PURPOSE: To judge the injury mode and injury severity of the real human body through the measured values of anthropomorphic test devices (ATD) injury indices, the mapping relationship of lumbar injury between ATD and human body model (HBM) was explored. METHODS: Through the ATD model and HBM simulation, the mapping relationship of lumbar injury between the 2 subjects was explored. The sled environment consisted of a semi-rigid seat with an adjustable seatback angle and a 3-point seat belt system with a seatback-mounted D-ring. Three seatback recline states of 25°, 45°, and 65° were designed, and the seat pan angle was maintained at 15°. A 23 g, 47 km/h pulse was used. The validity of the finite element model of the sled was verified by the comparison of ATD simulation and test results. ATD model was the test device for human occupant restraint for autonomous vehicles (THOR-AV) dummy model and HBM was the total human model for safety (THUMS) v6.1. The posture of the 2 models was adjusted to adapt to the 3 seat states. The lumbar response of THOR-AV and the mechanical and biomechanical data on L1 - L5 vertebrae of THUMS were output, and the response relationship between THOR-AV and THUMS was descriptive statistically analyzed. RESULTS: Both THOR-AV and THUMS were submarined in the 65° seatback angle case. With the change of seatback angle, the lumbar spine axial compression force (F_z) of THOR-AV and THUMS changed in the similar trend. The maximum F_z ratio of THOR-AV to THUMS at 25° and 45° seatback angle cases were 1.6 and 1.7. The flexion moment (M_y) and the time when the maximum M_y occurred in the 2 subjects were very different. In particular, the form of moment experienced by the L1 - L5 vertebrae of THUMS also changed. The changing trend of M_y measured by THOR-AV over time can reflect the changing trend of maximum stress of L1 and L2 of THUMS. CONCLUSION The F_z of ATD and HBM presents a certain proportional relationship, and there is a mapping relationship between the 2 subjects on F_z. The mapping function can be further clarified by applying more pulses and adopting more seatback angles. It is difficult to map M_y directly because they are very different in ATD and HBM. The M_y of ATD and stress of HBM lumbar showed a similar change trend over time, and there may be a hidden mapping relationship.
Humans ; Lumbar Vertebrae/injuries* ; Finite Element Analysis ; Biomechanical Phenomena ; Manikins ; Spinal Injuries/physiopathology*

Objective:To explore the value of 18F-FDG PET brain imaging in the auxiliary diagnosis of autoimmune encephalitis (AE) before treatment, and to analyze the regional and course-related characteristics of brain metabolic changes. Methods:The 18F-FDG PET brain imaging data of 49 AE patients (26 males, 23 females, age 48.0(29.0, 61.0) years) who did not receive first-line immunotherapy were retrospectively analyzed. Patients were collected from Renji Hospital, Shanghai Jiao Tong University School of Medicine, between July 2015 and December 2023. Forty-nine age- and gender-matched healthy subjects who underwent routine physical examination at the same time period were selected as the healthy controls (HC). The statistical parametric mapping (SPM) 8 two-sample t test ( P<0.001, k=50) was used to compare the imaging results of AE patients with those of HC. The screening results were adjusted by the cluster-level family-wise error rate (FWER) for P<0.05. Metabolic abnormalities associated with AE were identified, and differences in metabolic patterns at different stages of the disease course (short: ≤1 month; medium: >1 month and ≤3 month; long: >3 month) were compared by subgroup analysis. Mann-Whitney U test was used to analyze the data. Results:In the included AE patients, regions with elevated metabolism were mainly located in the limbic lobe, insula, putamen, and amygdala ( t values: 3.18-5.07, Z values: 3.17-4.76), while local metabolic reduction was observed in the frontal, parietal, and occipital lobes ( t values: 3.18-5.43, Z values: 3.23-5.06), with most of these regions passing FWER correction. In patients with anti- N-methyl- D-aspartate receptor (NMDAR) encephalitis, local metabolism increased in the right superior temporal gyrus ( t values: 3.55-4.79, Z values: 3.67-3.86) and decreased in the left middle temporal gyrus and inferior frontal gyrus ( t values: 3.55-5.43, Z values: 3.45-4.21), but the results did not pass the FWER correction. Subgroup analysis showed that in patients with short disease course ( n=17), regions with locally elevated metabolism included the brainstem, limbic lobe, and cerebellum ( t values: 3.37-5.27, Z values: 3.52-4.44), while regions with reduced metabolism were mainly located in the frontal, parietal, and occipital lobes ( t values: 3.37-6.77, Z values: 3.34-5.30), and these abnormal results all passed FWER correction. In patients with medium ( n=7) to long ( n=25) disease course, the regions with metabolic abnormalities were significantly reduced and did not pass FWER correction. Conclusions:18F-FDG PET can accurately identify brain metabolic abnormalities in AE patients, demonstrating significant regional and course-related characteristics. Metabolic abnormalities are more pronounced in patients with short disease course, while they are relatively less obvious in patients with medium to long disease course.

Objective:To explore the value of neutrophil extracellular traps (NETs) and interleukin (IL)-33 in the early diagnosis of contrast-induced acute kidney injury (CIAKI).Methods:It was a prospective cohort study. The clinical data of patients who underwent coronary angiography (CAG) in Sir Run Run Hospital, Nanjing Medical University from December 2022 to December 2023 were collected. The main indicators of NETs included myeloperoxidase (MPO), neutrophil elastase (NE), citrullinated histone H3 (H3Cit) and antimicrobial peptide LL-37 amide (LL-37). Serum samples were collected before CAG, and 2 hours and 12 hours after CAG, and the levels of MPO, NE, H3Cit, LL-37, IL-33 and neutrophil gelatinase-associated lipocalin (NGAL) were detected. The differences of clinical data between CIAKI group and non-CIAKI group were compared. Multivariate logistic regression model was applied to analyze the risk factors of CIAKI. The receiver- operating characteristic curve was used to evaluate the predictive performance of biomarkers. Spearman correlation analysis was used to analyze the correlations among those biomarkers.Results:A total of 280 eligible patients with CAG were included in this study, with age of (65±13) years and 203 males (72.5%). The incidence rate of CIAKI was 11.8% (33/280). Compared with non-CIAKI group, the proportions of diabetes ( χ2=5.302, P=0.021), preoperative positive urine protein ( χ2=6.871, P=0.009), taking beta-blockers ( χ2=4.580, P=0.032), diuretics ( χ2=21.987, P<0.001) and calcium channel blocker ( χ2=10.424, P=0.001), preoperative blood glucose ( Z=2.807, P=0.005), preoperative blood urea nitrogen ( Z=2.504, P=0.012), neutrophil at 24 hours after CAG ( Z=2.173, P=0.030), serum creatinine at 24 hours after CAG ( Z=4.000, P<0.001), and blood urea nitrogen at 24 hours after CAG ( Z=4.459, P<0.001) were higher, while the preoperative hemoglobin ( Z=-2.380, P=0.017) and serum albumin ( Z=-2.556, P=0.011) were lower in CIAKI group. Multivariate logistic regression analysis showed that increasing neutrophil at 24 hours after CAG ( OR=1.180，95% CI 1.037-1.341), diuretics ( OR=5.615，95% CI 2.294-13.745) and calcium channel blockers ( OR=3.141，95% CI 1.374-7.182) were independent influencing factors of CIAKI. There were statistically significant differences in the levels of serum NE, MPO, H3Cit, LL-37, NGAL and IL-33 among before CAG, 2 hours after CAG and 12 hours after CAG in the overall population, CIAKI group and non-CIAKI group (all P<0.05). In addition, the changes of IL-33 before CAG and 12 hours after CAG was positively correlated with the changes of MPO, NE, H3Cit, LL-37, NGAL, serum creatinine and blood urea nitrogen before CAG and 12 hours after CAG (all P<0.05). The levels of NE ( Z=3.435, P=0.001; Z=6.164， P<0.001), MPO ( Z=3.627, P<0.001; Z=4.729, P<0.001), H3Cit ( Z=5.174, P<0.001; Z=6.241, P<0.001), LL-37 ( Z=4.986, P<0.001; Z=6.346, P<0.001), NGAL ( Z=2.956, P=0.003; Z=4.263, P<0.001) and IL-33 ( Z=5.056, P<0.001; Z=6.240, P<0.001) in CIAKI group at 2 h and 12 h after CAG were significantly higher than those in non-CIAKI group. The receiver-operating characteristic curve indicated that the combined AUC of neutrophil 24 hours after CAG, diuretics and calcium channel blockers in predicting CIAKI was 0.791. NE ( AUC=0.701), MPO ( AUC=0.712), H3Cit ( AUC=0.777), LL-37 ( AUC=0.767) and IL-33 ( AUC=0.795) at 2 hours after CAG predicted CIAKI relatively well. NE ( AUC=0.865), MPO ( AUC=0.758), H3Cit ( AUC=0.834), LL-37 ( AUC=0.840) and IL-33 ( AUC=0.867) at 12 hours after CAG had better prediction effect for CIAKI. The AUC of NETs combined with IL-33 in predicting CIAKI at 2 hours and 12 hours after CAG was 0.874 and 0.956, respectively. Conclusions:CIAKI patients exhibit elevated levels of NETs and IL-33. Serum MPO, NE, H3Cit, LL-37 and IL-33 at 12 hours after CAG can predict the occurrence of CIAKI. The combination of NETs and IL-33 is more effective in predicting CIAKI.

Objective To investigate the effect of gender on prognosis after transcatheter patent foramen ovale(PFO)closure in patients with cerebral infarction or transient ischemic attack.Methods A retrospective cohort study was conducted involving patients with cerebral infarction or transient ischemic attack(TIA)who underwent PFO closure at our hospital between January 2013 and December 2023.The patients were grouped by gender,and related data were collected,including age,comorbidities,Risk of Paradoxical Embolism(RoPE)score,laboratory results,findings of transthoracic/transesophageal echocardiography(TTE/TEE),and post-procedural complications,such as device-related thrombosis(DRT),recurrent stroke,bleeding,and atrial fibrillation(AF).Results A total of 112 patients were enrolled,including 59 males and 53 females,at a mean age of 42.47±12.35 years.The females had significantly higher preoperative RoPE score than the males(6.6±1.4 vs 6.0±1.5,P=0.046),and a statistical difference was observed in the distribution of infarction sites between them(Chi-square=10.25,P=0.006),indicating that the males were prone to posterior circulation infarction.Intraoperative transthoracic echocardiography revealed a greater distance from the PFO to the aortic root in the females(9.3±2.4 mm vs 7.6±2.0 mm,P<0.001).During a median follow-up of 4 years,the male group had 1 case of myocardial infarction,1 cerebral hemorrhage,1 paroxysmal AF,2 gingival bleeding episodes,and 1 skin ecchymosis.In the female group,1 case experienced pulmonary embolism,1 paroxysmal atrial fibrillation,3 gingival bleeding episodes,2 skin ecchymoses,2 recurrent cerebral infarctions,and 2 recurrent TIAs.There was no statistical difference in overall adverse events between gender(P=0.291).Although the females had higher rates of recurrent cerebral infarction and TIA,this difference lacked statistical significance(P=0.222).Multivariate Cox regression analysis indicated that after adjusting for various potential confounding factors,such as RoPE score,age,hypertension,coronary heart disease,and other factors,gender was not an independent predictor of composite endpoint events after surgery.Conclusion Gender does not significantly affect overall prognosis after PFO closure in patients with cerebral infarction or TIA.However,females showed a trend toward higher rates of recurrent cerebral infarction and TIA.

Objective To explore the behavioral patterns and hippocampal neurogenesis of CHD8+mice,and to provide behavioral and morphological basis for improving autism like behavior and neurogenesis.Methods Genotype of wild type(WT)and CHD8+/-mice was identified.Weight measurement was conducted on both male and female mice of the WT and CHD8+/-strains.Subsequently,a battery of behavioral tests was administered,which included three-chamber test,self-grooming test,nesting test,Y-maze spontaneous alternation test,food burial test,open-field test and light-dark transition test.Afterwards,the mice were administered 2％pentobarbital sodium(2 ml/kg)to induce anesthesia.Their brains were frozen with 4％paraformaldehyde,removed for photography and analysis to identify any alterations in brain size.Western blotting and immunofluorescent labeling were used to detect changes in the process of hippocampus neurogenesis.Results Western blotting analysis demonstrated a decrease in the amounts of chromodomain helicase DNA binding protein 8(CHD8)protein in both male and female mice with CHD8+genotype,as compared to WT mice.There were no notable disparities in body weight between male and female WT and CHD8+mice,as well as in brain size.The three-chamber social behavior test revealed that both male and female CHD8+/-mice had social deficiencies(P＜0.05).During the open field test,there was no significant difference in the total distance moved by male and female WT and CHD8+/-mice.However,the amount of time spent in the central region was considerably lower in CHD8+/-mice compared to the WT mice(P＜0.01).Furthermore,the light-dark transition test revealed that both male and female CHD8+/-mice spent considerably less time investigating the white box compared to the WT mice(P＜0.05).Nevertheless,there were no notable alterations found in self-grooming,nesting,spontaneous alternation of Y-maze,and food burial experiments.In addition,Western blotting result demonstrated a significant drop in doublecortin(DCX)expression(P＜0.001),and immunofluorescent staining revealed a notable reduction in the number of DCX+cells(P＜0.01)in the hippocampus of CHD8+/-mice.Conclusion CHD8+/-mice exhibit social disorders and anxiety-like behaviors,with a decrease in the number of newly generated neurons in the hippocampus and neurogenesis disorders.

Objective This study aimed to investigate whether Trichinella spiralis Ts87 protein can facilitate immune evasion by degrading the mouse neutrophil extracellular traps(NETs).Methods First,we used bioinformatics tools to analyze the physicochemical properties of Ts87 and,through sequence homology alignment,confirmed its classification within the nuclease family.Molecular cloning and protein purification techniques were then employed to obtain high-purity Ts87 protein,and its nuclease activity was confirmed.Additionally,we compared the primary sequence of Ts87 with known active sites from human lysosomal DNase IIα and the structurally characterized Burkholderia thailandensis DNase II.This enabled us to predict potential active sites.Ts87 enzymatic mutants were generated using site-directed mutagenesis,and their functions were confirmed through enzymatic activity experiments.The extracellular nucleic acid content of mouse bone marrow neutrophils and the immunofluorescence staining of mouse NETs were assessed in vitro to verify whether the Ts87 protease mutants exhibited a decreased ability to degrade NETs.Finally,after immunizing mice with Ts87,calculated larvae burden and the degradation of NETs in vivo were observed by immunostaining the MPO and CitH3 expression in the intestinal NETs of the mice.Results High-purity Ts87 protein was successfully obtained and confirmed to possess nuclease activity,capable of degrading NETs in vitro.The Ts87 mutants exhibited reduced capacity in degrading NETs.In vivo experiments in mice demonstrated that the production of anti-Ts87 antibodies in immunized mice reduced the degradation of NETs,facilitating NET-mediated attack on the parasites and resulting in decreased larvae burden in the mice.Conclusions Trichinella spiralis can utilize Ts87 nuclease to evade capture by NETs,providing potential vaccine and drug targets for the prevention and treatment of trichinellosis.

Objective:To explore the value of 18F-FDG PET brain imaging in the auxiliary diagnosis of autoimmune encephalitis (AE) before treatment, and to analyze the regional and course-related characteristics of brain metabolic changes. Methods:The 18F-FDG PET brain imaging data of 49 AE patients (26 males, 23 females, age 48.0(29.0, 61.0) years) who did not receive first-line immunotherapy were retrospectively analyzed. Patients were collected from Renji Hospital, Shanghai Jiao Tong University School of Medicine, between July 2015 and December 2023. Forty-nine age- and gender-matched healthy subjects who underwent routine physical examination at the same time period were selected as the healthy controls (HC). The statistical parametric mapping (SPM) 8 two-sample t test ( P<0.001, k=50) was used to compare the imaging results of AE patients with those of HC. The screening results were adjusted by the cluster-level family-wise error rate (FWER) for P<0.05. Metabolic abnormalities associated with AE were identified, and differences in metabolic patterns at different stages of the disease course (short: ≤1 month; medium: >1 month and ≤3 month; long: >3 month) were compared by subgroup analysis. Mann-Whitney U test was used to analyze the data. Results:In the included AE patients, regions with elevated metabolism were mainly located in the limbic lobe, insula, putamen, and amygdala ( t values: 3.18-5.07, Z values: 3.17-4.76), while local metabolic reduction was observed in the frontal, parietal, and occipital lobes ( t values: 3.18-5.43, Z values: 3.23-5.06), with most of these regions passing FWER correction. In patients with anti- N-methyl- D-aspartate receptor (NMDAR) encephalitis, local metabolism increased in the right superior temporal gyrus ( t values: 3.55-4.79, Z values: 3.67-3.86) and decreased in the left middle temporal gyrus and inferior frontal gyrus ( t values: 3.55-5.43, Z values: 3.45-4.21), but the results did not pass the FWER correction. Subgroup analysis showed that in patients with short disease course ( n=17), regions with locally elevated metabolism included the brainstem, limbic lobe, and cerebellum ( t values: 3.37-5.27, Z values: 3.52-4.44), while regions with reduced metabolism were mainly located in the frontal, parietal, and occipital lobes ( t values: 3.37-6.77, Z values: 3.34-5.30), and these abnormal results all passed FWER correction. In patients with medium ( n=7) to long ( n=25) disease course, the regions with metabolic abnormalities were significantly reduced and did not pass FWER correction. Conclusions:18F-FDG PET can accurately identify brain metabolic abnormalities in AE patients, demonstrating significant regional and course-related characteristics. Metabolic abnormalities are more pronounced in patients with short disease course, while they are relatively less obvious in patients with medium to long disease course.

Objective:To explore the value of neutrophil extracellular traps (NETs) and interleukin (IL)-33 in the early diagnosis of contrast-induced acute kidney injury (CIAKI).Methods:It was a prospective cohort study. The clinical data of patients who underwent coronary angiography (CAG) in Sir Run Run Hospital, Nanjing Medical University from December 2022 to December 2023 were collected. The main indicators of NETs included myeloperoxidase (MPO), neutrophil elastase (NE), citrullinated histone H3 (H3Cit) and antimicrobial peptide LL-37 amide (LL-37). Serum samples were collected before CAG, and 2 hours and 12 hours after CAG, and the levels of MPO, NE, H3Cit, LL-37, IL-33 and neutrophil gelatinase-associated lipocalin (NGAL) were detected. The differences of clinical data between CIAKI group and non-CIAKI group were compared. Multivariate logistic regression model was applied to analyze the risk factors of CIAKI. The receiver- operating characteristic curve was used to evaluate the predictive performance of biomarkers. Spearman correlation analysis was used to analyze the correlations among those biomarkers.Results:A total of 280 eligible patients with CAG were included in this study, with age of (65±13) years and 203 males (72.5%). The incidence rate of CIAKI was 11.8% (33/280). Compared with non-CIAKI group, the proportions of diabetes ( χ2=5.302, P=0.021), preoperative positive urine protein ( χ2=6.871, P=0.009), taking beta-blockers ( χ2=4.580, P=0.032), diuretics ( χ2=21.987, P<0.001) and calcium channel blocker ( χ2=10.424, P=0.001), preoperative blood glucose ( Z=2.807, P=0.005), preoperative blood urea nitrogen ( Z=2.504, P=0.012), neutrophil at 24 hours after CAG ( Z=2.173, P=0.030), serum creatinine at 24 hours after CAG ( Z=4.000, P<0.001), and blood urea nitrogen at 24 hours after CAG ( Z=4.459, P<0.001) were higher, while the preoperative hemoglobin ( Z=-2.380, P=0.017) and serum albumin ( Z=-2.556, P=0.011) were lower in CIAKI group. Multivariate logistic regression analysis showed that increasing neutrophil at 24 hours after CAG ( OR=1.180，95% CI 1.037-1.341), diuretics ( OR=5.615，95% CI 2.294-13.745) and calcium channel blockers ( OR=3.141，95% CI 1.374-7.182) were independent influencing factors of CIAKI. There were statistically significant differences in the levels of serum NE, MPO, H3Cit, LL-37, NGAL and IL-33 among before CAG, 2 hours after CAG and 12 hours after CAG in the overall population, CIAKI group and non-CIAKI group (all P<0.05). In addition, the changes of IL-33 before CAG and 12 hours after CAG was positively correlated with the changes of MPO, NE, H3Cit, LL-37, NGAL, serum creatinine and blood urea nitrogen before CAG and 12 hours after CAG (all P<0.05). The levels of NE ( Z=3.435, P=0.001; Z=6.164， P<0.001), MPO ( Z=3.627, P<0.001; Z=4.729, P<0.001), H3Cit ( Z=5.174, P<0.001; Z=6.241, P<0.001), LL-37 ( Z=4.986, P<0.001; Z=6.346, P<0.001), NGAL ( Z=2.956, P=0.003; Z=4.263, P<0.001) and IL-33 ( Z=5.056, P<0.001; Z=6.240, P<0.001) in CIAKI group at 2 h and 12 h after CAG were significantly higher than those in non-CIAKI group. The receiver-operating characteristic curve indicated that the combined AUC of neutrophil 24 hours after CAG, diuretics and calcium channel blockers in predicting CIAKI was 0.791. NE ( AUC=0.701), MPO ( AUC=0.712), H3Cit ( AUC=0.777), LL-37 ( AUC=0.767) and IL-33 ( AUC=0.795) at 2 hours after CAG predicted CIAKI relatively well. NE ( AUC=0.865), MPO ( AUC=0.758), H3Cit ( AUC=0.834), LL-37 ( AUC=0.840) and IL-33 ( AUC=0.867) at 12 hours after CAG had better prediction effect for CIAKI. The AUC of NETs combined with IL-33 in predicting CIAKI at 2 hours and 12 hours after CAG was 0.874 and 0.956, respectively. Conclusions:CIAKI patients exhibit elevated levels of NETs and IL-33. Serum MPO, NE, H3Cit, LL-37 and IL-33 at 12 hours after CAG can predict the occurrence of CIAKI. The combination of NETs and IL-33 is more effective in predicting CIAKI.

In recent years, with the increasing societal focus on drug quality and safety, quality issues have become a major challenge faced by the pharmaceutical industry, directly impacting consumer health and market trust. By combining multispectral imaging technology with machine learning, it is possible to achieve rapid, non-destructive, and precise detection of traditional Chinese medicine(TCM) preparations, thereby revolutionizing traditional detection methods and developing more convenient and automated solutions. This paper provides a comprehensive review of the current applications of rapid, non-destructive detection techniques based on machine learning algorithms in the field of TCM preparations. It analyzed the principles and advantages of commonly used rapid, non-destructive detection techniques, offering a reference for the application and promotion of these technologies in TCM preparation detection. Additionally, this paper explored various data preprocessing techniques, operational processes, and machine learning algorithms to enhance data utilization efficiency. Finally, it focused on the challenges of applying machine learning in TCM preparation detection and offered corresponding recommendations, providing guidance for the future integration of machine learning with rapid, non-destructive detection techniques in practical production.
Machine Learning ; Drugs, Chinese Herbal/analysis* ; Medicine, Chinese Traditional/methods* ; Humans ; Quality Control

At present, China's traditional Chinese medicine(TCM) industry is developing rapidly with the support of modern science and technology. While promoting economic development and improving national health, it has brought multiple environmental problems. Under the "dual carbon" goals, the ecological fine manufacturing of TCM may become one of the breakthroughs for the TCM industry to practice low-carbon economy. From the perspective of low-carbon economy and considering the current situation of TCM pharmaceutical manufacturing, this paper analyzes the problems and shortcomings of the TCM pharmaceutical industry. In view of the key factors influencing the quality of TCM preparations under the ecological fine manufacturing mode, this paper proposes a practical and feasible selection plan for the ecological fine manufacturing mode of TCM, aiming to provide research ideas and a theoretical basis for the TCM industry in helping to achieve the goals of carbon peaking and carbon neutrality.
Drugs, Chinese Herbal/economics* ; Medicine, Chinese Traditional ; Carbon/analysis* ; China ; Drug Industry/economics*