Intestinal radiosensitivity makes radiation-induced intestinal injury (RIII) as a common complication among individuals exposed to accidental radiation and patients with abdominal or pelvic malignancies receiving radiotherapy. At present, there are no effective measures for the prevention and treatment of RIII. Developing novel prevention and treatment strategies is of great significance for improving the prognosis and quality of life for both individuals exposed to accidental radiation and cancer patients. Lactobacillus, a Gram-positive bacterium, is widely observed in humans and animals. It exhibits notable probiotic functions, including maintaining gut microbiota homeostasis, preserving intestinal barrier, and modulating immune responses. Substantial studies have demonstrated that Lactobacillus has remarkable protective and therapeutic effects against radiation-induced injury, specifically significantly alleviating RIII. These probiotic functions of Lactobacillus make it have high priority to become the chassis of genetically engineered strains. However, multiple factors influence the construction of a genetically engineered strain, limiting the application of Lactobacillus as a chassis. This review focuses on the probiotic functions of Lactobacillus, highlighting advances in research on Lactobacillus and its engineered probiotics in radiation protection and treatment. Furthermore, it summarizes key factors influencing the construction of genetically engineered strains based on the Lactobacillus chassis. It aims to provide insights for developing genetically engineered strains with radioprotective and therapeutic effects using Lactobacillus as the chassis.

Objective To discuss the technical advantages of MRI image fusion technology in guiding percutaneous balloon compression(PBC)for trigeminal neuralgia(TN).Methods The clinical data of 13 patients with TN,who received MRI image fusion technology-guided PBC from November 2022 to July 2023,were retrospectively analyzed.The MRI images of the trigeminal nerve obtained one week before surgery were fused with the intraoperative DynaCT images of the skull base so as to simultaneously display the Meckel s cave and foramen ovale,and under the 3-D view the optimal puncture path was determined.The needle was positioned at the entry point of the skin,than the skin was cut open with a sharp surgical blade and the needle was inserted to the foramen ovale area to a predetermined depth.Lateral skull base fluoroscopy and DynaCT scan were used to check that the puncture needle tip was placed into the foramen ovale.Than the puncture needle was replaced by a fine guiding-needle and it was pushed into the Meckel's cave.Under the dual guidance of lateral fluoroscopy and fusion image,the balloon was push forward and was filled with iodine contrast media to compress the trigeminal ganglion within the Meckel's cave.After completion of the treatment,the balloon and puncture needle were removed and manual oppression was applied on the face to achieve hemostasis.Results Immediately after PBC,the pain was relieved in all patients.No permanent or serious complications occurred.One patient had a relapse 3 months after PBC and a second PBC procedure had to be carried out.No obvious pain recurrence was observed in the remaining patients during follow-up period.During the surgery,the mean number of foramen ovale puncturing was(1.31±0.46)times,the mean X-ray exposure time was(8.64±5.66)min,and the mean cumulative dose of X-ray was(570.29±257.15)mGy.After PBC,12 patients(92.31％)developed facial numbness and one patient(7.69％)developed facial pain,all of which were healed after treatment.Conclusion MRI image fusion technology can improve the visualization and accuracy of PBC procedure.It can also reduce the number of puncturing,decrease the radiation exposure dose,and improve the surgical ability of young doctors.Therefore,MRI image fusion technology should be further developed and applied in clinical practice.

Intestinal radiosensitivity makes radiation-induced intestinal injury (RIII) as a common complication among individuals exposed to accidental radiation and patients with abdominal or pelvic malignancies receiving radiotherapy. At present, there are no effective measures for the prevention and treatment of RIII. Developing novel prevention and treatment strategies is of great significance for improving the prognosis and quality of life for both individuals exposed to accidental radiation and cancer patients. Lactobacillus, a Gram-positive bacterium, is widely observed in humans and animals. It exhibits notable probiotic functions, including maintaining gut microbiota homeostasis, preserving intestinal barrier, and modulating immune responses. Substantial studies have demonstrated that Lactobacillus has remarkable protective and therapeutic effects against radiation-induced injury, specifically significantly alleviating RIII. These probiotic functions of Lactobacillus make it have high priority to become the chassis of genetically engineered strains. However, multiple factors influence the construction of a genetically engineered strain, limiting the application of Lactobacillus as a chassis. This review focuses on the probiotic functions of Lactobacillus, highlighting advances in research on Lactobacillus and its engineered probiotics in radiation protection and treatment. Furthermore, it summarizes key factors influencing the construction of genetically engineered strains based on the Lactobacillus chassis. It aims to provide insights for developing genetically engineered strains with radioprotective and therapeutic effects using Lactobacillus as the chassis.

Objective To investigate the impact of diabetes stratification on the recovery of shoulder joint function following arthroscopic rotator cuff repair.Methods Between January 2020 and April 2024,a total of 216 patients who underwent arthroscopic rotator cuff repair at our hospital were enrolled in this study.According to preoperative blood glucose control status,the patients were categorized into four groups:Group A(non-diabetic patients),Group B(diabetic patients with well-controlled blood glucose),Group C(diabetic patients with mild dysglycemia),and Group D(diabetic patients with severe dysglycemia).All participants received standardized arthroscopic rotator cuff repair surgery and followed the same postoperative rehabilitation protocol.We assessed inflammatory factor levels,shoulder joint range of motion,Visual Analog Scale(VAS)pain scores,and Constant-Murley scores both preoperatively and at 1,2,3,and 6 months post-surgery.Furthermore,we examined rotator cuff thickness,axillary pouch width,and complication rates at the 6-month follow-up.A multivariate logistic regression model was employed to identify factors influencing shoulder function recovery after arthroscopic rotator cuff repair.Results At 1,3,and 6 months post-surgery,the levels of ESR(erythrocyte sedimentation rate)and CRP(C-reactive protein)in Groups A,B,C,and D exhibited a gradual increase(P<0.05).Simultaneously,the shoulder joint flexion,abduction,external rotation,internal rotation,and extension angles in all groups dem-onstrated a gradual decrease(P<0.05).The VAS pain scores in Group D were significantly higher at 1,3,and 6 months compared to Groups A,B,and C(P<0.05),while the Constant-Murley scores in Group D were signifi-cantly lower than those in Groups A,B,and C(P<0.05).No significant differences in VAS or Constant-Murley scores were observed between Groups A,B,and C(P>0.05).The rotator cuff thickness and axillary pouch width in Group D were significantly greater than those in Groups A and B(P<0.05).Furthermore,the incidence of superficial incision infection in Group D was significantly higher than that in Group A(P<0.05).Multivariate Logistic regression analysis revealed that age,HbA1c levels,and complete tear were risk factors for impaired shoulder function recovery after arthroscopic rotator cuff repair(P<0.05),whereas early repair served as a protective factor(P<0.05).Conclusion Poor blood glucose control in diabetic patients markedly compromises shoulder joint function and structural recovery after arthroscopic rotator cuff repair,leading to more severe postoperative pain,a higher incidence of incision infections,and a delayed resolution of the inflammatory response.

In July 2024,the Diagnosis Related Groups(DRG)2.0 is released based on the Notice from the National Healthcare Security Administration on Issuing the DRG 2.0 and Deepening the Relevant Work.Compared with DRG 1.1,version 2.0 was established based on a wider range of suggestions regarding the Adjacent Diagnosis Related Groups(ADRG),Major Comorbidity or Complication(MCC),and Comorbidity or Complication(CC)from various institutions.A list of disease diagnoses and surgical operations that are not used as grouping rules was compiled,and grouping efficacy was further improved by upgrading the algorithms for MCC and CC with the help of AI.Meanwhile,it is necessary to pay more attention to the number of cases of ADRG,the better methods to list the MCC/CC,the suggestions of various doctors and continuously standardize the data and update the grouping scheme of DRG.

Objective To investigate the impact of diabetes stratification on the recovery of shoulder joint function following arthroscopic rotator cuff repair.Methods Between January 2020 and April 2024,a total of 216 patients who underwent arthroscopic rotator cuff repair at our hospital were enrolled in this study.According to preoperative blood glucose control status,the patients were categorized into four groups:Group A(non-diabetic patients),Group B(diabetic patients with well-controlled blood glucose),Group C(diabetic patients with mild dysglycemia),and Group D(diabetic patients with severe dysglycemia).All participants received standardized arthroscopic rotator cuff repair surgery and followed the same postoperative rehabilitation protocol.We assessed inflammatory factor levels,shoulder joint range of motion,Visual Analog Scale(VAS)pain scores,and Constant-Murley scores both preoperatively and at 1,2,3,and 6 months post-surgery.Furthermore,we examined rotator cuff thickness,axillary pouch width,and complication rates at the 6-month follow-up.A multivariate logistic regression model was employed to identify factors influencing shoulder function recovery after arthroscopic rotator cuff repair.Results At 1,3,and 6 months post-surgery,the levels of ESR(erythrocyte sedimentation rate)and CRP(C-reactive protein)in Groups A,B,C,and D exhibited a gradual increase(P<0.05).Simultaneously,the shoulder joint flexion,abduction,external rotation,internal rotation,and extension angles in all groups dem-onstrated a gradual decrease(P<0.05).The VAS pain scores in Group D were significantly higher at 1,3,and 6 months compared to Groups A,B,and C(P<0.05),while the Constant-Murley scores in Group D were signifi-cantly lower than those in Groups A,B,and C(P<0.05).No significant differences in VAS or Constant-Murley scores were observed between Groups A,B,and C(P>0.05).The rotator cuff thickness and axillary pouch width in Group D were significantly greater than those in Groups A and B(P<0.05).Furthermore,the incidence of superficial incision infection in Group D was significantly higher than that in Group A(P<0.05).Multivariate Logistic regression analysis revealed that age,HbA1c levels,and complete tear were risk factors for impaired shoulder function recovery after arthroscopic rotator cuff repair(P<0.05),whereas early repair served as a protective factor(P<0.05).Conclusion Poor blood glucose control in diabetic patients markedly compromises shoulder joint function and structural recovery after arthroscopic rotator cuff repair,leading to more severe postoperative pain,a higher incidence of incision infections,and a delayed resolution of the inflammatory response.

In July 2024,the Diagnosis Related Groups(DRG)2.0 is released based on the Notice from the National Healthcare Security Administration on Issuing the DRG 2.0 and Deepening the Relevant Work.Compared with DRG 1.1,version 2.0 was established based on a wider range of suggestions regarding the Adjacent Diagnosis Related Groups(ADRG),Major Comorbidity or Complication(MCC),and Comorbidity or Complication(CC)from various institutions.A list of disease diagnoses and surgical operations that are not used as grouping rules was compiled,and grouping efficacy was further improved by upgrading the algorithms for MCC and CC with the help of AI.Meanwhile,it is necessary to pay more attention to the number of cases of ADRG,the better methods to list the MCC/CC,the suggestions of various doctors and continuously standardize the data and update the grouping scheme of DRG.

Objective To observe the efficacy of self-guided attention network for detecting responsible lesions related to cerebral palsy(CP)in children with periventricular white matter injury(PVWMI).Methods Totally 383 children with PVWMI were retrospectively enrolled and divided into CP group(n=243)and non-CP group(n=140),while 214 children without obvious brain abnormality on brain MRI were taken as control group.ROI of 4 key anatomical structures related to CP,i.e.centrum semiovale,posterior limb of internal capsule,cerebral peduncle and thalamus were delineated on T1WI,while responsible lesions related to CP within the key anatomical structures were labeled on T2WI,and the images were then registrated and used as input of the networks.ResNet34 network was adopted combined with attention and self-guided networks to train the network for detecting responsible lesions related to CP in children with PVWMI,and their efficacies were evaluated.The optimal network was screened,and its efficacy for segmenting the key anatomical structures was evaluated.Results Self-guided attention network was the optimal network,its area under the curve(AUC)for detecting lesions was 0.794-0.914,and the Dice similarity coefficient for segmenting the key anatomical structures was 0.702-0.764.Conclusion Self-guided attention network could be used for preliminarily detecting responsible lesions related to CP in children with PVWMI.

Objective To observe the efficacy of self-guided attention network for detecting responsible lesions related to cerebral palsy(CP)in children with periventricular white matter injury(PVWMI).Methods Totally 383 children with PVWMI were retrospectively enrolled and divided into CP group(n=243)and non-CP group(n=140),while 214 children without obvious brain abnormality on brain MRI were taken as control group.ROI of 4 key anatomical structures related to CP,i.e.centrum semiovale,posterior limb of internal capsule,cerebral peduncle and thalamus were delineated on T1WI,while responsible lesions related to CP within the key anatomical structures were labeled on T2WI,and the images were then registrated and used as input of the networks.ResNet34 network was adopted combined with attention and self-guided networks to train the network for detecting responsible lesions related to CP in children with PVWMI,and their efficacies were evaluated.The optimal network was screened,and its efficacy for segmenting the key anatomical structures was evaluated.Results Self-guided attention network was the optimal network,its area under the curve(AUC)for detecting lesions was 0.794-0.914,and the Dice similarity coefficient for segmenting the key anatomical structures was 0.702-0.764.Conclusion Self-guided attention network could be used for preliminarily detecting responsible lesions related to CP in children with PVWMI.

BACKGROUND:In clinical application,the therapeutic effect of transcranial magnetic stimulation depends on the ability to accurately target the areas of the brain that need to be stimulated.In recent years,with the development of neuronavigation systems,mobile augmented reality technology,and the new methods of processing magnetic resonance imaging(MRI)data,the accuracy of stimulus target localization and the optimization of target selection are expected to improve further. OBJECTIVE:To review the principle of MRI-based image navigation and its application in transcranial magnetic stimulation and summarize the roles of different modal MRI data analyses in guiding the selection of target areas for transcranial magnetic stimulation. METHODS:An online computer search for relevant literature was performed in PubMed,CNKI database and WanFang database,with the keywords"transcranial magnetic stimulation,coil positioning,neuronavigation,augmented reality,magnetic resonance,theory."Finally,63 documents were included for review. RESULTS AND CONCLUSION:Among the traditional methods of positioning transcranial magnetic stimulation coils,the"5 cm rule"and the international electroencephalogram 10-20 positioning method are the most commonly used.These methods have the advantages of simplicity and economy,but they rely too much on the operator's experience and there were technical differences between operators.The neuronavigation system,which is based on stereotactic technology,is the guiding method for positioning transcranial magnetic stimulation coils with the highest visual degree and accuracy.It achieves visual positioning through MRI data acquisition,3D brain reconstruction,head model registration and stereogeometric positioning.It has high application value in clinical treatment and scientific research,but it cannot be promoted in medical institutions due to its high cost.For various medical institutions,mobile augmented reality is a cost-effective and efficient alternative to the neuronavigation system,which achieves visual positioning of brain tissue under the scalp through MRI data acquisition,2D/3D image construction,virtual image and real brain image superposition.It has the advantages of directly visualization and low cost,and is expected to be popularized and applied in primary medical units.Although the superiority of clinical efficacy of visual coil positioning over the electroencephalogram 10-20 localization strategy has not yet been fully demonstrated,with the progress of brain MRI data analysis,visual positioning is expected to further optimize the target selection strategy of transcranial magnetic stimulation therapy and to improve the response rate and individuation degree of transcranial magnetic stimulation treatment.This is a promising and challenging research direction in the future.