Objective:To evaluate the performance of the neural network model in segmenting gout tophus in the first metatarsophalangeal（MTP1）joint ultrasound images.Methods:A total of 1 218 tophus images from 381 patients who underwent MTP1 ultrasound examinations in the Affiliated Hospital of Qingdao University between May 2023 and December 2024 were prospectively collected. The images were divided into training，validation，and test sets in a ratio of 7∶2∶1. Multiple neural network models were trained to automatically identify and segment tophus in the images，with physician-annotated tophus regions serving as the reference standard. Model performance was evaluated in the test set，and the impact of tophus characteristics（e.g.，echogenicity，size，and presence of bone erosion）on segmentation efficacy was analyzed.Results:In the test set，CMUNeXt demonstrated superior tophus segmentation performance versus Unet，Unet++，TransUnet，and CMU-Net，achieving an accuracy of 99.1%，precision of 79.1%，recall of 84.6%，intersection over union of 68.8%，and Dice similarity coefficient of 80.2%. Logistic regression identified tophus echogenicity，size，and bone erosion as independent efficacy factors OR（95% CI）=7.275（1.598-33.129），21.303（4.282-105.985），13.520（3.617-50.530），0.076（0.007-0.823）（all P<0.05）. Hypoechoic tophus demonstrated significantly superior segmentation performance compared to mixed-echoic and isoechoic tophus（all P<0.05），and lesions with larger maximum diameters（>10 mm）were segmented more effectively than smaller tophus（ P<0.05）. Conclusions:The CMUNeXt model enables accurate identification and segmentation of tophus in MTP1 ultrasound images，particularly excelling for larger and hypoechoic lesions. This approach holds significant promise for AI-assisted diagnosis of MTP1 gouty arthritis.

Objective:To evaluate the performance of the neural network model in segmenting gout tophus in the first metatarsophalangeal（MTP1）joint ultrasound images.Methods:A total of 1 218 tophus images from 381 patients who underwent MTP1 ultrasound examinations in the Affiliated Hospital of Qingdao University between May 2023 and December 2024 were prospectively collected. The images were divided into training，validation，and test sets in a ratio of 7∶2∶1. Multiple neural network models were trained to automatically identify and segment tophus in the images，with physician-annotated tophus regions serving as the reference standard. Model performance was evaluated in the test set，and the impact of tophus characteristics（e.g.，echogenicity，size，and presence of bone erosion）on segmentation efficacy was analyzed.Results:In the test set，CMUNeXt demonstrated superior tophus segmentation performance versus Unet，Unet++，TransUnet，and CMU-Net，achieving an accuracy of 99.1%，precision of 79.1%，recall of 84.6%，intersection over union of 68.8%，and Dice similarity coefficient of 80.2%. Logistic regression identified tophus echogenicity，size，and bone erosion as independent efficacy factors OR（95% CI）=7.275（1.598-33.129），21.303（4.282-105.985），13.520（3.617-50.530），0.076（0.007-0.823）（all P<0.05）. Hypoechoic tophus demonstrated significantly superior segmentation performance compared to mixed-echoic and isoechoic tophus（all P<0.05），and lesions with larger maximum diameters（>10 mm）were segmented more effectively than smaller tophus（ P<0.05）. Conclusions:The CMUNeXt model enables accurate identification and segmentation of tophus in MTP1 ultrasound images，particularly excelling for larger and hypoechoic lesions. This approach holds significant promise for AI-assisted diagnosis of MTP1 gouty arthritis.

Objective To observe the value of intravascular ultrasound elastography(IVUSE)for evaluating efficacy of ezetimibe combined with rosuvastatin for treating carotid atherosclerotic plaques.Methods Totally 200 ischemic cerebrovascular disease patients were prospectively enrolled and randomly divided into study group and control group(each n=100).Patients in study group were treated with ezetimibe combined with rosuvastatin,while those in control group were treated with atorvastatin alone for 4 months.The score of National Institutes of Health stroke scale(NIHSS)and related indicators of laboratory examination were recorded before and after treatment.Routine carotid artery ultrasound and IVUSE examination were performed,their efficacy for detecting vulnerable carotid plaque were compared taken the results of digital subtraction angiography(DSA)and CT before treatment as standards.The changes of clinical data,IVUSE parameters and stability of carotid plaque after treatment were observed.Results DSA detected single plaque in 162 cases and multiple plaques in 38 cases,with a total of 232 plaques,including 192 vulnerable plaques and 40 stable plaques.The accuracy of IVUSE for detecting vulnerable carotid plaque was higher than that of conventional ultrasound(x2=16.019,P＜0.001).After treatment,NIHSS score,total cholesterol,triglycerides,low-and high-density lipoprotein cholesterol improved better in study group than those in control group.Eccentric index and strain rate were higher,while the other plaque IVUSE parameters were lower in study group than those in control group(all P＜0.05).The improvement rate of plaque stability in study group after treatment was higher than that in control group(78.00％[78/100]vs.52.00％[52/100],P＜0.001).Conclusion IVUSE could be used to evaluate the efficacy of ezetimibe combined with rosuvastatin for treating carotid atherosclerotic plaque.

Objective To observe the value of intravascular ultrasound elastography(IVUSE)for evaluating efficacy of ezetimibe combined with rosuvastatin for treating carotid atherosclerotic plaques.Methods Totally 200 ischemic cerebrovascular disease patients were prospectively enrolled and randomly divided into study group and control group(each n=100).Patients in study group were treated with ezetimibe combined with rosuvastatin,while those in control group were treated with atorvastatin alone for 4 months.The score of National Institutes of Health stroke scale(NIHSS)and related indicators of laboratory examination were recorded before and after treatment.Routine carotid artery ultrasound and IVUSE examination were performed,their efficacy for detecting vulnerable carotid plaque were compared taken the results of digital subtraction angiography(DSA)and CT before treatment as standards.The changes of clinical data,IVUSE parameters and stability of carotid plaque after treatment were observed.Results DSA detected single plaque in 162 cases and multiple plaques in 38 cases,with a total of 232 plaques,including 192 vulnerable plaques and 40 stable plaques.The accuracy of IVUSE for detecting vulnerable carotid plaque was higher than that of conventional ultrasound(x2=16.019,P＜0.001).After treatment,NIHSS score,total cholesterol,triglycerides,low-and high-density lipoprotein cholesterol improved better in study group than those in control group.Eccentric index and strain rate were higher,while the other plaque IVUSE parameters were lower in study group than those in control group(all P＜0.05).The improvement rate of plaque stability in study group after treatment was higher than that in control group(78.00％[78/100]vs.52.00％[52/100],P＜0.001).Conclusion IVUSE could be used to evaluate the efficacy of ezetimibe combined with rosuvastatin for treating carotid atherosclerotic plaque.

Objective To understand the research hotspots and research trends about convolutional neural networks in the field of oncology imaging diagnosis by analyzing the characteristics of published literature at home and abroad over the past decade. Methods The SCI-E database was used as the data source to retrieve literature about convolutional neural networks in the field of oncology imaging diagnosis published from 2012 to 2022. The distribution characteristics of countries, institutions, journals, co-cited authors, and keywords of the studies were analyzed by CiteSpace software. Results A total of 1088 papers were eventually included, and they were mostly from China, the United States, and India. A total of 39 papers were published by Sun Yat-sen University, the research institution with the highest number of publications. Radiology Nuclear Medicine Medical Imaging was the journal with the highest number of publications. A total of 25 high-frequency keywords and 15 burst keywords were obtained. The formation of 12 author co-citation clusters such as image segmentation and lung nodule, as well as 11 keyword clusters such as automatic segmentation and breast cancer, was observed. Conclusion Current research on convolutional neural networks for oncology imaging diagnosis focuses on oncology segmentation, lung-nodule recognition, assisted diagnosis of breast cancer, and other high-frequency oncology.

Objective:To explore the application value of guide tube fenestration and drainage technology in intracranial artery stenting surgery.Methods:A total of 120 patients with symptomatic intracranial atherosclerotic stenosis admitted to the Xingtai Third Hospital from January 2021 to December 2022 were selected and randomly divided into an observation group ( n=60) and a control group ( n=60). Both groups were treated with intracranial artery stenting, with the observation group receiving guidance catheterization and window opening technique during the surgery. Two groups of surgeries were observed and compared: the degree of vascular stenosis before and after surgery, the Montreal Cognitive Assessment Scale (MoCA) scores before and one month after surgery, intraoperative complications, and prognosis. Results:The surgical time and catheter placement time in the observation group were (110.20±23.32)minutes and (11.32±2.01)minutes, respectively, which were significantly shorter than those in the control group (all P<0.05). The stent placement rate and operation success rate in the observation group were 95.00% and 96.67%, respectively, significantly higher than those in the control group (all P<0.05). The degree of postoperative vascular stenosis in the observation group was (32.29±7.11)%, significantly milder than that in the control group [(44.43±8.15)%, P<0.05]. One month after surgery, the MoCA scores of both groups improved significantly compared to before surgery (all P<0.05), and there was no statistically significant difference between the groups ( P>0.05). There was no statistically significant difference in the incidence of collateral circulation occlusion and vascular rupture between the two groups (all P>0.05). During the follow-up period, there was no statistically significant difference in the incidence of restenosis, intracranial hemorrhage, and recurrent ischemic stroke between the observation group and the control group (all P>0.05); The good prognosis rate of the observation group was 73.33%, significantly higher than that of the control group (53.33%, P<0.05). Conclusions:The application of guided catheter fenestration technique in intracranial artery stenting has good value, which is beneficial for improving the stent placement rate and operation success rate, and improving the degree of vascular stenosis.

Prosthetic loosening and periprosthetic inflammation, as serious complications after joint replacement surgery, often require the secondary surgery for repair, which is easy to adversely affect the physical/mental health and economic status of patients.Studies have shown that the functional phenotype expressed by macrophages by different stimuli, namely macrophage polarization state, prolonged M1 polarization can lead to the continuation of long-term inflammation, while timely and effective M2 macrophage phenotype will lead to enhanced osteogenesis and tissue remodeling cytokine secretion and subsequent osseointegration, which play a crucial role in the development and outcome of prosthetic loosening and periprosthetic inflammation.The local micro-environment of extracellular matrix (ECM) is an important factor in the activation, migration, proliferation and fusion of macrophages. Researchers have deeply understood it mainly through the crosstalk between surface properties of biomaterials and macrophages. As an effector cell, macro-phages can perform complex spatiotemporal cellular functional responses by sensing the physical and chemical environment (surface topography, wettability, chemical composition, biological proteins) represented by surface properties of biomaterials.This paper summarizes the recent findings on macrophage polarization and material surface properties.

Objective: To explore the changes of helper T lymphocytes 17 (Th17) and regulatory T lymphocytes (Tregs) in peripheral blood of patients with extensive burn at early stage in August 2nd aluminum dust explosion accident in Kunshan factory (hereinafter referred to as Kunshan explosion accident) and the significance. Methods: Twenty patients with extensive burn in Kunshan explosion accident admitted to our department of burns and plastic surgery were enrolled in burn group, and 10 healthy adult volunteers with no history of smoking were enrolled in healthy control group. Five mL of peripheral venous blood samples were collected from patients in burn group at admission (≤post injury hour 6, PIH 6) and PIH 24, and on post injury day (PID) 7, and from volunteers in healthy control group respectively. The percentages of CD64⁺ T lymphocytes, human leukocyte antigen-DR positive (HLA-DR⁺ ) T lymphocytes, CD3⁺ CD8^- Th17, and CD4⁺ CD25⁺ Tregs in peripheral blood T lymphocytes were determined by flow cytometer. Results: (1) The percentages of CD64⁺ T lymphocytes in peripheral blood T lymphocytes of patients in burn group at admission and PIH 24 [(2.35±0.32)% and (4.02±0.15)%] were higher than (0.67±0.11)% of healthy volunteers in healthy control group. The percentage of CD64⁺ T lymphocytes in peripheral blood T lymphocytes of patients in burn group on PID 7 [(0.39±0.25)% ] was lower than that of healthy volunteers in healthy control group. The percentages of HLA-DR⁺ T lymphocytes in peripheral blood T lymphocytes of patients in burn group at admission and PIH 24 [(54±18)% and (72±17)%] were higher than (38±14)% of healthy volunteers in healthy control group. The percentage of HLA-DR⁺ T lymphocytes in peripheral blood T lymphocytes of patients in burn group on PID 7 [(28±15)% ] was lower than that of healthy volunteers in healthy control group. (2) The percentages of CD3⁺ CD8^-Th17 in peripheral blood T lymphocytes of patients in burn group at admission and PIH 24 [(4.21±0.46)% and (7.38±0.39)%] were higher than (0.98±0.09)% of healthy volunteers in healthy control group. The percentage of CD3⁺ CD8^-Th17 in peripheral blood T lymphocytes of patients in burn group on PID 7 [(0.81±0.05)% ] was lower than that of healthy volunteers in healthy control group. (3) The percentages of CD4⁺ CD25⁺ Tregs in peripheral blood T lymphocytes of patients in burn group at admission and PIH 24, and on PID 7 [(1.78±0.26)%, (1.26±0.37)%, and (0.38±0.03)%] were lower than (3.24±0.52)% of healthy volunteers in healthy control group. Conclusions The percentage of Th17 in peripheral blood T lymphocytes of patients with extensive burn at early stage in Kunshan explosion accident increased at first and then decreased compared with that of healthy volunteers, indicating that the patients′ immune function increased first and then weakened. The percentages of Tregs in peripheral blood T lymphocytes at each time point were lower than the percentage of healthy volunteers, indicating that the patients′ immunomodulation gradually weakened after extensive burns.

Metastasis is the main cause of death in cancer patients. To improve the outcomes of patients undergoing a surgery, new adjuvant therapies that can effectively inhibit metastases have to be developed. Studies have shown that flavonoid naringenin, a natural product that is mainly present in grapes and citrus, may contribute to cancer prevention. It has many advantages compared to traditional chemotherapeutic drugs, such as low toxicity. To determine whether naringenin can also inhibit metastases, a breast cancer resection model that mimics clinical situations was established. We found that orally administered naringenin significantly decreased the number of metastatic tumor cells in the lung and extended the life span of tumor resected mice. Flow cytometry analysis revealed that T cells displayed enhanced antitumor activity in naringenin treated mice, with an increased proportion of IFN-γ and IL-2 expressing T cells. In vitro studies further demonstrated that relief of immunosuppression caused by regulatory T cells might be the fundamental mechanism of metastasis inhibition by naringenin. These results indicate that orally administered naringenin can inhibit the outgrowth of metastases after surgery via regulating host immunity. Thus, naringenin can be an ideal surgical adjuvant therapy for breast cancer patients.
Animals ; Anticarcinogenic Agents ; administration & dosage ; therapeutic use ; Antigens, CD ; analysis ; Breast Neoplasms ; drug therapy ; immunology ; pathology ; surgery ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Chemotherapy, Adjuvant ; Female ; Flavanones ; administration & dosage ; therapeutic use ; Humans ; Immunosuppressive Agents ; administration & dosage ; therapeutic use ; Interferon-gamma ; biosynthesis ; immunology ; Interleukin-2 ; biosynthesis ; immunology ; Lung Neoplasms ; drug therapy ; immunology ; prevention & control ; secondary ; Mice ; Mice, Inbred BALB C ; Mice, Inbred C57BL ; T-Lymphocytes, Regulatory ; drug effects ; immunology ; metabolism