, collaborate and strengthen academic exchanges at home and abroad; Focus on talent training (i.e. exports of great country, leading figures, etc.) and support the development of private hospitals specialised in microsurgery. The supportive roles of the Chinese Journal of Microsurgery shall be further enforced to facilitate the discipline development of microsurgery and promoting high-quality development of microsurgery.