Objective To investigate the application value of full-length lower extremity CT scans performed at different noise index(NI)in terms of image quality and radiation dose for robot-assisted total knee arthroplasty(RTKA).Methods Eighty patients who underwent RTKA were selected and randomly divided into four groups based on different NI:NI=8,NI=18,NI=28,and NI=38.Subjective scores were assigned to the full-length lower extremity CT images and the three-dimensional skeletal models generated by volume rendering(VR)post-processing.Objective evaluations were performed using three indicators:dose length product(DLP),volume CT dose index(CTDIvol),and hip-knee-ankle angle(HKA).The application value of full-length lower extremity CT scans in RTKA was analyzed.Results(1)As the NI value increased,the subjective scores of thin-slice images decreased.Images with NI between 8 and 18 met the imaging diagnostic standards,while those with NI higher than 18 were unacceptable.(2)As the NI value increased,all VR skeletal models met the acceptance criteria for RTKA.(3)As the NI value increased,DLP and CTDIvol gradually decreased,with statistically significant differences(P<0.05),However,in the comparison between the NI=28 and NI=38 groups,the difference was not statistically significant(P>0.05).Conclusion Performing full-length lower extremity CT scans with an NI of 28 not only meets the preoperative planning requirements for RTKA but also minimizes the radiation dose.

Objective To investigate the application value of full-length lower extremity CT scans performed at different noise index(NI)in terms of image quality and radiation dose for robot-assisted total knee arthroplasty(RTKA).Methods Eighty patients who underwent RTKA were selected and randomly divided into four groups based on different NI:NI=8,NI=18,NI=28,and NI=38.Subjective scores were assigned to the full-length lower extremity CT images and the three-dimensional skeletal models generated by volume rendering(VR)post-processing.Objective evaluations were performed using three indicators:dose length product(DLP),volume CT dose index(CTDIvol),and hip-knee-ankle angle(HKA).The application value of full-length lower extremity CT scans in RTKA was analyzed.Results(1)As the NI value increased,the subjective scores of thin-slice images decreased.Images with NI between 8 and 18 met the imaging diagnostic standards,while those with NI higher than 18 were unacceptable.(2)As the NI value increased,all VR skeletal models met the acceptance criteria for RTKA.(3)As the NI value increased,DLP and CTDIvol gradually decreased,with statistically significant differences(P<0.05),However,in the comparison between the NI=28 and NI=38 groups,the difference was not statistically significant(P>0.05).Conclusion Performing full-length lower extremity CT scans with an NI of 28 not only meets the preoperative planning requirements for RTKA but also minimizes the radiation dose.

Object To study the efficacy and potential mechanism of Tongbianling capsule in constipation. Methods The effects of Tongbianling capsule on intestinal motility in normal mice and carbon powder propulsion rate in small intestine of constipation model mice after were observed administration. The potential targets and key pathways of Tongbianling capsule in treating constipation were identified through network pharmacology. To verify the mechanism, the expression of p-PI3K/PI3K, p-AKT/AKT and CASP3 proteins in mouse colon tissue was detected by the western blot. Results The time for mice to excrete the first black stool was shortened and the number of fecal particles was increased in Tongbianling capsule administration group, and the carbon powder propulsion rate of mice in each Tongbianling capsule administration group was increased. The results of network pharmacology showed that treatment of constipation by Tongbianling capsule may be related to signaling pathways such as PI3K-Akt signaling pathway and 5-HT. The protein expression of p-PI3K/PI3K, p-AKT/AKT, and CASP3 in mouse colon tissue could be significantly downregulated in administration group. Conclusion Tongbianling capsule could effectively promote intestinal peristalsis in mice, increase the frequency of defecation, and effectively treat constipation. The mechanism of its action may be related to the direct or indirect regulation of intestinal motility by the PI3K-Akt signaling pathway.

Objective:To develop and design a during-treatment records auto-review program to comply the quality assurance(QA)requirement of radiotherapy chart auditing,and thereby improve the review efficiency and accuracy.Methods:Based on the items the guideline required,the Aria Oncology Information System database backup files was analyzed by Java,Vue,and etc.languages and the corresponding review logic was formulated.A total of 530 treatment records generated at Shanghai Concord Cancer Center from January to March 2024(10 weeks)were auto-reviewed and compared with the manual results for evaluating the accuracy and efficiency of the program.Results:The auto-review program was running smoothly.Overall with the above data,the sensitivity,specificity,accuracy and the error-miss rate were 73.4%,14.3%,87.7%and 12.3%respectively.For sub-set items,the source-skin distance(SSD)error detecting rate was 100%,the wrong session reporting was 100%correlated with the plans switching and the wrong fraction reporting was 100%related to plan revision.For the other items,auto and manual reviews gave out the same accuracy.Conclusion:The none-error results from the program are all true,so the manual rechecking could limit to those auto-review error records,which can reduce the workload by 73.4%,therefore improve the effectiveness and accuracy of the radiotherapy data review.

Objective To explore the anesthesia management experience in the interventional treatment of pediatric congenital heart diseases (CHD) percutaneously guided by transthoracic echocardiography (TTE) on a mobile operating platform. Methods From March to July 2023, a total of 13 patients from remote areas underwent interventional treatment for CHD on the mobile operating platform of Fuwai Yunnan Cardiovascular Hospital. Patients who received non-tracheal intubation general anesthesia were retrospectively included. Results Eight children who had difficulty cooperating with the surgery (due to young age, emotional tension, crying) received monitored anesthesia care with local anesthesia supplemented by sedative and analgesic drugs while maintaining spontaneous breathing under the monitoring and management of an anesthesiologist (i.e., non-tracheal intubation general anesthesia). Among them, there were 5 males and 3 females, with an age of (6.95±3.29) years and a body weight of (19.50±6.04) kg. Through transthoracic echocardiography, they were diagnosed with atrial septal defect (6 patients), residual shunt after patent ductus arteriosus ligation (1 patient), and severe pulmonary valve stenosis (1 patient). The surgery proceeded smoothly, with satisfactory anesthesia and surgical effects, complete analgesia, and satisfactory postoperative recovery. There was 1 patient of body movement and 1 patient of respiratory depression during the operation, and both patients completed the surgery successfully after treatment. All children had no serious surgery- and anesthesia-related complications. The anesthesia time was 40.5 (34.5, 47.5) min, the surgery time was 39.0 (33.0, 45.5) min, and the recovery time was 43.0 (28.0, 52.5) min Conclusion Interventional surgery for CHD guided by TTE at a mobile platform is a minimally invasive approach without radiation damage. Non-tracheal intubation general anesthesia with spontaneous breathing can be safely and effectively implemented in children who cannot cooperate.

Microwave thermochemotherapy (MTC) has been applied to treat lip squamous cell carcinoma (LSCC), but a deeper understanding of its therapeutic mechanisms and molecular biology is needed. To address this, we used single-cell transcriptomics (scRNA-seq) and spatial transcriptomics (ST) to highlight the pivotal role of tumor-associated neutrophils (TANs) among tumor-infiltrating immune cells and their therapeutic response to MTC. MNDA⁺ TANs with anti-tumor activity (N1-phenotype) are found to be abundantly infiltrated by MTC with benefit of increased blood perfusion, and these TANs are characterized by enhanced cytotoxicity, ameliorated hypoxia, and upregulated IL1B, activating T&NK cells and fibroblasts via IL1B-IL1R. In this highly anti-tumor immunogenic and hypoxia-reversed microenvironment under MTC, fibroblasts accumulated in the tumor front (TF) can recruit N1-TANs via CXCL2-CXCR2 and clear N2-TANs (pro-tumor phenotype) via CXCL12-CXCR4, which results in the aggregation of N1-TANs and extracellular matrix (ECM) deposition. In addition, we construct an N1-TANs marker, MX2, which positively correlates with better prognosis in LSCC patients, and employ deep learning techniques to predict expression of MX2 from hematoxylin-eosin (H&E)-stained images so as to conveniently guide decision making in clinical practice. Collectively, our findings demonstrate that the N1-TANs/fibroblasts defense wall formed in response to MTC effectively combat LSCC.
Humans ; Neutrophils/metabolism* ; Single-Cell Analysis ; Lip Neoplasms/genetics* ; Hyperthermia, Induced/methods* ; Microwaves/therapeutic use* ; Transcriptome ; Carcinoma, Squamous Cell/immunology* ; Tumor Microenvironment

Objective To explore the efficacy of the self-formulated Zhuzhang Formula in trea-ting the spleen deficiency with dysfunction of transportation syndrome of idiopathic short stature(ISS)and its effects on the growth rate,disease-related indicators,and bone metabolism indicators in affect-ed children.Methods A total of 80 children with ISS were enrolled as study subjects.They were randomly assigned to control group and observation group using random number table method,with 40 cases in each group.The control group received conventional western medicine treatment,while the observation group was administered self-formulated Zhuzhang Formula in addition to the treatment of the control group.Comparisons were made between the two groups in terms of clinical efficacy,TCM syndrome scores,growth parameters(monthly average height increment,annual growth rate),levels of disease-related indicators[serum insulin-like growth factor-1(IGF-1),bone morphogenetic pro-tein-2(BMP-2),insulin-like growth factor binding protein-3(IGFBP-3)],levels of bone metabo-lism indicators[bone alkaline phosphatase(BAP),type Ⅰ procollagen N-terminal propeptide(PⅠNP),type Ⅰ collagen cross-linked C-terminal telopeptide(β-CTX)],and the incidence of adverse reac-tions.Results The overall effective rate in the observation group was 97.50％,which was significantly higher than the 80.00％ in the control group(P＜0.05).After 3 and 6 months of intervention,the scores for symptoms such as short stature,sallow complexion,loss of appetite,weak voice and shortness of breath,limb weakness,and loose stools,as well as the total TCM syndrome scores,were lower in the observation group than those in the control group,with statistically significant differences(P＜0.05).After 6 months of intervention,the monthly average height increment and annual growth rate were higher in the observation group than those in the control group,and the differences were statistically significant(P＜0.05).After 3 and 6 months of intervention,the levels of IGF-1,BMP-2,IGFBP-3,BAP,and PⅠNP were higher in the observation group than those in the control group,while the level of β-CTX was lower,and the differences were statistically significant(P＜0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion The self-formulated Zhuchang Formula demon-strates remarkable efficacy in treating the spleen deficiency with dysfunction of transportation syndrome of ISS.It can alleviate clinical symptoms by regulating the levels of IGF-1,BMP-2,IGFBP-3,and bone metabolism indicators,thereby promoting the growth and development of affected children,and exhibits high safety.

Objective:To develop and design a during-treatment records auto-review program to comply the quality assurance(QA)requirement of radiotherapy chart auditing,and thereby improve the review efficiency and accuracy.Methods:Based on the items the guideline required,the Aria Oncology Information System database backup files was analyzed by Java,Vue,and etc.languages and the corresponding review logic was formulated.A total of 530 treatment records generated at Shanghai Concord Cancer Center from January to March 2024(10 weeks)were auto-reviewed and compared with the manual results for evaluating the accuracy and efficiency of the program.Results:The auto-review program was running smoothly.Overall with the above data,the sensitivity,specificity,accuracy and the error-miss rate were 73.4%,14.3%,87.7%and 12.3%respectively.For sub-set items,the source-skin distance(SSD)error detecting rate was 100%,the wrong session reporting was 100%correlated with the plans switching and the wrong fraction reporting was 100%related to plan revision.For the other items,auto and manual reviews gave out the same accuracy.Conclusion:The none-error results from the program are all true,so the manual rechecking could limit to those auto-review error records,which can reduce the workload by 73.4%,therefore improve the effectiveness and accuracy of the radiotherapy data review.

Using China National Knowledge Infrastructure, Wanfang, and PubMed database, literature search was conducted with the keywords ^“pregnancy^” and ^“monkeypox^”, and 27 related research articles were selected for analysis. Through a comprehensive review of the related literature, we aim to improve our knowledge of this viral disease, better our prevention, treatment and responses to future monkeypox outbreaks in China, so as to better protect the safety of mothers and infants. Maternal monkeypox can be prevented and controlled, if active and effective measures are taken in time. Drawing on the experience and lessons from monkeypox outbreaks at home and abroad, it is suggested that hospitals and public health agencies at all levels should raise awareness, and establish an effective emergency preparedness system for the prevention and control of potential future outbreaks.

Objective:To establish a rapid and accurate method for the detection of Klebsiella pneumoniae carbapenemase (KPC) carbapenemase gene based on recombinase aided amplification (RAA)-CRISPR-Cas13a (CRISPR-Cas13a) technology. Methods:Twenty-five clinical isolates of carbapenem-resistant Klebsiella pneumoniae (CRKP) and five carbapenem-sensitive Klebsiella pneumoniae (CSKP) strains preserved in 2020-2021 in Beijing Chuiyangliu Hospital were randomly collected, and the total DNA samples of the strains was extracted. RAA primers specific for KPC DNA and CRISPR RNA (crRNA) were designed to establish a rapid and accurate method for the detection of KPC carbapenemase gene based on RAA-CRISPR-Cas13a technology. The method was evaluated by plasmids and clinical sample strains, and the detection was also performed by Quantitative real-time PCR (qPCR) method to compare the detection rate and consistency of the two methods. Results:The RAA-CRISPR-Cas13a method can detect KPC plasmids and samples with a sensitivity of 1 copy/μl, which is higher than that of qPCR (10 1 copies/μl). Among the 30 clinical strains (including 25 CRKP strains and 5 CSKP strains), 23 strains were detected to carry KPC gene by both RAA-CRISPR-Cas13a method and qPCR method, and 7 strains were not detected with KPC gene. The detection rate of KPC gene in the 25 CRKP strains was 92% (23/25). The positive coincidence rate of the two methods was 100% (23/23). Conclusions:This study combined RAA amplification technology with CRISPR-Cas13a technology to establish a rapid and accurate method for detecting KPC carbapenemase gene. The method is useful for accurate screening of KPC carbapenemase-producing strains. It has a wide application prospect in drug resistance monitoring and infection control.