Objective To determine the therapeutic effect of fasciotomy+hypertonic saline flushing for crush syndrome(CS)in rats.Methods SD rats(weighing 250±20 g)were randomly divided into normal control group(NC group,n=10)and CS group(n=14).Rat CS model was established by compressing the buttocks and both hindlimbs with a weight of 7.5 kg for 4 h,and the presence of hematuria or anuria was defined as success of modeling.In 6 h after modeling,the fluid exuded from the compressed tissues was collected,and the contents of potassium ions(K+),calcium ions(Ca2+),myoglobin(Mb),and lactic acid(Lac)in the exudate of each group were detected.Another 63 male SD rats(weighing 250±20 g)were randomly and equally divided into blank control group(NC group),CS group,CS+fasciotomy group(CSO group),and CS+fasciotomy+difference doses of NaCl solution irrigation groups(0.9％,3.0％,5.0％and 7.0％NaCl,respectively).At 6 h after modeling,the renal blood flow was measured,the contents of K+,Ca2+,Mb,Lac,AST,ALT,Cr,and urea in the plasma of each group were detected,and the compressed tissues and kidney tissues were observed for pathological changes.Results Detection of exudates showed the contents of K+,Mb,and Lac were significantly higher,while that of Ca2+content was obviously decreased in the CS group than the NC group(P＜0.01).Plasma detection indicated that simple fasciotomy had no therapeutic effect,while it combined with NaCl solution flushing decreased the contents of K+,Mb,Lac,AST,ALT,urea and Cr,and increased the Ca2+content in the blood of the CS group(P＜0.05).Laser speckle contrast imaging revealed that simple fasciotomy could not increase renal blood flow,while the combination of fasciotomy and NaCl solution flushing notably increased the renal blood flow in the CS rats(P＜0.05).In addition,the combination treatment reduced the pathological damage in the kidneys induced by CS,but fasciotomy alone had no such effect(P＜0.5).Conclusion Fasciotomy combined with hypertonic NaCl solution(3％)flushing can significantly reduce the damage caused by CS in rats.

OBJECTIVES: International Ovarian Tumor Analysis (IOTA) working group proposed a logistic regression (IOTA LR2) model. It is served as a risk prediction model for benign and malignant adnexal tumors. This study aims to compare the diagnostic efficiency between the IOTA LR2 model and doctors' subjective assessment on diagnosing benign and malignant adnexal mass. METHODS: The ultrasonographic images of 616 adnexal masses were retrospectively analyzed by the senior doctors' group and the junior doctors' group using the IOTA LR2 model and subjective assessment. The postoperative pathological diagnosis was used as the gold standard to compare the diagnostic efficiency of the 2 methods. RESULTS: The area under the curves of subjective assessment and IOTA LR2 model for diagnosing malignant adnexal masses were 0.86 and 0.90 for the senior doctors' group and 0.79 and 0.88 for the junior doctors' group, respectively. The sensitivity and specificity of subjective assessment for diagnosing the malignant adnexal masses were 81.0% and 91.3% for the senior doctors' group and 70.1% and 88.7% for the junior doctors' group, respectively. The sensitivity and specificity of the IOTA LR2 model for diagnosing the malignant adnexal masses were 79.6% and 88.1% for the senior doctors' group, and 79.6% and 81.7% for the junior doctors' group, respectively.There were no significant difference in the sensitivities between the senior doctors' group and junior doctors' group using the IOTA LR2 model and the senior doctors' group using subjective assessment (both P>0.05). CONCLUSIONS The diagnostic efficiency of the IOTA LR2 model is equal to the senior doctors' experiences. This model can help junior doctors to reduce the missed diagnosis of malignant adnexal masses.
Adnexal Diseases/pathology* ; Diagnosis, Differential ; Female ; Humans ; Ovarian Neoplasms/diagnostic imaging* ; Retrospective Studies

Purpose: This study compared the diagnostic performance of the Ovarian-Adnexal Reporting and Data System (O-RADS), the Risk of Malignancy Index 4 (RMI4), the International Ovarian of Tumor Analysis Logistic Regression Model 2 (IOTA LR2), and the IOTA Simple Rules (IOTA SR) in predicting the malignancy of adnexal masses (AMs). Methods: This retrospective study included 575 women with AMs between 2017 and 2020. All clinical messages, ultrasound images, and pathological findings were collected. Two senior doctors (group I) and two junior doctors (group II) used the four systems to classify AMs. The postoperative pathological diagnosis was used as the gold standard to evaluate the diagnostic efficiency. A receiver operating characteristic curve was used to test the diagnostic performance. The interrater agreement between the two groups was tested using kappa values. Results: Of all 592 AMs, 447 (75.5%) were benign, 123 (20.8%) were malignant, and 22 (3.7%) were borderline. The intergroup consistency test yielded kappa values of 0.71, 0.92, 0.68, and 0.77 for the O-RADS, RMI4, IOTA LR2, and IOTA SR, respectively. To predict malignant lesions, the areas under the curve of the O-RADS, RMI4, IOTA LR2, and IOTA SR systems were 0.90, 0.89, 0.90, and 0.86 for group I and 0.89, 0.87, 0.88, and 0.84 for group II, respectively. The O-RADS had the highest sensitivity (91.0% in group I and 84.8% in group II). Conclusion The four diagnostic systems could compensate for junior doctors’ inexperience in predicting malignant adnexal lesions. The O-RADS performed best and showed the highest sensitivity.

Objective To improve the efficiency of blood collection in hemodialysis patients by inventing and applying new blood collection needles.Methods One hundred and eighty cases of hemodialysis patients were randomly divided into control group 1(CG1),control group 2(CG2),experimental group(EG). Comparison of the three groups in time of blood collection,the number of operation that had the risk of acupuncture injury and the number of the blood samples that had been contaminated. Results There were statistically significant difference (P<0.05)in three groups.The number of times of blood collection in the number of operations that had the risk of acupuncture injury,and the number of the blood sample that had been contaminated. CG1 had the longest blood collection time(12.55 min),EG had the shortest blood collection time(5.09 min);the risk of acupuncture injury was the highest in CG2 and the lowest in the EG.The number of contamination of blood samples and the amount of inaccurate sample in CG1 were the highest,and the lowest in the EG. Conclusions The working efficiency of transfer type anti-acupuncture needle(TTAN)during blood sample collection in hemodialysis patients is signifi-cantly better than that of traditional blood collection method,and it is helpful to reduce the risk of acupuncture injury and the risk of contamination in blood samples,which is worthy of promotion.

Objective To investigate the regulatory effects of endogenous sulfur dioxide (SO2) on collagen accumulation in pulmonary arterial fibroblasts of rats and its mechanisms.Methods Primary rat pulmonary artery fibroblasts were used in the experiment and were divided into 3 groups:the control group,the L-aspartate-beta-hydroxamate(HDX) group and the HDX ± SO2 group.SO2 content of pulmonary artery fibroblasts supernatant was detected by adopting high performance liquid chromatography (HPLC).Collagen type Ⅰ and collagen type Ⅲ in pulmonary artery fibroblasts were determined by using immunofluorescence.Phosphorylation of Smad2/3,protein expression of matrix metalloproteinase (MMP)-13 and tissue inhibitors of MMP (TIMP)-1 were detected by using Western blot.One-way ANOVA was used for multiple group comparisons followed by Bonferroni test for each group.P ＜ 0.05 was considered as significant difference.Results Compared with control group,endogenous SO2 content in HDX group was significantly decreased [(14.30-± 0.48) μmol/L vs.(20.14 ± 0.49) μμmol/L,P ＜ 0.01],the level of Smad2/3 increased (1.03 ±0.31 vs.0.48 ± 0.20,P ＜ 0.01),protein expressions of MMP-13 and TIMP-1 in pulmonary artery fibroblasts were decreased (MMP-13:0.28 ± 0.06 vs.0.75 ± 0.11,P ＜ 0.01;TIMP-1:0.40 ± 0.05 vs.0.66 ± 0.20,P ＜ 0.01),and the ratio of MMP-13/TIMP-1 was decreased (0.71 ± 0.12 vs.1.23 ± 0.45,P ＜0.01).However,contents of collagen Ⅰ and collagen Ⅲ were significantly increased.Compared with HDX group,the level of Smad2/3 phosphorylation in HDX ± SO2 group decreased (0.57 ± 0.16 vs.1.03 ± 0.31,P ＜ 0.01),protein expression of MMP-13 and TIMP-1 upregulated (MMP-13:0.63 ± 0.06 vs.0.28 ± 0.06,P ＜ 0.01;0.59 ± 0.11 vs.0.40 ± 0.05,P =0.015),the ratio of M MP-13/TIMP-1 (1.10 ± 0.22 vs.0.71 ± 0.12,P =0.033) increased,but contents of collagen type Ⅰ and type Ⅲ were reduced obviously.Conclusions SO2 promotes the degradation of collagen and collagen accumulation in pulmonary artery fibroblasts of rats probably by inhibiting Smad2/3 signal pathway,increasing protein expression of MMP-13 and TIMP-1,and upregulating the ratio of MMP-13/TIMP-1.