Objective·To preliminarily investigate the value of high-order functional magnetic resonance imaging in the evaluation of benign and malignant bone and soft tissue tumors and the changes after chemotherapy.Methods·Patients clinically diagnosed with bone and soft tissue tumors at the Department of Orthopaedics,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,from October 2014 to December 2024 were enrolled.The patients were divided into a control group and an amide proton transfer-weighted imaging(APTw)group according to the imaging method.All patients underwent conventional magnetic resonance imaging(MRI),diffusion-weighted imaging(DWI),and dynamic contrast-enhanced imaging(DCE)before surgery.Patients in the APTw group received additional APTw imaging.Both groups were divided into non-malignant and malignant lesion subgroups according to pathological results.According to whether the patients received chemotherapy before enrollment,the patients with malignant lesions in the APTw group were further divided into malignant group without chemotherapy and malignant group with chemotherapy.Clinical and imaging data,including APT values,apparent diffusion coefficient(ADC),and time-intensity curves(TICs)from the largest tumor section,were collected and analyzed to assess the diagnostic performance of APTw,DWI,and DCE,and to evaluate changes after chemotherapy.Results·Eighty-five patients were enrolled,including 51 males and 34 females,with ages ranging from 10 to 84 years,and a mean age of(43.05±17.62)years.There were 51 patients in the control group(16 with non-malignant lesions and 35 with malignant lesions)and 34 patients in the APTw group(5 with non-malignant lesions and 29 with malignant lesions;23 malignant lesions without chemotherapy and 6 malignant lesions with chemotherapy).The clinical and imaging data showed that only the tumor margin of the control group and the maximum tumor diameter of the APTw group had statistically significant differences in their malignant and non-malignant lesion groups(P<0.05).In the APTw group,there was a statistically significant difference in APT values between the malignant lesion group and the non-malignant lesion group(P<0.001).Further analysis showed that the APT values in the malignant group without chemotherapy were significantly lower than that in the malignant group with chemotherapy(P<0.001).However,there were no statistically significant differences in APT values between the malignant group with chemotherapy and the non-malignant lesion group(P>0.05).There were no significant differences in ADC values and TIC types between malignant and non-malignant lesion groups in the control group and the APTw group(P>0.05).The area under the curve(AUC)of the diagnostic model in the APTw group(MRI+DWI+DCE+APTw)for distinguishing malignant from benign tumors was significantly higher than that of the control group(MRI+DWI+DCE)(P<0.05).The Youden index and specificity of the diagnostic model in the APTw group were higher than those in the control group.Conclusion·As a high-order functional MRI technique,APTw imaging is capable of evaluating the nature(benign or malignant)of bone and soft tissue tumors and detecting changes after chemotherapy.It serves as a valuable supplement to conventional MRI,DWI,and DCE imaging,providing a novel noninvasive tool for the diagnosis and treatment evaluation of bone and soft tissue tumors.

Objective·To preliminarily investigate the value of high-order functional magnetic resonance imaging in the evaluation of benign and malignant bone and soft tissue tumors and the changes after chemotherapy.Methods·Patients clinically diagnosed with bone and soft tissue tumors at the Department of Orthopaedics,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,from October 2014 to December 2024 were enrolled.The patients were divided into a control group and an amide proton transfer-weighted imaging(APTw)group according to the imaging method.All patients underwent conventional magnetic resonance imaging(MRI),diffusion-weighted imaging(DWI),and dynamic contrast-enhanced imaging(DCE)before surgery.Patients in the APTw group received additional APTw imaging.Both groups were divided into non-malignant and malignant lesion subgroups according to pathological results.According to whether the patients received chemotherapy before enrollment,the patients with malignant lesions in the APTw group were further divided into malignant group without chemotherapy and malignant group with chemotherapy.Clinical and imaging data,including APT values,apparent diffusion coefficient(ADC),and time-intensity curves(TICs)from the largest tumor section,were collected and analyzed to assess the diagnostic performance of APTw,DWI,and DCE,and to evaluate changes after chemotherapy.Results·Eighty-five patients were enrolled,including 51 males and 34 females,with ages ranging from 10 to 84 years,and a mean age of(43.05±17.62)years.There were 51 patients in the control group(16 with non-malignant lesions and 35 with malignant lesions)and 34 patients in the APTw group(5 with non-malignant lesions and 29 with malignant lesions;23 malignant lesions without chemotherapy and 6 malignant lesions with chemotherapy).The clinical and imaging data showed that only the tumor margin of the control group and the maximum tumor diameter of the APTw group had statistically significant differences in their malignant and non-malignant lesion groups(P<0.05).In the APTw group,there was a statistically significant difference in APT values between the malignant lesion group and the non-malignant lesion group(P<0.001).Further analysis showed that the APT values in the malignant group without chemotherapy were significantly lower than that in the malignant group with chemotherapy(P<0.001).However,there were no statistically significant differences in APT values between the malignant group with chemotherapy and the non-malignant lesion group(P>0.05).There were no significant differences in ADC values and TIC types between malignant and non-malignant lesion groups in the control group and the APTw group(P>0.05).The area under the curve(AUC)of the diagnostic model in the APTw group(MRI+DWI+DCE+APTw)for distinguishing malignant from benign tumors was significantly higher than that of the control group(MRI+DWI+DCE)(P<0.05).The Youden index and specificity of the diagnostic model in the APTw group were higher than those in the control group.Conclusion·As a high-order functional MRI technique,APTw imaging is capable of evaluating the nature(benign or malignant)of bone and soft tissue tumors and detecting changes after chemotherapy.It serves as a valuable supplement to conventional MRI,DWI,and DCE imaging,providing a novel noninvasive tool for the diagnosis and treatment evaluation of bone and soft tissue tumors.

The aim of this study was to evaluate the roles of interleukin (IL)-17A in risk stratification and prognosis of patients with sepsis-associated acute kidney injury (SAKI). Methods: We enrolled 146 sepsis patients (84 non-SAKI and 62 SAKI patients) admitted to the emergency department from November 2020 to November 2021. Patients with SAKI were differentiated based on the severity of acute kidney injury. All clinical parameters were evaluated upon admission before administering antibiotic treatment. Inflammatory cytokines were assessed using flow cytometry and the Pylon 3D automated immunoassay system (ET Healthcare). In addition, a receiver operating characteristic (ROC) curve was utilized to determine the prognostic values of IL-17A in SAKI. Results: The levels of creatinine, IL-2, IL-4, IL-6, IL-17A, tumor necrosis factor alpha, C-reactive protein, and procalcitonin (PCT) were significantly higher in the SAKI group than in the non-SAKI group (p < 0.05). The level of IL-17A revealed significant differences among stages 1, 2, and 3 in SAKI patients (p < 0.05). The mean levels of PCT, IL-4, and IL-17A were significantly higher in the non-survival group than in the survival group in SAKI patients (p < 0.05). In addition, the area under the ROC curve of IL-17A was 0.811. Moreover, the IL-17A cutoff for differentiating survivors from non-survivors was 4.7 pg/mL, of which the sensitivity and specificity were 77.4% and 71.0%, respectively. Conclusion: Elevated levels of IL-17A could predict that SAKI patients are significantly prone to worsening kidney injury with higher mortality. The usefulness of IL-17A in treating SAKI requires further research.

Objective:To observe the effect of electro-acupuncture (EA) on learning, memory and the differentiation of neural stem cells in the hippocampus in the presence of chronic cerebral ischemia.Methods:A total of 120 male Sprague-Dawley rats had chronic cerebral ischemia induced by bilateral ligation of the common carotid arteries. The model was successfully established in 104 of them, and they were randomly divided into a model group and an EA group, each of 52. The EA group was given 20 minutes of EA at acpoints Baihui and Dahui every day for 7 days, followed by an interval of 2 days. The current output was 1mA and the frequency was 15Hz. The model group was not given any intervention. One, 2, 4 and 6 weeks after the modelling, 6 rats from each group were injected with BrdU, and any proliferation and differentiation of neural stem cells was observed. The rats′ learning and memory were also evaluated using the Morris water maze, and neurogenesis of in the dentate gyrus was observed using BrdU+ NeuN and BrdU+ GFAP double-labelled immunofluorescence.Results:The learning and memory of the EA group were significantly better than those of the model group 2, 4 and 6 weeks after the modelling. After two weeks BrdU+ NeuN and BrdU+ GFAP-positive cells were found in the granule cell layer of the hippocampus, and compared with the model group, there were siginificantly more such neurons in the EA group. The gliocyte levels were not significantly different.Conclusion:Electro-acupuncture can improve learning and memory in the face of chronic cerebral ischemia by promoting the differentiation of neural stem cells.

The adjacent anatomy of the pelvis is complicated, with digestive, urinary, reproductive and other organs as well as important blood vessels and nerves. Therefore, accurate resection of pelvic tumors and precise reconstruction of defects after resection are extremely difficult. The development of medical 3D printing technology provides new ideas for precise resection and personalized reconstruction of pelvic tumors. The “triune” application of 3D printing personalized lesion model, osteotomy guide plate and reconstruction prosthesis in pelvic tumor limb salvage reconstruction treatment has achieved good clinical results. However, the current lack of normative guidance standards such as preparation and application of 3D printing personalized lesion model, osteotomy guide plate and reconstruction prosthesis restricts its promotion and application. The formulation of this consensus provides normative guidance for 3D printing personalized pelvic tumor limb salvage reconstruction treatment.

AIM: To investigate the protective effect of ferulic acid on palmitic acid-induced lipotoxicity in HepG2 cells and to explore its potential molecular mechanisms. METHODS: HepG2 cells were induced by palmitic acid to establish a lipotoxicity model, while ferulic acid was added prior to palmitic acid treatment. Lactate dehydrogenase (LDH) was used to detect cell damage. Methyl azozole trace enzyme reaction is used for 3-(4, 5)-dimethylthiahiazo (-z-y1)-3, 5-di-phenytetrazoliumromide (MTT) was employed to detect cell viability. The molecular mechanisms of the protective effect of ferulic acid was analyzed by Western Blotting. RESULTS: There was no cytotoxic effect of different concentrations of ferulic acid (25, 50, 100, 200 μmol/L) treatment on HepG2 cells (P>0.05). Ferulic acid intervention significantly inhibited palmitic acid-induced cell death and improved palmitic acid-induced reduction of cell mitochondrial membrane potential (P<0.05). The activation of p38 significantly enhanced palmitic acid-induced hepatocellular lipotoxicity (P<0.05), while inhibition of p38 significantly improved palmitic acid-induced cell damage (P<0.05). In addition, ferulic acid significantly inhibited the upregulation of p38 phosphorylation by palmitic acid treatment (P<0.05). p38 activator exposure blocked the protective effect of ferulic acid on lipotoxicity (P<0.05). CONCLUSION: Ferulic acid effectively improves hepatocellular injury induced by lipotoxicity.The inhibition of p38 signaling pathway is potentially involved in its protective effect. Ferulic acid may be an effective factor in the prevention and treatment of liver disease with lipotoxicity as a major pathological characteristic.

Objective: To investigate the therapeutic effect of free superficial circumflex iliac artery perforator (SCIP)flap for reconstruction of soft tissue defects secondary to resection of retromolar and lateral buccal squamous cell carcinoma. Methods: From January 2014 to January 2017, eight patients with retromolar and lateral buccal squamous cell carcinoma received radical resection and reconstructed with SCIP flap immediately. CTA and color Doppler sonography were routinely performed before the surgery. According to the size of the defect in the recipient area, the flap vascularized by the perforator vessel was carefully prepared and transferred to the buccal-pharynx-palate composite defect. The recipient area and donor area were sutured tightly after arteriovenous anastomosis under microscope. The survival and functional recovery of the flap were observed after operation. Results: The flap sizes ranged from 5 cm× 6 cm to 7 cm×9 cm.The mean diameter of the superficial circumflex iliac arteries was 0.65 mm. And the mean diameter of the veins was 1.2 mm. The mean arterial pedicle length was 7.0 cm, and the venous pedicle length was 8.0 cm. Eight flaps were all survived. The shape of the buccal-parapharyngeal-palate was good and the mouth opening was normal after operation. Conclusions Superficial circumflex iliac artery perforator flap was a good choice for repairing the defect of parapharyngeal squamous cell carcinoma in the posterior molar region.

Objective To evaluate the effect of 3D printing models applied to Medical Imaging Di-agnosis Undergraduate Teaching. Methods Students in the year 2012/2013 of Shanghai Jiao Tong Univer-sity School of Medicine stomatology specialty were chosen for this study, including 38 students in the exper-imental group (2013) and 40 students in the control group (2012). All of them were taught by the same group of teachers, including 28 core curriculum hours and 5 practice class hours. 3D printing technology with PPT was applied to the experimental group in the medical imaging diagnostic teaching, and conventional teaching including PPT and usual models in the control group. Medical students were given a test about cardiovascular system and tasked with completion of drawing hand and foot bones. Students in experimental group were also asked to complete a questionnaire about their experience. Results The questionnaire showed that 3D printing teaching molds with PPT was of great significance to improve the students interest in learning imaging anatomy, to meet the vast majority of students' learning requirements, and to achieve satis-factory results. The average scores of the circulatory system test in the experimental group were higher than that of the control group [(8.32 ±2.352) vs. (6.15 ±1.284), P<0.05)]. Students in experimental group per-formed better than students in the control group on the Locomotor system test [(6.81 ±1.347] vs. (3.84 ± 0.985), P<0.01]. Conclusions 3D printing mold combined with PPT teaching method can promote the med-ical imaging anatomy structure, learning effect and teaching quality, and has practical value in the under-graduate teaching of medical imaging diagnosis.

Objective To evaluate the short-term curative effect and the safety of transcatheter arterial chemoembolization (TACE) therapy by using microspheres and lipiodol for hepatocellular carcinoma (HCC).Methods A total of 87 patients with pathologically proved HCC were randomly divided into the study group (n=44,using embospheres of 100-300 μm in diameter together with lipiodol) and the control group (n=43,using gelfoam particles of 350-560 μm in diameter together with lipiodol).Postopertaive biochemical (liver function and AFP) findings and imaging (CT and/or MRI) manifestations were recorded,and the clinical efficacy and adverse reactions were analyzed.Results TACE was performed in all 87 patients.After the treatment,both the disease benefit rate and the postoperative reduction in AFP level in the study group were remarkably better than those in the control group (P＜0.05),but postoperative liver function indexes were not significantly different from the preoperative ones (P＞0.05).The average number of interventional therapy within the follow-up period of 6 months in the study group was smaller than that in the control group (P＜0.05).No statistically significant differences in 6-,12-and 18-month survival rates existed between the two groups (P＞0.05).Conclusion In treating HCC,TACE by combination use of microspheres and lipiodol is safe,its short-term curative effect is more obvious than TACE by combination use of gelfoam particles and lipiodol,and it can reduce the times of interventional procedure.Before TACE,careful planning of the pre-treatment of hepatic artery-portal vein fistula and the superselective catheterization with micro catheter should be taken into consideration.

OBJECTIVE To investigate the effects of aerobic exercise on enteric nervous injury in rats exposed to malathion.METHODS Adult male Wistar rats were treated with non-load swi mming every other day,three ti mes a week,each one hour,for six weeks.Before exercise,the rats were trea-ted with malathion 100 mg·kg -1·d -1 by oral gavage,six days a week,for six weeks.The activities of seru m acetylcholinesterase(AChE)and butyrocholinesterase(BuChE)were determined.In addition,the s mall intestinal propulsion indexes were measured.Also,the distribution of nerve plexus in ileu m was observed.The i mmunohistoche mical method was used to measure the levels of protein gene-related petide 9.5 (PGP9.5),substance P (SP),and vasoactive intestinal peptide (VIP).RESULTS Co m-pared with normal control,malathion exposure decreased the activities of seru m AChE and BuChE (P<0.01 ),increased the s mall intestinal propulsion indexes (P <0.05).In addition,the levels of PGP9.5 decreased (P<0.05).At the sa me ti me,the levels of SP increased,and the levels of VIP decreased (P<0.05).Aerobic exercise did not change the activites of cholinesterases,but decreased s mall intes-tinal propulsion indexes,increased the levels of PGP9.5,decreased the levels of SP,and increased the levels of VIP.Co mpared with the malathion exposure only,the rats in malathion ad ministration co mbined with aerobic exercise group de monstrated much lower activites of cholinesterase (P <0.01 ),and the s mall intestinal propulsion indexes decreased fro m (89 ±4)% to (79 ±5)%(P <0.01 ).Moreover,the levels of PGP9.5 increased fro m 0.012 ±0.003 to 0.029 ±0.015 (P <0.01 ).At the sa me ti me,the levels of SP decreased fro m0.174 ±0.067 to 0.1 10 ±0.057(P<0.05),and the levels of VIP increased fro m 0.0076 ±0.0029 to 0.01 1 1 ±0.0047 (P <0.05).The levels of above para meters were sa me or close to those of the normal control.CONCLUSION Malathion exposure induced disorders of enteric nervous syste m in rats,and the aerobic exercise abated the toxic response in enteric nervous syste m of malathion exposure rats.However,these effects were not mediated through recovery of cholinesterases inhibition.