BACKGROUND:Due to the complex movement of the scapula,which is a six-degree-of-freedom activity in three-dimensional space,it is difficult to measure it accurately using traditional methods.The image and model matching technology based on dual-plane X-ray is a three-dimensional measurement method that has gradually developed and matured in recent years.Two high-speed cameras are used to project and shoot from orthogonal directions.Compared with a single perspective,this method has advantages in observation range and reduction of out-of-plane errors,and is suitable for the study of scapula kinematics.OBJECTIVE:X-ray biplane and image-model registration technology were used to explore the differences in scapular kinematics between normal individuals and patients with rotator cuff tears,providing a basis for the treatment and rehabilitation of rotator cuff tear patients.METHODS:From April 2023 to January 2024,10 patients with normal shoulders and 10 patients with rotator cuff tears who met the inclusion criteria were enrolled from Guanghua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine.The subjects underwent a shoulder CT scan to create a 3D model and a local scapular coordinate system.X-ray biplane images were taken during shoulder abduction with two C-arm machines.The 2D and 3D images were registered to compare scapular kinematic differences between the two groups at 0°,15°,30°,45°,60°,75°,and 90° of abduction,including scapular rotation angle and displacement distance.RESULTS AND CONCLUSION:(1)During shoulder abduction,the scapula of both groups showed upward rotation,but the upward rotation of the rotator cuff tear group was greater than that of the control group,and the difference was significant when the abduction was 30°-90°(P＜0.01).At the same time,the scapula internal rotation of both groups gradually increased,but the rotator cuff tear group was significantly greater than the control group when the abduction was 45°-90°(P＜0.01).In addition,the anteroposterior tilt of the scapula of the two groups was significantly different when the abduction was 15°-90°(P＜0.01).The scapula posterior tilt of the control group gradually increased during abduction,while the scapula of the rotator cuff tear group tilted forward except for a slight posterior tilt at 15°-30° abduction.(2)In terms of displacement,the upward displacement of the rotator cuff tear group was less than that of the control group during abduction,and the difference was significant at 15°-90°(P＜0.05),but there was no significant difference in lateral and anterior-posterior displacement between the two groups(P＞0.05).(3)Rotator cuff tear can cause scapular dyskinesis,characterized by increased upward rotation,internal rotation,and abnormal forward tilt during shoulder abduction.Identifying and addressing scapular dyskinesis is crucial for treating rotator cuff tear.

BACKGROUND:Due to the complex movement of the scapula,which is a six-degree-of-freedom activity in three-dimensional space,it is difficult to measure it accurately using traditional methods.The image and model matching technology based on dual-plane X-ray is a three-dimensional measurement method that has gradually developed and matured in recent years.Two high-speed cameras are used to project and shoot from orthogonal directions.Compared with a single perspective,this method has advantages in observation range and reduction of out-of-plane errors,and is suitable for the study of scapula kinematics.OBJECTIVE:X-ray biplane and image-model registration technology were used to explore the differences in scapular kinematics between normal individuals and patients with rotator cuff tears,providing a basis for the treatment and rehabilitation of rotator cuff tear patients.METHODS:From April 2023 to January 2024,10 patients with normal shoulders and 10 patients with rotator cuff tears who met the inclusion criteria were enrolled from Guanghua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine.The subjects underwent a shoulder CT scan to create a 3D model and a local scapular coordinate system.X-ray biplane images were taken during shoulder abduction with two C-arm machines.The 2D and 3D images were registered to compare scapular kinematic differences between the two groups at 0°,15°,30°,45°,60°,75°,and 90° of abduction,including scapular rotation angle and displacement distance.RESULTS AND CONCLUSION:(1)During shoulder abduction,the scapula of both groups showed upward rotation,but the upward rotation of the rotator cuff tear group was greater than that of the control group,and the difference was significant when the abduction was 30°-90°(P＜0.01).At the same time,the scapula internal rotation of both groups gradually increased,but the rotator cuff tear group was significantly greater than the control group when the abduction was 45°-90°(P＜0.01).In addition,the anteroposterior tilt of the scapula of the two groups was significantly different when the abduction was 15°-90°(P＜0.01).The scapula posterior tilt of the control group gradually increased during abduction,while the scapula of the rotator cuff tear group tilted forward except for a slight posterior tilt at 15°-30° abduction.(2)In terms of displacement,the upward displacement of the rotator cuff tear group was less than that of the control group during abduction,and the difference was significant at 15°-90°(P＜0.05),but there was no significant difference in lateral and anterior-posterior displacement between the two groups(P＞0.05).(3)Rotator cuff tear can cause scapular dyskinesis,characterized by increased upward rotation,internal rotation,and abnormal forward tilt during shoulder abduction.Identifying and addressing scapular dyskinesis is crucial for treating rotator cuff tear.

Objective:To analyze the clinical characteristics of infective endocarditis（IE）in children without congenital heart disease（CHD）.Methods:The clinical data of 51 children with IE admitted to the Department of Pediatrics at the First Affiliated Hospital of Zhengzhou University from February 2014 to February 2024 were retrospectively analyzed.According to whether they had CHD，they were divided into non-CHD group（12 cases）and CHD group（39 cases）.The clinical manifestations，laboratory tests，etiology results，efficacy and prognosis of the non-CHD group were analyzed.Results:The proportion of skin pustule found in non-CHD group (2/12) was significantly higher than that in CHD group(0/39)( P=0.041).Compared with CHD group, the common pathogen in non-CHD group was Staphylococcus aureus( P=0.002).There were no statistically significant differences in age, gender, symptoms, laboratory tests, ultrasound detection rate and distribution of vegetations, positive rate of blood culture, course of anti infection treatment, and mortality rate between the two groups. Conclusion:For children with IE who do not houre underlying CHD,skin pustule is an important indicator, and Staphylococcus aureus is the most common pathogen. The use of broad-spectrum antibiotics as early empirical anti infective agents is key to improve prognosis.

Objective:To analyze the clinical characteristics of infective endocarditis（IE）in children without congenital heart disease（CHD）.Methods:The clinical data of 51 children with IE admitted to the Department of Pediatrics at the First Affiliated Hospital of Zhengzhou University from February 2014 to February 2024 were retrospectively analyzed.According to whether they had CHD，they were divided into non-CHD group（12 cases）and CHD group（39 cases）.The clinical manifestations，laboratory tests，etiology results，efficacy and prognosis of the non-CHD group were analyzed.Results:The proportion of skin pustule found in non-CHD group (2/12) was significantly higher than that in CHD group(0/39)( P=0.041).Compared with CHD group, the common pathogen in non-CHD group was Staphylococcus aureus( P=0.002).There were no statistically significant differences in age, gender, symptoms, laboratory tests, ultrasound detection rate and distribution of vegetations, positive rate of blood culture, course of anti infection treatment, and mortality rate between the two groups. Conclusion:For children with IE who do not houre underlying CHD,skin pustule is an important indicator, and Staphylococcus aureus is the most common pathogen. The use of broad-spectrum antibiotics as early empirical anti infective agents is key to improve prognosis.

Chloromethyl ether and diclomethyl ether are statutory substances that cause occupational lung cancer. From 2021 to 2022, the Department of Occupational Diseases of the Eighth People's Hospital of Hebei Province successively received 4 cases of lung cancer from a chemical company that required occupational disease diagnosis. All four patients had a clear occupational history of chloromethyl ether and diclomethyl ether for more than 1 year, diagnosis of primary small cell lung cancer supported by relevant histopathology, immunohistochemistry, and tumor markers. All the 4 patients were diagnosed as occupational lung cancer (chloromethyl ether, diclomethyl ether) .

Febrile infection-related epilepsy syndrome (FIRES) is primarily characterized by frequent focal epileptic seizures followed by generalized seizures and status epilepticus.Multiple anti-seizure drugs are ineffective in its treatment, and there′s a high mortality rate during the acute phase.Survivors often suffer from drug-resistant epilepsy and neurological dysfunctions.Anakinra is an interleukin-1 receptor antagonist.Recent studies have shown that it has potential therapeutic effects on FIRES.This article analyzes the mechanism, efficacy, safety, and future challenges of Anakinra in the treatment of FIRES, aiming to provide a basis for its application in FIRES.

Objective:To explore the clinical characteristics and genetic etiology for a Chinese pedigree affected with Dyschromatosis symmetrica hereditaria (DSH) in conjunct with developmental delay.Methods:A child who had presented at the First Affiliated Hospital of Zhengzhou University on May 28 2021 for abnormal skin pigmentation of the extremities and growth retardation for over 2 years was selected as the study subject. Clinical data of the child and his pedigree (11 individuals from three generations) was collected. The child was subjected to whole exome sequencing, and candidate variant was verified by Sanger sequencing.Results:The child, a two-year-and-seven-month-old male, had hyper- and hypopigmentation on his hands, feet and face, in addition with delayed development. All members of his pedigree had typical presentation of DSH. A heterozygous c. 2657G>A variant was found in exon 8 of the ADAR gene in the child, his mother, and elder sister. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), the variant was predicted as likely pathogenic (PM1+ PM2_Supporting+ PP1+ PP3). Conclusion:The c. 2657G>A variant of the ADAR gene probably underlay the DSH in this pedigree.

Chloromethyl ether and diclomethyl ether are statutory substances that cause occupational lung cancer. From 2021 to 2022, the Department of Occupational Diseases of the Eighth People's Hospital of Hebei Province successively received 4 cases of lung cancer from a chemical company that required occupational disease diagnosis. All four patients had a clear occupational history of chloromethyl ether and diclomethyl ether for more than 1 year, diagnosis of primary small cell lung cancer supported by relevant histopathology, immunohistochemistry, and tumor markers. All the 4 patients were diagnosed as occupational lung cancer (chloromethyl ether, diclomethyl ether) .

Objective:To validate and compare the value of the Status Epilepticus in Pediatric Severity Score (STEPSS) versus PEDSS in assessing the short-term prognosis of children with status epilepticus (SE).Methods:Clinical data of 152 children with SE hospitalized at the First Affiliated Hospital of Zhengzhou University from January 2020 to December 2022 were retrospectively analyzed.According to the STEPSS and PEDSS scores, children with SE were scored and their prognosis was predicted.Receiver operating characteristic (ROC) curves of the 2 scales in assessing the short-term prognosis of SE in children were plotted, and the area under the curve (AUC), optimal cut-off, sensitivity and specificity were calculated, thus validating and comparing the value of the STEPSS versus PEDSS in assessing the short-term prognosis of children with SE.Results:Of the 152 children with SE, 90 were male and 62 were female, with the age of (5.8±3.9) years (1 month to 15 years). There were 112 cases with good prognosis and 40 cases with poor prognosis, involving 13 deaths.The AUC of STEPSS and PEDSS scores in predicting the death in children with SE were 0.908(95% CI: 0.848-0.967) and 0.887(95% CI: 0.831-0.942), respectively, both with the optimal cut-off value of 4.The sensitivity of STEPSS and PEDSS scores in predicting the death in children with SE were 0.740 and 0.846, respectively, and the specificity were 0.745 and 0.835, respectively.There was no significant difference in predicting the death in children with SE between the 2 scales ( P>0.05). In predicting adverse outcomes, the AUC of the STEPSS and PEDSS scores were 0.869(95% CI: 0.800-0.937) and 0.926(95% CI: 0.873-0.979), respectively, both with the optimal cut-off value of 3.The sensitivity of STEPSS and PEDSS scores in predicting adverse outcomes in children with SE were 0.827 and 0.900, respectively, and the specificity were 0.732 and 0.866, respectively.There was significant difference in predicting the adverse outcomes in children with SE between the 2 scales ( P<0.05). Conclusions:Compared with the STEPSS, the PEDSS has a higher application in predicting the short-term treatment outcome of children with SE, which can be used as a routine method to assess the prognosis of children with SE.

As a promising method in artificial intelligence, deep learning has been proven successful in several domains ranging from acoustics and images to natural language processing. With medical imaging becoming an important part of disease screening and diagnosis, deep learning-based approaches have emerged as powerful techniques in medical image areas. In this process, feature representations are learned directly and automatically from data, leading to remarkable breakthroughs in the medical field. Deep learning has been widely applied in medical imaging for improved image analysis. This paper reviews the major deep learning techniques in this time of rapid evolution and summarizes some of its key contributions and state-of-the-art outcomes. The topics include classification, detection, and segmentation tasks on medical image analysis with respect to pulmonary medical images, datasets, and benchmarks. A comprehensive overview of these methods implemented on various lung diseases consisting of pulmonary nodule diseases, pulmonary embolism, pneumonia, and interstitial lung disease is also provided. Lastly, the application of deep learning techniques to the medical image and an analysis of their future challenges and potential directions are discussed.