ObjectiveTo investigate the influencing factors and independent risk factors for lower extremity deep vein thrombosis （DVT） in patients with acute necrotizing pancreatitis （ANP）， to analyze the effectiveness of three commonly used risk assessment models for thrombosis （Caprini score， Padua score， and Wells score）， and to provide a reference for clinical identification of high-risk individuals and optimization of prevention and treatment strategies. MethodsA retrospective analysis was performed for the clinical data of 320 patients with ANP who were admitted to Luzhou People’s Hospital and The Affiliated Hospital of Southwest Medical University from April 2013 to April 2024， and according to the presence or absence of DVT during hospitalization， the patients were divided into thrombosis group with 25 patients and control group with 295 patients. After propensity score matching， the two groups were compared in terms of past history and various examination results during hospitalization. The risk factors for lower extremity DVT in ANP patients during hospitalization were analyzed through univariate and multivariate Logistic regression， and a DVT risk prediction model was established based on independent influencing factors. The receiver operating characteristic （ROC） curve was used to assess the performance of models， and the DeLong test was used for comparison of the area under the ROC curve （AUC）， sensitivity， and specificity. The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between two groups； the chi-square test was used for comparison of categorical data between groups. ResultsAfter matching， the patients were divided into thrombosis group with 24 patients and control group with 112 patients. The clinical characteristics analysis showed that compared with the control group， the thrombosis group had significantly higher degree of pancreatic necrosis， D-dimer level， Bedside Index for Severity in Acute Pancreatitis （BISAP） score， and proportion of patients undergoing dialysis （all P<0.05）. The multivariable Logistic regression analysis showed that BISAP score， degree of pancreatic necrosis， and D-dimer level were independent risk factors for lower extremity DVT in ANP patients during hospitalization （all P<0.05）. The BISAP-Caprini score model had an AUC of 0.832 （95% confidence interval： 0.722 — 0.942， P<0.001） in predicting the risk of lower extremity DVT， with a Youden index of 1.661， an optimal cut-off value of 0.26， a sensitivity of 75.0%， and a specificity of 91.1%. ConclusionD-dimer， BISAP score， and the degree of pancreatic necrosis are independent risk factors for lower extremity DVT in patients with ANP during hospitalization， and the BISAP-Caprini score model can effectively predict the risk of DVT in ANP patients.

OBJECTIVE: To investigate the impact of bone mass and volume of low-density zones beneath the tibial plateau on the maximum von Mises stresses experienced by the cartilage and meniscus in the knee joint. METHODS: The study included one healthy adult volunteer, from whom CT scans were obtained, and one patient diagnosed with knee osteoarthrisis (KOA), for whom X-ray films were acquired. A static model of the knee joint featuring a low-density zone was established based on a normal knee model. In the finite element analysis, axial loads of 1 000 N and 1 800 N were applied to the weight-bearing region of the upper surface of the femoral head for model validation and subsequent finite element studies, respectively. The maximum von Mises stresses in the femoral cartilage, as well as the medial and lateral tibial cartilage and menisci, were observed, and the stress percentage of the medial and lateral components were concurrently analyzed. Additionally, HE staining, as well as alkaline magenta staining, were performed on the pathological specimens of patients with KOA in various low-density regions. RESULTS: The results of model validation indicated that the model was consistent with normal anatomical structures and correlated with previous calculations documented in the literature. Static analysis revealed that the maximum von Mises stress in the medial component of the normal knee was the lowest and increased with the advancement of the hypointensity zone. In contrast, the lateral component exhibited an opposing trend, with the maximum von Mises stress in the lateral component being the highest and decreasing as the hypointensity zone progressed. Additionally, the medial component experienced an increasing proportion of stress within the overall knee joint. HE staining demonstrated that the chondrocyte layer progressively deteriorated and may even disappear as the hypointensity zone expanded. Furthermore, alkaline magenta staining indicated that the severity of microfractures in the trabecular bone increased concurrently with the expansion of the hypointensity zone. CONCLUSION The presence of subtalar plateau low-density zone may aggravate joint degeneration. In clinical practice, it is necessary to pay attention to the changes in the subtalar plateau low-density zone and actively take effective measures to strengthen the bone status of the subtalar plateau low-density zone and restore the complete biomechanical function of the knee joint, in order to slow down or reverse the progression of osteoarthritis.
Humans ; Finite Element Analysis ; Knee Joint/physiology* ; Tibia/anatomy & histology* ; Cartilage, Articular/physiology* ; Menisci, Tibial/physiopathology* ; Tomography, X-Ray Computed ; Osteoarthritis, Knee/diagnostic imaging* ; Weight-Bearing ; Bone Density ; Adult ; Stress, Mechanical ; Male ; Middle Aged ; Biomechanical Phenomena ; Female

The endometrial microenvironment and the immune regulation of pregnancy is a recent focus and challenge in the field of reproductive immunology. During the establishment of pregnancy, the immune cells assist in shaping a fetus-friendly immune microenvironment through adaptive reprogramming, thereby allowing the embryo to obtain "immune privilege". Immunometabolism is an emerging research field that has been developing rapidly in the last decade, focusing on the interaction between the immunology and metabolism and their roles in the physiopathology. However, the current evidence regarding how immunometabolism is involved in the regulation of the endometrial microenvironment and maternal-fetal immune tolerance is insufficient. In light of the implications of tumor immunometabolism for immunometabolism in pregnancy, the metabolic pathways of immune cell differentiation and function are reviewed for their potential regulatory role in shaping the maternal-fetal tolerance microenvironment. The relationship between metabolic and nutritional abnormalities and pregnancy disorders is analyzed. Finally, the possibility of improving pregnancy outcomes through immunometabolic inhibitors or dietary interventions is explored from a clinical application perspective.

The endometrial microenvironment and the immune regulation of pregnancy is a recent focus and challenge in the field of reproductive immunology. During the establishment of pregnancy, the immune cells assist in shaping a fetus-friendly immune microenvironment through adaptive reprogramming, thereby allowing the embryo to obtain "immune privilege". Immunometabolism is an emerging research field that has been developing rapidly in the last decade, focusing on the interaction between the immunology and metabolism and their roles in the physiopathology. However, the current evidence regarding how immunometabolism is involved in the regulation of the endometrial microenvironment and maternal-fetal immune tolerance is insufficient. In light of the implications of tumor immunometabolism for immunometabolism in pregnancy, the metabolic pathways of immune cell differentiation and function are reviewed for their potential regulatory role in shaping the maternal-fetal tolerance microenvironment. The relationship between metabolic and nutritional abnormalities and pregnancy disorders is analyzed. Finally, the possibility of improving pregnancy outcomes through immunometabolic inhibitors or dietary interventions is explored from a clinical application perspective.

Alzheimer's disease (AD) is a typical neurodegenerative disease, which is clinically manifested as amnesia, loss of language ability and self-care ability, and so on. So far, the cause of the disease has still been unclear and the course of the disease is irreversible, and there has been no cure for the disease yet. Hence, early prognosis of AD is important for the development of new drugs and measures to slow the progression of the disease. Mild cognitive impairment (MCI) is a state between AD and healthy controls (HC). Studies have shown that patients with MCI are more likely to develop AD than those without MCI. Therefore, accurate screening of MCI patients has become one of the research hotspots of early prognosis of AD. With the rapid development of neuroimaging techniques and deep learning, more and more researchers employ deep learning methods to analyze brain neuroimaging images, such as magnetic resonance imaging (MRI), for early prognosis of AD. Hence, in this paper, a three-dimensional multi-slice classifiers ensemble based on convolutional neural network (CNN) and ensemble learning for early prognosis of AD has been proposed. Compared with the CNN classification model based on a single slice, the proposed classifiers ensemble based on multiple two-dimensional slices from three dimensions could use more effective information contained in MRI to improve classification accuracy and stability in a parallel computing mode.
Alzheimer Disease ; diagnosis ; Brain ; diagnostic imaging ; Cognitive Dysfunction ; Deep Learning ; Humans ; Neural Networks (Computer) ; Neuroimaging ; Prognosis

Objective To investigate the clinical effect of low molecular weight heparin calcium (MvH) in the treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)complicated with pulmonary heart disease. Methods 128 AECOPD patients with pulmonary heart disease from January 2016 to December 2016 in our hospital were randomly divided into observation group and control group in equal number by random digit table with EXCEL2007. Apart from the basic treatment like anti infection,oxygen,expectorant,maintenance of water and electrolyte balance and cardiotonic treatment ,the observation group was treated with MvH. The two groups were compared in terms of pre-and post-ventricular end diastolic volume(EDV),end systolic volume(ESV),right ventricular ejection fraction(RVEF),pulmonary artery acceleration time(AT),arterial oxygen pressure(PaO2),arterial partial pressure of carbon dioxide(PaCO2),pH value,whole blood viscosity at low shear the whole blood viscosity at high shear rate,plasma viscosity,hematocrit,plasma D- dimer(D-D). Results After treatment,EDV and ESV of the observation group were significantly lower than the control group (P < 0.05)and RVEF and AT were higher than the control group(P < 0.05). PaCO2 was lower than that of the control group(P < 0.05). PaO2,pH values were higher than those of the control group(P < 0.05). After treatment,the whole blood viscosity,whole blood low shear viscosity at high shear rate,plasma viscosity,hematocrit, plasma level of D-D of the observation group were all lower than those of the control group (P < 0.05). Conclusion Subcutaneous injection with MvH to treat the patients with AECOPD complicated with pulmonary heart disease can improve the blood rheology and improve heart function and blood gas level.

In recent years, researchers have introduced various methods in many domains into medical image processing so that its effectiveness and efficiency can be improved to some extent. The applications of generative adversarial networks (GAN) in medical image processing are evolving very fast. In this paper, the state of the art in this area has been reviewed. Firstly, the basic concepts of the GAN were introduced. And then, from the perspectives of the medical image denoising, detection, segmentation, synthesis, reconstruction and classification, the applications of the GAN were summarized. Finally, prospects for further research in this area were presented.

Objective: To assess the effect of combined treatment using cell scaffold and human fibroblast growth factor for small soft tissue defects of digits caused by trauma. Methods: From May 2012 to September 2016, twenty cases of small soft tissue defect of digits were repaired with cell scaffold combined with recombinant human basic fibroblast growth factor. The average defect area was 2.5 cm². Wounds were debrided and repaired with artificial dermis. Every 2 or 3 days the dressings were changed and the wounds were treated externally with fibroblast growth factor until cell scaffolds have been removed 3-4 weeks after surgery. Results: The group of 20 cases was followed up for 2-24 months. Wounds were healed with satisfactory appearance and no recurrence of wound or obvious hypertrophic scar was observed. No obvious functional problem was found in interphalangeal motion. Conclusions The method of repairing wound with cell scaffold combined with human fibroblast growth factor is simple and it result in healing of wounds with high quality.It provides a new choice for repairing wound in digits.

Objective To explore the feasibility of electromagnetic navigation for hepatic ducts exploration by choledochoscope based on a three-dimensional (3D) printing model.Methods The retrospective descriptive study was conducted.The clinical data of 1 patient with obstructive jaundice combined with secondary biliary tract dilation who was admitted to the Beijing Tsinghua Changgung Hospital in April 2016 were collected.Digital imaging and standardized format data of enhanced computed tomography (CT) scan were collected,3D reconstruction of liver and bile duct were done under a 3D printing model,and then a hollow model of bile duct was achieved.Choledochoscope with internal electromagnetic probe was inserted into the printed hepatic ducts.Four points of anatomical markers in left and right hepatic ducts and common hepatic duct were chosen as fiducial markers for calibration and registration.Results After registration,the scope can be tracked in main hepatic segmental bile ducts.The locations of choledochoscope matched precisely the navigation results.Conclusion Electromagnetic navigation may bring accurate tracking effectiveness for choledochoscopic examination.

Objective To investigate the diagnostic value of serum tumors M2 pyruvate kinase (TuM2-PK),carcino-embryonic antigen (CEA),CA199,CA724,CA125 and CA242 in colon cancer.Methods Serum levels of TuM2-PK,CEA,CA199,CA724,CA125 and CA242 in 231 patients with colon cancer,105 patients with colon benign lesion diseases and 166 normal controls were measured by the ELISA and electrochemiluminescence assays.The operation working characteristic curve (ROC) and the logistic regression-ROC were used to evaluate the diagnostic value of tumor markers for colon cancer individually and in combination.The models of logistic regression analysis and partial least-squares discriminant analysis (PLS-DA) were established to diagnose patients with colon cancer based on the optimal panel of serum tumor markers.Resalts Concentrations of serum TuM2-PK,CEA,CA199,CA125 and CA724 in the colon cancer group are higher than those in the colon benign diseases group and the normal controls (P＜0.05).The area under the operation working characteristic curve (AUC) of CA199 is the highest 0.79 [95％ confidence interval (95％CI),0.75-0.83] at the cutoff value of 69.5 U/L with 64.1％ of sensitivity and 89.7％ of specificity.The AUC of combined serum tumor markers based on logistic regression analysis is higher than those in individuals,of which serum (CEA+ CA199+TuM2-PK) is the optimal [AUC=0.89,95％ confidence interval(95％CI),0.86-0.92].The diagnostic accuracy of logistic analysis and PLS-DA model for colon cancer is 82.7％ and 77.5％,and for colon cancer is 93.7％ and 95.6％,respectively.Conclusion The combination of serum tumor markers CEA,CA199 and TuM2-PK is more suitable as a diagnostic model for the screening of colon cancer.