Real-time acquisition of pulmonary ventilation and perfusion information through thoracic electrical impedance tomography (EIT) holds significant clinical value. This study proposes a novel method based on the rime (RIME) algorithm-optimized variational mode decomposition (VMD) to separate lung ventilation and perfusion signals directly from raw voltage data prior to EIT image reconstruction, enabling independent imaging of both parameters. To validate this approach, EIT data were collected from 16 healthy volunteers under normal breathing and inspiratory breath-holding conditions. The RIME algorithm was employed to optimize VMD parameters by minimizing envelope entropy as the fitness function. The optimized VMD was then applied to separate raw data across all measurement channels in EIT, with spectral analysis identifying relevant components to reconstruct ventilation and perfusion signals. Results demonstrated that the structural similarity index (SSIM) between perfusion images derived from normal breathing and breath-holding states averaged approximately 84% across all 16 subjects, significantly outperforming traditional frequency-domain filtering methods in perfusion imaging accuracy. This method offers a promising technical advancement for real-time monitoring of pulmonary ventilation and perfusion, holding significant value for advancing the clinical application of EIT in the diagnosis and treatment of respiratory diseases.
Humans ; Electric Impedance ; Algorithms ; Tomography/methods* ; Pulmonary Ventilation/physiology* ; Lung/diagnostic imaging* ; Image Processing, Computer-Assisted/methods* ; Adult

Objective:To study the risk factors of venous thromboembolism(VTE)and the predictive value of the improved VTE score model to identify the risk of VTE in gynecological surgery patients.Methods:From Janu-ary 1,2020 to December 31,2022,41 patients with VTE after gynecological surgery were selected as the VTE group,and a total of 164 patients with adjacent gynecological surgeries during the same period were selected as the non-VTE group with a ratio of 1 :4.Univariate and multivariate Logistic regression analysis were used to ana-lyze the risk factors of VTE after gynecological surgery,and a modified VTE risk factor rapid assessment model(referred to as the improved VTE score model)was constructed.The receiver operating characteristic(ROC)curve was used to study the predictive value for VTE for in gynecological surgery,and compared with the Caprini score model(Caprini table for short).Results:①Multivatiate Logistic regression analysis showed that there were independent risk factors for postoperative VTE in gynecology surgery(OR＞1,P＜0.05),including age≥60 years,BMI≥28 kg/m2,malignant tumors,surgery time＞3 hours,history of thrombosis,and the increased D-di-mer difference before and after surgery.②The Area under Curve(AUC)of ROC was 0.963 in the improved VTE score model with a Youden index 81.10％,sensitivity 87.80％and specificity 93.29％.The AUC of the Caprini score model was 0.888 with Youden index 63.41％,sensitivity 73.17％and specificity 90.24％.The improved VTE score model the Caprini score model identified 92.68％and 85.37％of VTE patients as high-risk or ex-tremely high-risk,respectively,but the difference was not statistically significant(P＜0.05).Conclusions:More attention should be paid to the six independent risk factors for postoperative VTE in gynecology surgery.The two score models showed a similar identified level.However,the improved VTE score model is more simple and easier to operate,has better practicality,and has certain clinical promotion value.

Objective:To investigate the effects of autophagy-targeted DNA vaccine against Japanese encephalitis virus (JEV) on the immune-related functions of dendritic cells (DCs) in BALB/c mice.Methods:Healthy female BALB/c mice were randomly divided into 5 groups and injected with pcDNA3.1(+ ) empty vector (negative control), pJME plasmid, recombinant pJME-LC3 plasmid muscle, sterile PBS (blank control group) and live attenuated JEV vaccine (positive control group), respectively. The mice were immunized three times with an interval of two weeks. Splenic DCs were isolated two weeks after the last immunization. Immunofluorescence assay was used to observe the expression of the recombinant plasmid in dendritic cells. Expression of major histocompatibility complex Ⅱ (MHC Ⅱ) on DCs and the uptake of FITC-Dextran by DCs were observed by flow cytometry. CCK8 assay was used to detect the effects of DCs on the proliferation of spleen mononuclear cells from allogeneic mice.Results:The expression of plasmid-encoded protein in the DCs of the pJME-LC3 group was significantly higher than that of the pJME, pJME-LC3+ 3-MA and pcDNA3.1(+ ) empty vector groups. The uptake of FITC-Dextran by DCs was significantly enhanced in the pJME-LC3 group than in the other groups ( P<0.05), and the expression of MHC Ⅱ moleculars on DCs was increased in the pJME-LC3 group as well ( P<0.05). The splenic DCs from the mice in the pJME-LC3 group had a stronger effect on the proliferation of spleen mononuclear cells from allogeneic mice that those from other groups ( P<0.05). Conclusions:The recombinant plasmid pJME-LC3 could promote the ability of mouse splenic DCs to present antigen and to stimulate lymphocyte proliferation after immunization, suggesting that the autophagy-targeted recombinant DNA vaccine against JEV could enhance immune responses by affecting the function of DCs in BALB/c mice.

As a conservative lysosomal degradation pathway, autophagy possess various functions that have been well studied in the immune system. Regulatory effects of autophagy on the differentiation of immune cells have been gradually revealed. In order to investigate the specific mechanisms, it is very necessary to summarize the role of autophagy in the proliferation, development and differentiation of immune cells. Effects of autophagy on the functions and differentiation of immune cells have been summarized by introducing the selective degradation function of autophagy in some articles. This review focused on some classical immune cells and elucidated the important regulatory effects of autophagy and the nutrient signaling metabolic pathways involved in autophagy on immune cell differentiation.

Objective To investigate the safety and feasibility of robotic nephrectomy,work bench surgery with robotic kidney autotransplantation in the treatment of complex renal tumors.Methods The clinical data of 5 patients with renal tumors admitted from January 2018 to July 2018 were analyzed retrospectively.There were 4 males and 1 females.The median age was 49 years old,ranging 32-66 years.The median body mass index was 25.6 kg/m2,ranging 21.1-27.8 kg/m2.Serum creatinine level was 87.2 μmol/L,ranging 78.0-88.9μmol/L before bench surgery.5 patients had multiple bilateral renal tumors and had undergone laparoscopic or robotic partial nephrectomy on the contralateral kidney.For bench surgery kidney,4 cases were on the left side and 1 case was on the right side.Each kidney has more than 2 separate tumors,combined with complete endophytic tumors,tumors larger than 7 cm in diameter or hilar tumors.5 patients were all performed robotic nephrectomy,work bench partial nephrectomy with robotic kidney autotransplantation under general anesthesia.The patient was first in a lateral decubitus position for robotic nephrectomy,and the kidney was removed through a median 6 cm periumbilical incision.After kidney removal,kidney tumors were resected and kidney was reconstructed on a hypothermic working table.Then the kidney was packed in a plastic bag,filling with ice slush.The corresponding parts of the plastic bag were cut to expose the renal artery and vein.Finally,the patient was moved to lithotomy position with Trendelenburg tilt of 20°,and the autologous kidney wrapped in the plastic bag was placed through the previous periumbilical incision into the abdominal cavity for robotic kidney autotransplantation.The renal artery and vein were anastomosed end-to-side with the right external iliac artery and vein.The ureter and bladder were anastomosed.Autologous kidneys were placed in abdominal cavity in 4 cases,and placed in right iliac fossa with retroperitonealization in 1 case.Ice slush on the surface of the autologous kidney did not completely melt before the blood supply was restored during the operation,and the autologous kidney immediately urinated after the blood supply was restored.Results All surgeries were performed successfully without conversion to open surgeries.The total operation time was 460 min,ranging (415-645 min),the time of robotic nephrectomy was 120 min,ranging (74-300 min),the time of robotic kidney autotransphntation was 135 min,ranging(103-163 min),the warm ischemia time was 3 min,ranging (1.5-6.0 min),the cold ischemia time was 182 min,ranging(135-210 min),the rewarming time was 50 min,ranging(45-55 min),the estimated blood loss during operation was 100 ml,ranging(50-300 ml),and the hospital stay was 6 d,ranging(5-9 d).The number of resected tumors was 4,ranging(2-6).The pathology reveals clear cell carcinoma in 3 cases and chromophobe cell carcinoma in 2 cases.The surgical margins were all negative.The serum creatinine levels were 111.1 μmol/L (87-217.6 μ mol/L) and 106.1 μmol/L (87.1-172 μmol/L) on the 7th and 30th day after operation,respectively.One month after operation,CT showed that the function and morphology of the autologous kidneys were fine.No recurrence or metastasis was found in 5 patients during a median follow-up of 7 months,ranging (5.4-11.7 mon).Conclusions For patients with complex renal tumors who cannot undergo in situ partial nephrectomy,robotic nephrectomy,work bench surgery with robotic kidney autotransplantation can completely remove the tumors,maximize the preservation of renal function and minimize the trauma of patients,making the ultimate means of nephron-sparing surgery for patients with complex renal tumors more minimally invasive and safe.

Aim To investigate the effect of SM-1 on seven main cytochrome P450(CYP450)in human liver microsomes.Methods Substrate or SM-1 was incubated with human liver microsomes for 30 min in vitro,and divided into control group and experimental group.The effects of SM-1 on the main phase I metabolic enzymes in human liver microsomes was detected by HPLC.Phenacetin,bupropion,paclitaxel,tolbutamide,omeprazole,dextromethorphan,testosterone were investigated as probe drugs.Results Inhibition rate of SM-1 on the classical substrate of human liver microsomal CYP was 0.05％,3.37％,0.08％,2.07％,4.20％,-0.15％and 10.84％,respectively.Conclusions SM-1 may have inhibitory effect on CYP3A4.Attention should be paid to the interaction of clinical drug induced by CYP enzyme inhibition.

Objective:To investigate the immune mechanism of Shengxian decoction in experimental autoimmune myasthenia gravis(EAMG) rats. Methods:Lewis rats were immunized with the rat sequence 97-116 of the AChRαsubunit(Rα97-116) in CFA, 25 of which were successful. They were randomly divided into 5 groups:EAMG model group,prednisone group(5. 4 mg/kg),Shengxian decoction low, medium, high dose groups ( dosage 2. 6 g/kg, 5. 2 g/kg, 10. 4 g/kg ) . Clinical symptoms, weight, and the decrement percentage of RNS(5 Hz) were evaluated,and ELISA were adopted to determine the titers of AChR Ab,TGF-β,IFN-γ,IL-2,IL-4 and IL-17 in serum. Results:After molding,the percentage of decrement of RNS in each group noticeably increased by more than 10% in comparison with that in the CFA control group ( P<0. 01 or P<0. 05 ) . At the same time, they were also subjected to progressive decreasing weight and typical myasthenia symptoms,showing the successful molding. With medication,the decrement percentage of RNS of rats in the groups with low,medium and high dose of Shengxian decoction were all on obvious decline with alleviated weight decrease (P<0. 01),testifying to the symptom improvement. Compared with the CFA control group,the groups with low,medium and high dose of Shengxian decoction were coupled with decreasing AChR Ab content(P<0. 05),rising TGF-βlevel and reducing IFN-γ,IL-2,IL-4 and IL-17 level(P<0. 01 or P<0. 05). Conclusion: Shengxian decoction can turn the decrement percentage of RNS around,improve the progressive weight decrease in EAMG rats and increase the weight gains. By up-regulating the TGF-βlevel,lowering IFN-γ,IL-2,IL-4 and IL-17 level,preventing B cells from producing AChR Ab and reducing the content of AChR Ab in serum,it will soothe the damage of NMJ to AChR and cure EAMG.

Silk fibroin is a natural macromolecular fibroin. It has broad prospects in tissue engineering application due to its good physical and mechanical properties and good biocompatibility. This paper reviews its chemistry structure, property, the usage as matrix of tissue-engineering scaffold using electrospinning technology, and the influence on growth, proliferation and function of vascular endothelial cell, smooth muscle cell, keratinocyte and fibroblast. It also addresses the advantages and disadvantages of silk fibroin applied in tissue engineering study like artificial vascular, skin, bone stent etc. The potential applications on esophageal tissue engineering and regenerative medicine were discussed.
Animals ; Biocompatible Materials ; Blood Vessel Prosthesis ; Bombyx ; chemistry ; Electrochemical Techniques ; Fibroins ; chemistry ; Humans ; Myocytes, Smooth Muscle ; physiology ; Tissue Engineering ; methods ; Tissue Scaffolds ; chemistry

OBJECTIVE: To study the location of facial nerve and prevent facial nerve injury in middle ear surgery according to dissection of temporal bone and experience of middle ear surgery. METHOD: Thirty sides of temporal bones were exposed tympanic and mastoid segment of facial nerve with facial nerve decompression. The course of facial nerve was located by the markers of middle ear. RESULT: Tympanic segment of facial nerve passed between horizontal semicircular canal and stapes,then superior and anterior to the cochleariform process. Mastoid segment of facial nerve located in posterior wall of tympanic cavity. The mastoid segment of facial nerve travelled below the level of horizontal semicircular canal and annulus membrane tympani, and the extension line of its posterior margin and posterior-one-third of horizontal semicircular canal intersected to form an included angle (117.04 +/- 2.42) degrees. External genu of facial nerve located anterior and inferior to the horizontal semicircular canal. The shortest distance was (1.97 +/- 0.53) mm between middle point of horizontal semicircular canal and facial nerve, (1.03 +/- 0.29) mm between incus short process and facial nerve, (0.93 +/- 0.25) mm between cochleariform process and facial nerve, (1.18 +/- 0.42) mm between head of stapes and facial nerve, (3.08 +/- 0.28) mm between tympani sulcus and facial nerve at the vestibule window level, and (2.13 +/- 0.34) mm between tympani sulcus and facial nerve at round window level, respectively. CONCLUSION Horizontal semicircular canal carina, incus short process, stapes, annulus membrane tympani and cochleariform process are ideal landmarks of tympanic and mastoid segment of facial nerve, which are helpful in middle ear surgery.
Ear, Middle ; surgery ; Facial Nerve ; surgery ; Facial Paralysis ; prevention & control ; Female ; Humans ; Intraoperative Complications ; prevention & control ; Male ; Mastoid ; anatomy & histology ; surgery ; Microsurgery ; methods