Objective To explore the relationship between systemic immune-inflammation index(SII)and prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)complicat-ed with type Ⅱ respiratory failure.Methods A total of 92 patients with AECOPD complicated with type Ⅱrespiratory failure admitted to Honghui Hospital Affiliated to Xi'an Jiaotong University from February 2022 to February 2024 were selected as the research subjects.According to the 28-day survival status,they were di-vided into the survival group(n=69)and the death group(n=23).The counts of neutrophils,lymphocytes and platelets of the patients were detected by the fully automatic hematology analyzer,and SII was calculated.The receiver operating characteristic curve was used to analyze the predictive value of SII for the prognosis of patients.Multivariate Logistic regression analysis was used to explore the influencing factors of prognosis in patients.Results The platelet count,neutrophil count,SII and acute physiology and chronic health evaluationⅡ(APACHE Ⅱ)score in the survival group were lower than those in the death group,while the lymphocyte count in the survival group was higher than that in the death group,the differences were statistically signifi-cant(P＜0.05).In patients with AECOPD complicated with type Ⅱ respiratory failure,SII was positively correlated with APACHEⅡ score(r=0.612,P＜0.001).The areas under the curve(AUC)of platelets,neu-trophils and lymphocytes in predicting the prognosis of patients with AECOPD complicated with type Ⅱ re-spiratory failure were 0.776(95％CI:0.731-0.826),0.849(95％CI:0.799-0.894),and 0.732(95％CI:0.687-0.782),respectively,the AUC of SII in predicting the prognosis of patients with AECOPD complicat-ed with type Ⅱ respiratory failure was 0.925(95％CI:0.880-0.975).The proportion of death groups com-bined with heart diseases and blood urea nitrogen(BUN),B-type natriuretic peptide(BNP)were higher than those in the survival group,while hemoglobin(Hb)was lower than that in the survival group,and the differ-ences were statistically significant(P＜0.05).Combined cardiac diseases,BUN,Hb,BNP and SII were the in-fluencing factors for the prognosis of patients with AECOPD complicated with type Ⅱ respiratory failure(P＜0.05).Conclusion The increase of SII is related to the prognosis of patients with AECOPD complicated with type Ⅱ respiratory failure,and it has certain predictive value for the prognosis of patients with AECOPD complicated with type Ⅱ respiratory failure.

BACKGROUND:Mechanical stimulation has been confirmed to promote osteogenic differentiation of bone marrow stromal stem cells,but the mechanism is unknown.Primary cilia are important mechanoreceptors and regulate various signaling pathways such as TGF-β1/BMP-2/SMAD.They are likely to be important targets for mechanical regulation of bone marrow stromal stem cells. OBJECTIVE:To investigate the effect and mechanism of fluid shear stress on osteogenic differentiation of bone marrow stromal stem cells. METHODS:Rat bone marrow stromal stem cells were divided into control group,mechanical stimulation group(fluid shear mechanics intervention by shaking table),mechanical stimulation + IFT88 silencing group(mechanical stimulation + silencing IFT88 expression with siRNA).After 24 hours of intervention,qRT-PCR was utilized to determine the expression of transforming growth factor β1 and bone morphogenetic protein 2.Western blot assay was used to detect the expression of phosphorylated SMAD2/3 protein.Immunofluorescent staining of primary cilia was conducted and morphology was analyzed. RESULTS AND CONCLUSION:Shear stress stimulation could promote the transcriptional activity of transforming growth factor β1 and bone morphogenetic protein 2 genes,and increase the expression of phosphorylated SMAD2/3 protein.After siRNA interfered with primary cilia,this mechanical response effect was significantly reduced.There was a Spearman correlation between the change ratio of the primary cilium area of bone marrow stromal stem cells and the increased ratio of transforming growth factor β1 and bone morphogenetic protein 2 gene transcription.These findings indicate that primary cilia/intraflagellar transport mediates the activation of fluid shear stress-responsive transforming growth factor β1/bone morphogenetic protein 2/SMAD signaling pathway and promotes osteogenic differentiation of bone marrow stromal stem cells.

Objective:To explore the feasibility of MRI to assist the early diagnosis of midfoot tendon and ligament injuries.Methods:Fifty-two patients with midfoot ligament and tendon injuries who visited Beijing Jishuitan Hospital from September 2016 to December 2021 were enrolled in the study, and 20 healthy volunteers were recruited as controls. All participants underwent mid foot coronal (short axis), sagittal, and axial (long axis) MRI T1 weighted imaging and proton fat suppression sequence examination. The MRI images were evaluated by 2 senior radiologists independently.Results:The consistency of the two radiologists in diagnosis of tendons, ligaments, bones, and soft tissues were good ( κ=0.916, 0.896, and 0.893, respectively). The tendons and ligaments of the midfoot in 20 healthy volunteers (40 feet) showed uniform bands of varying thickness with slightly low signal intensity; the anterior tibial tendon showed a thin line shape, the posterior tibial tendon showed a slightly thick band with uniform low signal intensity, and the calcaneonavicular ligament showed a thin line-like low signal intensity running in different directions. In 52 patients with midfoot tendon and ligament injuries, 18 had anterior tibial tendon injuries, 20 had posterior tibial tendon injuries, and 14 had calcaneonavicular ligament injuries. The injured tendon or ligament was characterized by uneven thickness, blurred edges, and continuous interruption on T1WI sequence, uneven enhancement of signal in the tendon or ligament running area on PD-FS sequence, accumulation of fluid in the tendon sheath, and partial tearing. The partial tear showed discontinuity and thickening of tendons, while the complete tear showed that the tendons were interrupted and retracted, the fiber structure disappeared and was filled with liquid, and the surrounding soft tissue edema was present. Conclusion:MRI can clearly display the course and anatomical structure of the attachment end of the midfoot tendon and ligament, which may assist in early diagnosis of midfoot tendon and ligament injuries.

Objective To explore the MRI characteristics of anatomy and injuries of the tendons and ligaments in the midfoot.Methods Twenty healthy volunteers and 46 patients with midfoot trauma were selected for retrospective analysis.All subjects underwent examination on MR T1WI and proton density-fat suppression(PD FS)scans on three planes,respectively.Then the MRI features of tendon and ligaments injury were compared.Results The tendons and ligaments of 20 healthy volunteers(40 lateral feet)showed homogeneous low signal intensity with varing thickness.The anterior tibialis tendons showed a thin linear shape,and the posterior tibialis tendons showed a slightly thick band with uniform low signal intensity,and the calcaneonavicular ligament showed thin linelike low signal in different directions.In the 46 patients with midfoot injuries,there were 16 cases of anterior tibialis tendons injuries,18 cases of posterior tibialis tendons injuries,and 12 cases of calcaneonavicular ligament injuries.According to the MRI findings,the degree of injuries of tendons and ligaments was divided into injury,partial tear,and complete rupture.Conclusion MRI can clearly show the anatomy and injury features of ligaments and tendons in midfoot,which is of important value for the early diagnosis and accurate treatment of the ligaments and tendons injuries.

OBJECTIVE To establish an analytical method for the simultaneous determination of multiple anesthetics and their metabolites in aquatic products by ultra performance liquid chromatography-tandem mass spectrometry with pass-through solid phase extraction purification. METHODS After homogenization, the samples were extracted by 80% acetonitrile aqueous solution, and purified by ProElt PLS-A pass-through solid phase extraction column. The extract was determined by positive ion mode with mobile phase of 0.1% formic acid water and 0.1% formic acid acetonitrile in the separation by programmed gradient. Multiple reaction monitoring mode was used to draw standard curves with the matrix-matched method. RESULTS The calibration curves of the 14 anesthetics showed good linearity in the concentration range of 1-50 µg·L-1 and their metabolites showed good linearity in the concentration range of 10-500 μg·L-1, with the correlation coefficients >0.99. The limits of detection were 0.5 μg·kg-1 in anesthetics and 5 µg·kg-1 in their metabolites. The lower limits of quantification were 1 μg·kg-1 in anesthetics and 10 μg·kg-1 in their metabolites. The recoveries at high, medium and low concentrations ranged from 62.48% to 116.5% with RSDs<10%. CONCLUSION The method is simple and can be used for the accurate detection of anesthetics and their metabolites in aquatic products with high reliabilities.

Objective:To analyze the MRI findings of tendinopathy of the common extensor tendon (CET) and common flexor tendon (CFT) and to explore its application for injury classification.Methods:Sixty-two patients with elbow tendinopathy of CET and/or CFT who were examined in the Radiology Department of Beijing Jishuitan Hospital from August 2019 to April 2022 were enrolled as the case group, and 20 healthy subjects (40 elbows) were recruited as the control group. The clinical data of patients and MRI findings of elbow joint of all subjects were reviewed. The MRI of tendinopathy of CFT and CET were read by 2 senior radiologists independently, and the consistency was tested by the κ test. The MRI manifestations for injury classification were discussed. Results:The κ values of CFT, CET, medial collateral ligament complex and lateral collateral ligament complex were 0.645, 0.657, 0.615 and 0.653 respectively. MRI clearly showed the anatomical structure of CFT, CET and surrounding soft tissue. The CFT and CET of the elbow of 20 normal volunteers (40 sides) in the control group showed thin line or banded low signal in each MRI sequence, and the muscle fibers were continuous. In 27 patients with classification Ⅰ injury of CFT and/or CET of elbow joint, MRI showed thickening or thinning of tendons and increased signal intensity on fat suppression T2-weighted imaging. In 27 cases of classification Ⅱ injury, MRI showed that the fluid signal involved 20% to 80% of the tendon thickness. In 8 cases of classification Ⅲ injury, MRI showed that the fluid signal involved more than 80% of the tendon thickness. Conclusions:Tendinopathy of CFT and CET of elbow joint has its characteristic MRI manifestations, indicating that MRI can be used for the diagnosis of tendinopathy. In addition, MRI can also be used for the injury classification.

Parkinson disease (PD) is a common neurodegenerative disease with motor and non-motor symptoms that seriously affect the quality of life and social function of patients. The current non-invasive techniques in PD brain function studies mainly include functional magnetic resonance imaging and electroencephalography, which made it difficult to assess brain function under motor state or magnetoelectric treatment. As an emerging functional neuroimaging technique, functional near-infrared spectroscopy (fNIRS) can monitor the real movement-related cortical responses of PD patients in real time, providing a safe and non-invasive method with high ecological validity for direct monitoring of brain activity. This article presented a review of recent advances in the application of fNIRS technology in PD research, intending to provide new ideas for functional neuroimaging studies in PD. The results suggested that PD gait and balance deficits were closely associated with abnormal activation of the cerebral cortex, particularly the prefrontal cortex, involving a compensatory strategy of cortical cognitive resources for basal ganglia dysfunction. Drugs, deep brain stimulation, and other interventions could be applied to fNIRS techniques to evaluate neurorehabilitation effects and reveal the neural basis of intervention effects. This area of research is currently in its infancy, but the evidence provided supports for the translation of fNIRS into clinical practice. Future research should develop multimodal imaging techniques and in-depth studies of broad areas of the cerebral cortex to obtain more valuable findings for clinical practice.

Objective:To explore the magnetic resonance imaging (MRI)features of the normal anatomy and injuries of ligaments in the elbow joint.Methods:Thirty-eight healthy volunteers (38 sides) and 82 patients with elbow joint injuries were recruited in the Radiology Department of Beijing Jishuitan Hospital from February 2019 to February 2022 and the MRI findings were analyzed. The healthy subjects had no history of trauma, elbow joint ligament injury or pain, and the elbow joint function was normal. Among the 82 patients with elbow joint injuries, 8 cases were confirmed by operation and 74 were confirmed by follow-up. The MRI characteristics of normal anatomy and injuries of the medial collateral ligament and lateral collateral ligament complex of the elbow were compared and analyzed by blind method.Results:The medial collateral ligament and lateral collateral ligament complex in 38 healthy volunteers showed as thin strip low signal on T1-weighted imaging (T1WI) and fat suppression proton density-weighted imaging (PD-FS), and the annular ligament showed as annular linear low signal surrounding the radial head. Among the 82 patients with elbow injuries, in the medial side, there were 6 cases with medial collateral ligament injuries alone, 2 with common flexor tendon injuries alone, and 4 with medial collateral ligament and common flexor tendon injuries; while in the lateral side, there were 9 cases with the lateral collateral ligament complex injuries alone, 21 with common extensor tendon injuries alone, and 31 with the lateral collateral ligament complex and common extensor tendon injuries. In addition, there were 9 cases of medial collateral ligament coupled with lateral collateral ligament complex injuries. Among the 9 cases of combined ligament injuries (5 cases with injuries of the common flexor or extensor tendon), 5 cases were complete tears and 4 cases were partial tears. Among the 10 cases of medial collateral ligament injuries, 9 patients were strain and one was complete tear. Among the 40 cases of lateral collateral ligament complex injuries, 29 patients were strain, 10 were partial tears and one was complete tear. The strained ligament showed as thickened and blurred on T1WI, and the fiber was still continuous; while on PD-FS, the injured ligaments demonstrated as heterogeneously increased signal intensity. Partial tear showed as fiber thickening and partial discontinuity. A complete tear showed that the fiber was discontinuous and retracted with surrounding soft tissue edema.Conclusion:MRI is an accurate method for evaluation of the anatomy and pathological conditions of the medial collateral ligament and lateral collateral ligament complex of the elbow joint, and has important application value in the diagnosis and treatment of elbow ligament injury.

Objective:To study the relationship between distal radioulnar joint (DRUJ) effusion and the integrity of triangular fibrcarotilage (TFC) in asymptomatic young adults.Methods:Thirty two asymptomatic young adults, 22 males and 10 females with a mean age of 25 year(20-30) were recruited in the study between September 2014 and October 2019. All subjects had no wrist pain, no wrist deformity or wrist mass, and had no history of wrist trauma or surgery. The DRUJ effusion was definedasfluid-like high signal intensityon fatsuppression proton density-weighted MRI.The presence of distal radioulnar joint effusion, the shape of the effusion, and the presence of triangular fibrocartilage abnormalities were documented.Results:Among 32 subjects, 25(78.1%, 15 males and 10 females) presented with distal radioulnar joint effusion on wrist MR images, including linear/tubular in 21 cases(84.0%) and saccular in 4 cases(16.0%).Twenty cases (62.5%) had distal radioulnar joint effusion while the TFC was intact, among whom, the effusion was confined to the proximal side of distal radioulnar jointin 17 cases, and reached the lower surface of TFC in 3 cases. In 5 cases (15.6%) with TFC tear, the effusion reached the lower surface of TFC in 4 cases. There were neutral, positive and negative variations of the ulna in 23, 6 and 3 cases, respectively, among whomthe distal radioulnar effusion was presented in 17, 5, 3 cases, and TFC tear in 1, 4 and 0 cases, respectively.The presence of distal radioulnar effusion was not significantly correlated with genders( P=0.069) or types of ulna variance( P=0.702). Conclusion:The distal radioulnar joint effusion maybe resent in asymptomatic young adults, and it maybe complicated with TFC tear.

Objective:To explore the anatomy and injuries features of the thumb extensor and flexor mechanism with MRI.Methods:Ten healthy subjects without thumb injury and 20 patients with thumb extensor or flexor mechanism injuries were recruited in the study between September 2013 and September 2021. All subjects underwent MRI examination, the MRI features of thumb extensor or flexor mechanism in healthy subjects and patients were analyzed. The imaging findings were compared with the surgical results and confirmed by followed up in patients.Results:The healthy subjects showed homogeneous low-signal-intensity on T1-weighted and proton-fat saturation sequence(PD FS) images. Twenty patients with thumb extensor or flexor mechanism injures(including 8 cases of extensor pollicislongusinjury,1 case of extensor pollicisbrevis injury, 4 cases of flexor pollicislongus injury, 2 cases offlexor pollicis brevis injury and 5casesofpulley injury) demonstrated poor definition in T1WI, and heterogeneously increased signal intensity in PD-FS. Depending on the degree of injury, the fibers may be partially or completely discontinuity of the involved tendons. There was edema in the soft tissues surrounding the injured sites.Conclusion:MRI is an accurate method for evaluation of the anatomy and pathological conditions of the thumb extensor and flexor mechanism.