Acute respiratory distress syndrome (ARDS) is the leading cause of respiratory failure with high morbidity and mortality. Pulmonary surfactant (PS)-based complementary therapies have exhibited potential for ARDS healing and applied as an adjunctive therapy strategy. Coacervate (Coac) has the characteristics of softness, deformability and excellent molecular enrichment properties, and has attracted extensive attention in the biomedical field. Here PS and coacervate were combined for the potential ARDS treatment. The Coac, fabricated from polyallylamine hydrochloride (PAH) and adenosine triphosphate (ATP) by simple mixing, exhibited soft droplet property and high enrichment for dexamethasone sodium phosphate (DSP). To avoid the fusion effect of membraneless coacervate and endow it with biological functions of PS, liposomes with PS-biomimetic lipid components (PS-lipo) were further introduced to construct PS-biomimetic membranized coacervate (DSP@PS-Coac). The DSP@PS-Coac demonstrated high lung targeting effect and significant penetration efficiency after intravenous injection. Furthermore, PS-lipo replenished the endogenous PS pool and facilitated the distribution of DSP in inflammatory cells in the lung. In the ARDS mouse model, PS-Coac and DSP exerted synergetic anti-inflammatory functions, via reducing the recruitment of inflammatory neutrophils and modulating macrophages into anti-inflammatory phenotype. The overall results confirmed that DSP@PS-Coac may provide a promising delivery option for the treatment of ARDS.

Objective:To investigate the quality control of magnetic resonance enterography(MRE)in the diagnosis of intestine diseases,and analyze the factors that affected the imaging quality of MRE,and enhance the imaging quality of MRE through adopted the measures of quality control.Methods:The documents of MRE examinations of 167 patients with intestinal disease who admitted to the 900th Hospital of People's Liberation Army Joint Service Support Force from May 2018 to March 2023 were retrospectively analyzed.The image qualities of all patients were evaluated after they completed clinical and image examinations.The reasons that image quality could not meet the requirement of diagnosis were analyzed.And then,the measures of quality control were proposed.Results:In 167 patients with intestinal disease,the MRE images of 153 patients(91.62%)could meet the requirement of diagnosis.In 14 patients(8.38%)whose MRE images could not meet the requirement of diagnosis,the reason of 3 cases(1.80%)was poor respiratory coordination,and that of 2 cases(1.20%)was there were more severe magnetic sensitive artifacts in images,and that of 1 case(0.60%)was severe intestinal peristalsis leaded to blurred images,and that of 2 cases(1.20%)was the flow void effect from intestinal peristalsis inside of intestinal cavity could not meet the requirement of diagnosis,and that of 4 cases(2.40%)was the intestinal tube without incomplete dilation caused by poor oral filling contrast agent,and that of 2 cases(1.20%)was many residues in intestine due to poor preparation for intestine.Aimed at the factors that MRE images could not meet requirement of diagnosis,we proposed the following quality control measures:①the biphasic contrast agents with favorable safety,without severe adverse reactions,which can fully dilate intestinal cavity,should be selected.②we should do well for the dilation of intestinal tube,and inhibit the intestinal peristalsis and conduct respiratory training.③we should conduct scan with wide field at coronal site,so as to display panorama image of intestine.④The scans of conventionally anatomical sequence and functional imaging sequence on axis position were performed on lesions.Conclusion:MRE technique should choose appropriate contrast agent in the quality control of the diagnosis of intestine diseases,and do well the preparation for patients before examination.Using intraluminal contrast agents,conducting intestinal dilation and optimal imaging technique are essential for obtaining intestinal MRE images with high quality.

Background::Breast cancer (BC) risk-stratification tools for Asian women that are highly accurate and can provide improved interpretation ability are lacking. We aimed to develop risk-stratification models to predict long- and short-term BC risk among Chinese women and to simultaneously rank potential non-experimental risk factors.Methods::The Breast Cancer Cohort Study in Chinese Women, a large ongoing prospective dynamic cohort study, includes 122,058 women aged 25-70 years old from the eastern part of China. We developed multiple machine-learning risk prediction models using parametric models (penalized logistic regression, bootstrap, and ensemble learning), which were the short-term ensemble penalized logistic regression (EPLR) risk prediction model and the ensemble penalized long-term (EPLT) risk prediction model to estimate BC risk. The models were assessed based on calibration and discrimination, and following this assessment, they were externally validated in new study participants from 2017 to 2020.Results::The AUC values of the short-term EPLR risk prediction model were 0.800 for the internal validation and 0.751 for the external validation set. For the long-term EPLT risk prediction model, the area under the receiver operating characteristic curve was 0.692 and 0.760 in internal and external validations, respectively. The net reclassification improvement index of the EPLT relative to the Gail and the Han Chinese Breast Cancer Prediction Model (HCBCP) models for external validation was 0.193 and 0.233, respectively, indicating that the EPLT model has higher classification accuracy.Conclusions::We developed the EPLR and EPLT models to screen populations with a high risk of developing BC. These can serve as useful tools to aid in risk-stratified screening and BC prevention.

The limitations of endovascular repair technology for organ arterial injury at the present stage were analyzed,and an endovascular repair device for organ arterial trunk injury was designed to make up for the shortcomings of the existing technology and improve the success rate of treatment.The new balloon injection device is mainly used for the repair of organ arterial trunk injury,which has good passing ability,can effective repair wound and hemostasis,and protect organ function.In clinical practice,it provided a new treatment method for visceral artery trunk injury with limited use of conventional endovascular treatment techniques and no open surgery opportunity.This device can effectively solve the problems of organ dysfunction caused by arterial embolization in the case of arterial trunk injury,and limited by the degree of tube tortuous in the case of stent isolation surgery.

Objective:To analyze the development status,frontiers and hotspots of radiomics research in the past five years from 2019 to 2023,and to provide theoretical reference and guidance for radiomics research in China.Methods:The relevant literature in the field of radiomics published in the core database of Web of Science(WOS)from January 1,2003 to August 10,2023 were searched.According to the inclusion and exclusion criteria,6,777 eligible literatures were screened and obtained,including 6,254 articles in the past five years from January 1,2019 to August 10,2023.Bibliometric methods were used to analyze the clustering of countries and regions,institutions,journals,authors,keywords and draw visual maps.Results:The 6,777 radiomics-related articles published between 2003 and 2023 were first published in 2011,and the number of papers tended to stabilize in 2018,and then the number showed a significant trend of increasing year by year.Among the 6,254 articles published from 2019 to 2023,China(3,564 articles),United States(1,164 articles),and Italy(530 articles)ranked the top 3 in terms of publication volume,with close cooperation between countries.General Electric of the United States published the most papers(448 articles),and the journal Frontiers in Oncology(704 papers)ranked first in terms of paper publication volume.From 2019 to 2023,the diseases of concern in the field of radiomics are rectal cancer,hepatocellular carcinoma,breast cancer,and lung cancer(especially non-small cell lung cancer).Conclusion:Although China ranks first in the number of national publications,the quality of research still needs to be improved.In the future,the research trend in the field of radiomics may be the diagnosis and differential diagnosis of various diseases,the prediction and evaluation of curative effect,the evaluation of tumor disease metastasis and the identification of gene phenotype based on radiomics combined with multiple imaging techniques.

Objective:To realize the optimization and upgradation of the detection method of you only look once(YOLO)algorithm model based on the improved YOLO network on the ultrasound image for breast tumor.Methods:A total of 659 images of breast tumor of the Kaggle database were selected as the initially dataset,and the image annotation tool Labelimg was used to conduct pre-labeling for the detection targets in the images.According to a ratio as 7:3,629 images of the 659 images were divided into the train set and validation set,and the other 30 images were used as the test set.The convolutional block attention module(CBAM)and bidirectional feature pyramid network(BiFPN)were introduced into the original YOLO algorithm to underwent structural improvement,which was named as YOLOv5-BiFPN-CBAM.Both the train set and validation set were placed in original YOLO algorithm model and YOLOv5-BiFPN-CBAM model to conduct train,which included 200 rounds of iterative training.The obtained optimal weight files were used in the final test of test set.Results:After 200 rounds of iterative train for two kinds of models,the test results of validation set indicated that the mean values of average precision of two kinds of models were respectively 72.1%and 80.5%for all ultrasound images of breast tumor.The result,that the optimal weight file of improved model was tested by test set,indicated the test ability of improved model was significantly enhanced than that of original model for small target in image.Conclusion:Compared with the original YOLO algorithm model,the improved YOLO algorithm model has higher recognition capability for image,which also enhances precision and sensitivity in identifying small targets of ultrasound images of breast tumor.This model is helpful to improve the diagnostic efficiency in clinical practice for breast tumor.

Objective:To explore diagnostic value of artificial intelligence(AI)technique on intracranial aneurysm(IA)in multi-slices computed tomography angiography(CTA)for head and neck.Methods:A retrospective analysis was performed on the cases data of 137 patients with suspected IA who were firstly diagnosed in Fuzong Teaching Hospital of Fujian University of Traditional Chinese Medicine from January 2022 to December 2023,all of them underwent CTA and digital subtraction angiography(DSA)examinations.The results of DSA examination were taken as the"gold standard".The work efficiency and detection effectiveness of two groups for IA were analyzed through manual post-processing and diagnosis(manual group)and CTA with intelligent assistant diagnostic system on head and neck(AI group).Results:In 137 patients with suspected IA,the DSA examination showed that there were 139 aneurysms in 112 patients.The post-processing time was(190.25±30.71)s in AI group,which was significantly shorter than that[(954.37±95.68)s]in manual group,and the difference was statistically significant(t=92.020,P＜0.001),and the image quality of AI group was higher.In the manual group,102 cases with aneurysms were found,which showed good consistency with the"gold standard"(Kappa=0.713),while the AI group found 93 cases with aneurysms,which showed moderate consistency with the"gold standard"(Kappa=0.518).Both groups had higher diagnostic accuracy for the presence or absence of subarachnoid hemorrhage of intracranial aneurysm,but the difference of that between them was not statistically significant difference(P＞0.05).The detection rates of anterior cerebral artery,middle cerebral artery,posterior cerebral artery,anterior communicating artery,posterior communicating artery,vertebral-basilar artery,and artery aneurysms of internal carotid in manual group and AI group were respectively 80.00％vs.80.00％,92.59％vs.81.48％,100.00％vs.100.00％,84.00％vs.52.00％,83.33％vs.0％,80.00％vs.60.00％,69.23％vs.57.69％,and both of them did not found lesions of posterior inferior cerebellar artery.The overall detection rates of two groups were respectively 78.42％and 57.55％,and the overall detection rate of lesion locations of manual group was higher than that of AI group,and the difference in overall coincidence rate between two groups was statistically significant(x2=13.899,P＜0.05).DSA confirmed 7 lesions which aneurysm's diameter was＜3 mm,and the manual group and the AI group identified respectively 3 cases and 1 case for the 7 lesions.A total of 60 lesions with 3～5 mm diameter were found by DSA,and the manual group and the AI group identified respectively 50 cases and 43 cases for the 60 lesions.A total of 72 lesions with＞5 mm diameter were found by DSA,and the manual group and the AI group identified respectively 63 cases and 63 cases,without statistically significant difference between them(P＞0.05).Conclusion:AI technique can significantly improve work efficiency of diagnosis for intracranial aneurysm,and obtain better processing effects of image.Although AI technique has shown a certain value of reference and auxiliary in diagnosing intracranial aneurysms,its diagnostic accuracy and precise in identifying lesion location are still lower than those of manual diagnosis,and it need further deep learning to improve its diagnostic ability.

Objective:To explore the value of mitoxantrone hydrochloride injection for tracing in endoscopic thyroidectomy (ETE) via anterior chest approach for papillary thyroid carcinoma (PTC) .Methods:A retrospective analysis was conducted on patients undergoing ETE via anterior chest approach for PTC admitted to Beijing Longfu Hospital (Medical Treatment Combination with Peking Union Medical College Hospital) from Sep. 2022 to Mar. 2024. The patients were divided into two groups: the control group (without tracer) and the tracer group (with mitoxantrone hydrochloride injection for tracing). All surgeries were performed by the same thyroid surgical team. Baseline, postoperative pathologies and complications were compared between the 2 groups.Results:A total of 25 patients (13 in the control group and 12 in the tracer group) were included in this study, and the average dissection of unilateral central region lymph nodes in the tracer group was 7.4±4.6, significantly more than in the control group (2.4±1.9) ( P=0.004). There were no instances of mistakenly resected parathyroid gland in the postoperative pathology or accidental injury of recurrent laryngeal nerve in either group. The incidence of transient hypocalcemia did not significantly different between the two groups ( P=0.503). However, the incidence of transient hypoparathyroidism in the tracer group was 1 (1/12,8.3%), significantly lower than in the control group 4 (4/13,30.8%) ( P=0.009). The tracer group exhibited more impressive levels in parathyroid hormone (5.4±8.1) pg/mL compared to the control group (20.0±11.1) pg/mL ( P=0.001) .The total volume of postoperative drainage in the tracer group (142.9±71.7) mL was more than that of the control group (87.7±38.8) mL ( P=0.030). But It did not affect the extubation time in either group ( P=0.610). No residual tracer was observed at the skin puncture site in the tracer group after 2 weeks. Conclusions:Mitoxantrone hydrochloride injection for tracing as tracer in ETE via breast approach can increase the number of pathological lymph nodes dissection in cervical central region. Combined with negative development, identifying and protecting the function of parathyroid glands show feasible and potential application value to improve the safety of thyroidectomy. The use of mitoxantrone hydrochloride injection for tracer has the risk of increased exudation from the surgical area, but does not affect the time to remove the drain.

Objective:To explore the use of near-infrared autofluorescence probe (NIRAF-P) and its application in identifying parathyroid glands during surgery.Methods:A total of 68 patients undergoing thyroid surgery at Peking Union Medical College Hospital and Beijing Longfu Hospital between Dec. 2023 and Jun. 2024 were selected. During the operation, the near-infrared parathyroid gland detector was used to identify the parathyroid gland tissue to be tested, and histopathological examination was performed. The positive predictive value and accuracy of the near-infrared parathyroid gland detector were analyzed.Results:A total of 111 parathyroid glands were identified in 68 patients, and the positive predictive value and accuracy of the NIRAF-P were 95.5% and 94.6%, respectively.Conclusions:The NIRAF-P has high accuracy in identifying parathyroid glands. The standardized application of the NIRAF-P can help improve the efficiency of identifying parathyroid glands during surgery.

ObjectiveTo investigate the effect of Rehmanniae Radix Praeparata on neurological function injury in ischemic stroke rats and explore its mechanism. MethodMale SD rats were randomized into sham operation， model， low- and high -dose （3.5 g·kg^-1 and 7 g·kg^-1） Rehmannia Radix Praeparata， and nimodipine （0.01 g·kg^-1） groups. The rat model of middle cerebral artery occlusion （MCAO） was established with the modified suture occlusion method. Zea-Longa 5-point scoring was employed to evaluate the neurological function of rats. The cerebral infarction volume was detected by 2，3，5-triphenyltetrazolium chloride （TTC） staining. Hematoxylin-eosin staining and Nissl staining were employed to observe the morphology and damage of the brain tissue. Meanwhile， the serum levels of lactate dehydrogenase （LDH）， oxidative stress-related indicators superoxide dismutase （SOD）， glutathione peroxidase 4 （GPX4）， and malondialdehyde （MDA）， and the iron （Fe） content in the brain tissue were determined. To explore the mechanism of Rehmanniae Radix Preparata in mitigating the neurological damage in ischemic stroke rats， Western blotting was employed to determine the expression levels of proteins in the ischemic brain tissue. The autophagy-associated proteins included autophagy effector （beclin-1）， microtubule-associated protein light chain 3 （LC3B）， and ubiquitin-binding protein p62 （p62）. The ferroptosis-associated proteins included transferrin （TF）， transferrin receptor 1 （TFR1）， ferritin heavy chain 1 （FTH1）， and ferropotin （FPN1）. The neurological function injury-associated proteins included brain-derived neurotrophic factor （BDNF） and tyrosine kinase receptor B （TrkB）. ResultCompared with the sham operation group， the model group showed increased neurological function score， cerebral infarction volume， and appearance of nuclear pyknosis and vacuole of cells in the cerebral cortex. In addition， the model group presented elevated levels of LDH， MDA， and Fe （P<0.01） and lowered levels of SOD and GPX4 （P<0.01）. Compared with the model group， Rehmanniae Radix Praeparata decreased the content of LDH， MDA， and Fe （P<0.05， P<0.01） and elevated the levels of SOD and GPX4 （P<0.05， P<0.01）. Compared with the sham operation group， the modeling promoted the expression of beclin-1，LC3B Ⅱ/Ⅰ， TF， and TFR1 and inhibited the expression of p62， FTH1， FPN1， BDNF， and TrkB （P<0.01）. The expression levels of these proteins were recovered after the treatment with Rehmanniae Radix Praeparata. ConclusionRehmanniae Radix Praeparata may inhibit ferroptosis and improve the neurological function in ischemic stroke rats by down-regulating the autophagy level in the brain tissue.