Objective:To explore advantages of CT and MRI imaging in clinical assessment of specific indicators (trochlear dysplasia and tibial tubercle lateralization) of acute patellar dislocation in adolescents by comparing CT versus MRI imaging.Methods:A retrospective study was conducted to analyze the CT and MRI imaging data of 73 patients with acute patellar dislocation who had been admitted to Department of Orthopedics, The Second Hospital of Tangshan from January 2014 to September 2024. There were 37 males (21 left knees and 16 right knees) and 36 females (19 left knees and 17 right knees), with a mean age of 15 (13, 16) years. On MRI images, the distance between the patellar tendon-trochlear groove (PT-TG) was measured. On CT images, the distance between the tibial tuberosity-trochlear groove (TT-TG) was measured. Additionally, the distance from the tibial tubercle-Roman arch (TT-RA), the sulcus angle (SA), the trochlear depth (TD), the lateral trochlear inclination (LTI), and the trochlear facet asymmetry (TFA) were measured on both MRI and CT images.Results:The TT-TG measured on CT [(20.47±4.42) mm] was significantly greater than that on MRI [(17.89±4.23) mm] ( t = -4.047, P < 0.001). The TT-RA [(24.28±4.27) mm], TD [2.95 (2.36, 4.08) mm], LTI (15.4°±3.85°), and TFA [0.42 (0.38, 0.49)] measured on CT were all significantly greater than those on MRI [(21.34±3.99) mm, 2.52 (1.64, 2.98) mm, 14.11°±3.58°, 0.38 (0.34, 0.44)] ( P < 0.001). The SA measured on CT (151.30°±6.74°) was significantly less than that measured on MRI (159.06°±5.40°) ( P < 0.001). The intra-observer ICC values for all indicators were greater than 0.9, and the inter-observer ICC values greater than 0.85. Conclusions:There are differences between CT and MRI in each indicator in evaluation of acute patellar dislocation in adolescents. The PT-TG measured on MRI and the TT-RA measured on CT can better evaluate the tibial tubercle lateralization; the indicators for trochlear dysplasia measured on MRI respond better to the severity of trochlea dysplasia than those on CT.

Objective:To explore advantages of CT and MRI imaging in clinical assessment of specific indicators (trochlear dysplasia and tibial tubercle lateralization) of acute patellar dislocation in adolescents by comparing CT versus MRI imaging.Methods:A retrospective study was conducted to analyze the CT and MRI imaging data of 73 patients with acute patellar dislocation who had been admitted to Department of Orthopedics, The Second Hospital of Tangshan from January 2014 to September 2024. There were 37 males (21 left knees and 16 right knees) and 36 females (19 left knees and 17 right knees), with a mean age of 15 (13, 16) years. On MRI images, the distance between the patellar tendon-trochlear groove (PT-TG) was measured. On CT images, the distance between the tibial tuberosity-trochlear groove (TT-TG) was measured. Additionally, the distance from the tibial tubercle-Roman arch (TT-RA), the sulcus angle (SA), the trochlear depth (TD), the lateral trochlear inclination (LTI), and the trochlear facet asymmetry (TFA) were measured on both MRI and CT images.Results:The TT-TG measured on CT [(20.47±4.42) mm] was significantly greater than that on MRI [(17.89±4.23) mm] ( t = -4.047, P < 0.001). The TT-RA [(24.28±4.27) mm], TD [2.95 (2.36, 4.08) mm], LTI (15.4°±3.85°), and TFA [0.42 (0.38, 0.49)] measured on CT were all significantly greater than those on MRI [(21.34±3.99) mm, 2.52 (1.64, 2.98) mm, 14.11°±3.58°, 0.38 (0.34, 0.44)] ( P < 0.001). The SA measured on CT (151.30°±6.74°) was significantly less than that measured on MRI (159.06°±5.40°) ( P < 0.001). The intra-observer ICC values for all indicators were greater than 0.9, and the inter-observer ICC values greater than 0.85. Conclusions:There are differences between CT and MRI in each indicator in evaluation of acute patellar dislocation in adolescents. The PT-TG measured on MRI and the TT-RA measured on CT can better evaluate the tibial tubercle lateralization; the indicators for trochlear dysplasia measured on MRI respond better to the severity of trochlea dysplasia than those on CT.

Objective:To investigate the diagnostic value of computed tomography(CT)combined with TaqMan probe for cardiopulmonary injury of pediatric patients with mycoplasma pneumonia of different clinical features.Methods:The medical records of 80 pediatric patients with mycoplasma pneumonia admitted to Shijiazhuang Maternal and Child Health Care Hospital from March 2020 to March 2023 were collected,and they were divided into<1 year old group(29 cases),1-3 years old group(23 cases)and>3 years old group(28 cases).They also were divided into long disease course group(43 cases,the disease course>7 d)and short disease course group(37 cases,the disease course≤7 d).All of pediatric patients underwent CT combined with TaqMan probe method to detect the cardiopulmonary injury,and to analyze the incidences of cardiopulmonary injury in pediatric patients of different age groups and different disease course groups.The CT and TaqMan probe were adopted to detect the pleural effusion,myocardial thickness,cardiothoracic ratio and the expression level of mycoplasma nucleic acid,and receiver operating characteristic(ROC)curves were adopted to analyze the diagnostic value of CT and probe in detecting cardiopulmonary injury of patients with mycoplasma pneumonia.Results:CT imaging showed that typical pulmonary abnormalities were present in patients of 62.5%,with a diagnostic accuracy of 93.75%(75/80),which main findings were pulmonary ground glass nodules(GGO),combined bacterial pneumonia and reticulation.Bronchiectasis was found in a small portion of patients.Bilateral pulmonary involvement was found in patients with pulmonary abnormalities,and the involvement of lower lobe was the most obvious in them.The 38 pediatric patients with clinically suspected incidental pulmonary embolism(PE)received additional CT examination with contrast agent,and the 24 pediatric patients of them were diagnosed as PE,and the diagnostic accuracy was 63.15%(24/38).TaqMan probe method was adopted to detect mycoplasma infection,and a high sensitivity and wide dynamic range detection system was established,which could conduct six times of dilutions for 10-fold between 0.2-0.2×10-5.Preparation was performed in 1 ng/μ l microbial community(MMC)-DNA standards,which had high linear dynamic range of 6 times of log10 dilutions with regression coefficient of R2=1.The detection lower limit was found to be 2×10-15 g/μl DNA.The incidence of cardiopulmonary injury gradually decreased with increasing age of pediatric patients with mycoplasma pneumonia of different ages.The incidences of cardiopulmonary injury in pediatric patients with mycoplasma pneumonia of<1 year old group,1 to 3 years old group and>3 years old group were respectively 93.10%,73.91%and 21.43%,and there were significant differences among the 3 groups(x2=7.660,33.019,P<0.05).The incidence(93.02%)of cardiopulmonary injury of long disease course group was significantly higher than that of short disease course group(27.03%),and the differences were statistically significant(x2=12.070,36.960,P<0.05),respectively.The amount of pleural effusion in the cardiopulmonary injury group was significantly higher than that in the non-cardiopulmonary damage group,and the myocardial thickness of cardiopulmonary injury group was significantly increased at the same time,and the cardiothoracic ratio of cardiopulmonary injury group was also significantly higher than that of non-cardiopulmonary injury group.There was significant difference in the expression level of mycoplasma nucleic acid(t=9.52,3.33,4.22,10.00,P<0.05).ROC curve analysis showed that the AUC value of CT combined with TaqMan probe method was larger than 0.5 in diagnosing cardiopulmonary injury of pediatric patients with mycoplasma pneumonia of different clinical features,and the AUC value of the combined diagnosis was largest.Conclusion:CT combined with TaqMan probe method has higher diagnostic value for the cardiopulmonary injury of pediatric patients with mycoplasma pneumonia.It should be considered to conduct the diagnosis of cardiopulmonary injury for pediatric patients who persistently exist the clinical symptom of mycoplasma pneumonia.The adaptation of existing TaqMan probe method,and the further expanded dPCR detection combination would improve the microbial diagnostic toolbox,which would provide reliable quantitative data for treatment decisions to cardiopulmonary injury of pediatric patients with mycoplasma pneumonia.

The extraction of neuroimaging features of migraine patients and the design of identification models are of great significance for the auxiliary diagnosis of related diseases. Compared with the commonly used image features, this study directly uses time-series signals to characterize the functional state of the brain in migraine patients and healthy controls, which can effectively utilize the temporal information and reduce the computational effort of classification model training. Firstly, Group Independent Component Analysis and Dictionary Learning were used to segment different brain areas for small-sample groups and then the regional average time-series signals were extracted. Next, the extracted time series were divided equally into multiple subseries to expand the model input sample. Finally, the time series were modeled using a bi-directional long-short term memory network to learn the pre-and-post temporal information within each time series to characterize the periodic brain state changes to improve the diagnostic accuracy of migraine. The results showed that the classification accuracy of migraine patients and healthy controls was 96.94%, the area under the curve was 0.98, and the computation time was relatively shorter. The experiments indicate that the method in this paper has strong applicability, and the combination of time-series feature extraction and bi-directional long-short term memory network model can be better used for the classification and diagnosis of migraine. This work provides a new idea for the lightweight diagnostic model based on small-sample neuroimaging data, and contributes to the exploration of the neural discrimination mechanism of related diseases.
Humans ; Time Factors ; Migraine Disorders/diagnostic imaging* ; Magnetic Resonance Imaging ; Brain/diagnostic imaging* ; Neuroimaging

OBJECTIVES: This study evaluated the association between obesity and glaucoma in middle-aged and older people. A population-based retrospective cohort study was conducted using data from the China Health and Retirement Longitudinal Study. METHODS: Glaucoma was assessed via self-reports. Multivariate logistic regression analysis and a Cox proportional hazards model were used to assess the relationship between obesity and glaucoma risk. RESULTS: Older males living in urban areas who were single, smokers, and non-drinkers were found to have a significantly higher incidence of glaucoma (all p<0.05). Diabetes, hypertension, and kidney disease were also associated with higher glaucoma risk, while dyslipidemia was associated with lower risk (all p<0.05). After the model was adjusted for demographic, socioeconomic, and health-related variables, obesity was significantly associated with a 10.2% decrease in glaucoma risk according to the Cox proportional hazards model (hazard ratio, 0.90; 95% confidence interval [CI], 0.83 to 0.97) and an 11.8% risk reduction in the multivariate logistic regression analysis (odds ratio, 0.88; 95% CI, 0.80 to 0.97). A further subgroup analysis showed that obesity was associated with a reduced risk of glaucoma in people living in rural areas, in smokers, and in those with kidney disease (all p<0.05). Obesity also reduced glaucoma risk in people with diabetes, hypertension, or dyslipidemia more than in healthy controls (all p<0.05). CONCLUSIONS This cohort study suggests that obesity was associated with a reduced risk of glaucoma, especially in rural residents, smokers, and people with kidney disease. Obesity exerted a stronger protective effect in people with diabetes, hypertension, or dyslipidemia than in healthy people.

Objective To analyze the clinical efficacy and safety off emoral head replacement(FHR)assisting by the traction table in direct anterior approach(DAA)for the treatment of femur neck fractures in gerontal patients.Methods A retrospective analysis was conducted on 79 elderly patients who under went FHR for femoral neck fractures from March 2019 to July 2020.A total of 42 patients underwent FHR through DAA by using traction table were assigned to the observation group and 37 patients receiving FHR through the PLA to the control group.The perioperative data,follow-up results and complications were compared between the two groups.Results The observation group was significantly superior to the control group in intraoperative blood loss(P<0.05),where as the former was inferior to the latter in preoperative preparation time(P<0.05).There was no significant difference in anesthesia time and operation time between the two groups(P>0.05).The observation group resumed first postoperative standing time,partial-weight bearing walking time and full-weight bearing walk-ing time significantly earlier than control group(P<0.05).Harris score at 1 month after the operation in the observation group were significantly higher than that of the control group(P<0.05),whereas which became not statistical significant between the two groups in 6 months and 1 year(P>0.05).No significant difference was found between the two groups for the incidence of complications(P>0.05).Conclusion DAA-FHR assisting by the traction table for the treatment of femur neck fractures in the elderly was effective and safe,but the preoperative preparation time was longer.

Objective:To investigate the relationship of blood lipid levels with bone mass and fracture risk in elderly patients with type 2 diabetes mellitus (T2DM).Methods:A total of 744 elderly patients with T2DM who were treated in Tangshan Second Hospital from November 2018 to May 2020 were divided into normal bone mass group, low bone mass group and osteoporosis group according to bone mass levels. The total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and triglyceride (TG) levels in the three groups were compared, and the relationship between lipid indexes and bone mass was analyzed. The risk of fracture was calculated in the low bone mass group, and the relationship between lipid index and fracture risk was analyzed by linear regression. The blood lipid index between subjects with fracture and without fracture in osteoporosis group was compared, and the relationship between blood lipid index and fracture was analyzed by logistic regression.Results:There were significant differences in gender and age among the three groups (χ 2=38.80, F=4.94, P<0.05). The normal bone mass group had the smallest proportion of women and the youngest average age, while the osteoporosis group had the largest proportion of women and the average age. maximum. The LDL-C level in normal bone mass group was higher than those in the low bone mass group and the osteoporosis group, and LDL-C level in the low bone mass group was higher than that in the osteoporosis group ( F=3.38, P<0.05). In the low bone mass group, the risk of systemic fracture was 3.50% (2.40%, 4.10%) and hip fracture was 0.99% (0.80%, 1.20%). Linear regression showed that LDL-C and TG were positively correlated with the risk of systemic fractures in the low bone mass group (LDL-C: B=0.98, P=0.006;TG: B=0.23, P=0.024);TG was positively correlated with the risk of hip fracture in the low bone mass group ( B=0.16, P=0.002). In the osteoporosis group, the levels of HDL-C and LDL-C were lower in the patients with fractures than those without fractures ( t=3.24, P=0.001; t=2.98, P=0.003). Logistic regression analysis showed that higher HDL-C and LDL-C levels were protection factors for fracture risk in the osteoporosis group ( β=-2.73, P=0.009, OR=0.06, 95 %CI=0.04-0.10; β=-0.15, P=0.033, OR=0.83, 95 %CI=0.74-0.99). Conclusion:The relationship of serum lipid index with bone mass and fracture risk in hospitalized elderly T2DM patients is complicated, it is suggested to set individual blood lipid control targets according to the bone mass of patients.

Objective:To investigate the clinical outcomes of homodigital reversed dorsal digital artery island flap innervated by the dorsal digital nerve to repair degloving injury of distal thumb.Methods:From July 2016 to June 2019, a total of 15 cases (15 thumbs) with degloving injury of distal part were admitted to the Department of Hand Surgery, the Second Hospital of Tangshan. Nine males and six females were involved, with an average age of 49 years (range, 41 to 69 years). There were twist injury in eight cases and crush injury in seven cases, with four cases of distal phalanx fracture. The defect dimensions after debridement ranged from 3.5 cm×1.8 cm to 4.6 cm×2.4 cm, and the dimension of the flaps ranged from 3.8 cm×2.1 cm to 5.0 cm×2.7 cm. All defects were repaired using homodigital reversed dorsal digital artery island flap innervated by the dorsal digital nerve. The survival, appearance and sensory recovery of the flaps and function of the injured fingers were observed at the follow-up after operation.Results:All the flaps survived without wound infection and blood supply disorder. The follow-up times ranged from 9 to 22 months (mean, 16 months). There was satisfactory appearance of the flaps with similar color and texture to the surrounding tissue. Fracture healing ranged from 4 to 6 weeks. At final follow-up, the values of static 2-PD test of the flaps ranged from 5 to 10 mm (mean, 7.8 mm). The results of range of motion of injured thumb joints were excellent in nine cases and good in five cases. There was slight linear scar left at the donor area of dorsal thumb.Conclusions:The innervated reversed dorsal digital artery island flap has a simple procedure and minimal donor-site cost, which is especially suitable for elderly patients who refuse to free toe transfers.

Objective:To explore the effect of venous anastomosis of the pedicled digital artery dorsal branch island flap in repairing fingertip or pulp defects of the same finger.Methods:From February 2016 to September 2018, a total of 56 emergency cases (67 fingers) with fingertip or pulp defects in 2-5 fingers were admitted to the Second Hospital of Tangshan (hereinafter referred to as the author′s affiliation), and the prospective research was conducted. The patients were divided into venous anastomosis group of 29 cases (35 fingers) and non-venous anastomosis group of 27 cases (32 fingers) by drawing lots. There were 18 males and 11 females in venous anastomosis group, aged 17 to 62 years, with wound area of 1.6 cm×1.3 cm-3.1 cm×2.4 cm after debridement. There were 17 males and 10 females in non-venous anastomosis group, aged 20 to 59 years, with wound area of 1.7 cm×1.2 cm-3.0 cm×2.4 cm after debridement. According to the location and size of the fingertip or pulp defect of patients in the two groups, the flap was designed on the dorsum of the middle or proximal phalanx of the injured finger. During the operation, the epineurium of dorsal branch of the proper digital nerve or the dorsal digital nerve carried by the flap was anastomosed end-to-end with the stump of proper digital nerve in the wound. One or two superficial vein (s) carried by the flap was/were interrupted end-to-end anastomosed with the superficial veins on the dorsum or palm of the wound surface in venous anastomosis group, and the venous anastomosis was not performed in non-venous anastomosis group. The flap size resected ranged from 1.8 cm×1.5 cm to 3.4 cm×2.6 cm in venous anastomosis group, and that ranged from 1.9 cm×1.4 cm to 3.3 cm×2.6 cm in non-venous anastomosis group. The donor site wounds in the two groups were resurfaced by free full-thickness skin graft harvested from the proximal forearm or the medial side of the upper arm. The blood circulation of the flap of patients in 2 groups was observed after operation. During follow-up after operation, the patients′ satisfaction for the appearance of the flap was evaluated by Michigan Hand Function Questionnaire, the flap color was observed by the chief physician of the Department of Hand Surgery in the author′s affiliation, and the incidence of flap pigmentation was calculated. Data were statistically analyzed with t test and chi-square test. Results:All the flaps of patients survived without tension blister in venous anastomosis group after operation. Tension blisters occurred in 6 cases (6 fingers) in non-venous anastomosis group due to venous reflux obstruction, and the flaps survived after removing some sutures of the pedicle and changing dressing. During follow-up of 8-20 months, with an average of 15 months, the patients′ satisfaction score for flap appearance in venous anastomosis group was (4.6±0.5) points, which was obviously higher than (4.3±0.6) points of non-venous anastomosis group ( t=2.482, P<0.05). The incidence of flap pigmentation in venous anastomosis group was 9% (3/35), which was significantly lower than 31% (10/32) of non-venous anastomosis group ( χ2=5.498, P<0.05). Conclusions:The pedicled digital artery dorsal branch island flap with venous anastomosis repairs the same fingertip or pulp defects, resulting in unobstructed venous reflux, low incidence of flap pigmentation, good appearance and high patient satisfaction.

Objective To observe the differences of biological property of glioma stem cells (GSCs) and glioma non-stem cells (nGSCs), and their related protein expressions. Methods The proliferations of GSCs1, GSCs2 and nGSCs1 and nGSCs2 were detected by CCK8 after two, 4, 6, 8, 10 and 12 d of culture in vitro. The sensitivities of the cells to temozolomide (TMZ) were detected by CCK8 after 2 d of culture. The adhesion abilities of cells were tested by adhesion assay. Transwell assay was used to detect the migration and invasion abilities of cells. The activity of matrix metalloproteinase-2 (MMP-2) was detected by gelatin zymography. Western blotting and immunofluorescence staining were used to detect the protein expressions of Notchl and epidermal growth factor receptor (EGFR). Results The survival rate of nGSCs1 was significantly higher than that of GSCs1 and the survival rate of nGSCs2 was significantly higher than that of GSCs2 after 4, 6, 8, 10 and 12 d of culture (P<0.05). The inhibitory concentration (IC)50 of TMZ for GSCs1, nGSCs1, GSCs2 and nGSCs2 was (1536.0±17.67) μmol/L, (514.5±13.44) μmol/L, (2543.0±39.87) μmol/L, (889.6±17.43) μmol/L, respectively (P<0.05). Number of GSCs1 adhering to extracellular matrix proteins Fibronectin and Collagen I was significantly larger than that of nGSCs1, and that of GSCs2 was significantly larger than that of nGSCs2 (P<0.05). The number of migrated GSCs112 and 24 h of cultivation was statistically larger than that of nGSCs1, and that of GSCs2 was statistically larger than that of nGSCs2 (P<0.05). The number of invaded GSCs124 and 36 h of cultivation was larger than that of nGSCs1, and that of invaded GSCs2 was larger than that of nGSCs2, with statistical differences (P<0.05). The activity of MMP2 secreted by GSCs1 was significantly higher than that by nGSCs1, and that of MMP2 secreted by GSCs2 was significantly higher than that by nGSCs2 (P<0.05). Western blotting showed that the relative protein expression level of EGFR/Notch1 in GSCs1 was significantly lower than that in nGSCs1, and that in GSCs2 was significantly lower than that in nGSCs2 (P<0.05). The results of immunofluorescence staining were consistent with those of Western blotting; EGFR protein strongly expressed in nGSCs and weakly expressed in GSCs; Notch1 protein strongly expressed in GSCs and weakly expressed in nGSCs. Conclusion As compared with the high-EGFR-expressing and proliferative primary glioma cells, the high-Notch1-expressing glioma stem cells have higher activity level of MMP-2,stronger abilities of adhesion, migration and invasion, which may be contributed to glioma treatment resistance and its occurrence.