ObjectiveTo construct a group-based trajectory model (GBTM) for early medication adherence check-in, and to analyze the relationship between different trajectories and treatment outcomes in tuberculosis patients using data that were generated from smart tools for monitoring their medication adherence and check-in. MethodsFrom October 1, 2022 to September 30, 2023, a total of 163 pulmonary tuberculosis patients diagnosed in Fengxian District were selected as the study subjects. The GBTM was utilized to analyze the weekly active check-in trajectories of the subjects during the first 4 weeks and establish different trajectory groups. The χ² tests were employed to compare the differences between groups and logistic regression analysis was conducted to explore the relationship between different trajectory groups and treatment outcomes. ResultsA total of four groups were generated by GBTM analyses, of which a low level of punch card was maintained in group A, 6% of the drug users increased rapidly from a low level in group B, 17% of drug users increased gradually from a low level in group C, and 18% of drug users maintained a high level of punch card in group D. The trajectory group was divided into two groups according to homogeneity, namely the low level medication punch card group (group A) and the high level medication punch card group (group B, group C, and group D). The results of multivariate logistic regression analyses revealed that low-level medication check-in (OR=3.250, 95%CI: 1.089‒9.696), increasing age (OR=1.030, 95%CI: 1.004‒1.056), and not undergoing sputum examination at the end of the fifth month (OR=2.746, 95%CI: 1.090‒7.009) were significantly associated with poor treatment outcomes. ConclusionThe medication check-in trajectory of pulmonary tuberculosis patients within the first 4 weeks is correlated with adverse outcomes, or namely consistent low-level medication adherence check-ins are associated with poor treatment outcomes, while high-level medication adherence check-ins are associated with a lower incidence of adverse outcomes.

A novel approach named hierarchical vascular morphology awareness and noisy label refine for hepatic vessel segmentation(HN-Seg)is proposed to achieve precise vessel segmentation while reducing dependency on high-quality labels.HN-Seg comprises of(1)hierarchical vascular morphology aware network which employs a multi-scale local morphology attention mechanism and a global morphology preservation loss function to ensure the integrity of overall vascular morphology,and(2)self-distillation noisy label refine module which leverages the uncertainty in model outputs to optimize noisy labels through uncertainty optimization and consistency regularization,thereby maximizing the knowledge extracted from images during training and refining noisy labels.Experimental results on the hepatic vessel dataset demonstrate that HN-Seg achieves superior segmentation performance,outperforming 6 methods(UNet,UNet++,UNETR,SwinUNetR,FRUNet,and MTCL).HN-Seg attains DSC and clDice scores of 0.727 and 0.773,showing improvements of 9.6%and 21.5%over the baseline method UNETR.

Objective To observe the value of noninvasive right ventricular pressure-strain loop(RVPSL)for quantitative evaluation on right ventricular myocardial function changes in liver cirrhosis patients after TIPS.Methods Totally 26 cases of liver cirrhosis who would undergo TIPS were prospectively recruited as liver cirrhosis group.Echocardiography was performed before and 1 week,1 month after TIPS,and parameters of right ventricular myocardial function,including routine right ventricular echocardiography,right ventricular strain and right ventricular myocardial work were acquired.Meanwhile,30 healthy adults were recruited as control group,and the above parameters were recorded.Then these parameters were compared between groups,also before and after TIPS within liver cirrhosis group,and the changes of right ventricular myocardial function after TIPS were evaluated.Results Right ventricular global work index(RVGWI),right ventricular global constructive work(RVGCW)and right ventricular global wasted work(RVGWW)in liver cirrhosis group were higher than those in control group at all time points(all P＜0.05).One weak and 1 month after TIPS,right ventricular global longitudinal strain(RVGLS)and right ventricular free wall longitudinal strain(RVFWLS)in liver cirrhosis group were all higher than those in control group(all P＜0.05).In liver cirrhosis group,RVGWI,RVGCW and RVGWW 1 week after TIPS were all higher than those before TIPS and 1 month after TIPS(all P＜0.05),while RVGLS 1 weak and RVGWI 1 month after TIPS were both higher than those before TIPS(both P＜0.05).Conclusion Noninvasive RVPSL could be used to sensitively and quantitatively evaluate right ventricular function changes in patients with liver cirrhosis after TIPS.

Objective To observe the value of noninvasive right ventricular pressure-strain loop(RVPSL)for quantitative evaluation on right ventricular myocardial function changes in liver cirrhosis patients after TIPS.Methods Totally 26 cases of liver cirrhosis who would undergo TIPS were prospectively recruited as liver cirrhosis group.Echocardiography was performed before and 1 week,1 month after TIPS,and parameters of right ventricular myocardial function,including routine right ventricular echocardiography,right ventricular strain and right ventricular myocardial work were acquired.Meanwhile,30 healthy adults were recruited as control group,and the above parameters were recorded.Then these parameters were compared between groups,also before and after TIPS within liver cirrhosis group,and the changes of right ventricular myocardial function after TIPS were evaluated.Results Right ventricular global work index(RVGWI),right ventricular global constructive work(RVGCW)and right ventricular global wasted work(RVGWW)in liver cirrhosis group were higher than those in control group at all time points(all P＜0.05).One weak and 1 month after TIPS,right ventricular global longitudinal strain(RVGLS)and right ventricular free wall longitudinal strain(RVFWLS)in liver cirrhosis group were all higher than those in control group(all P＜0.05).In liver cirrhosis group,RVGWI,RVGCW and RVGWW 1 week after TIPS were all higher than those before TIPS and 1 month after TIPS(all P＜0.05),while RVGLS 1 weak and RVGWI 1 month after TIPS were both higher than those before TIPS(both P＜0.05).Conclusion Noninvasive RVPSL could be used to sensitively and quantitatively evaluate right ventricular function changes in patients with liver cirrhosis after TIPS.

A novel approach named hierarchical vascular morphology awareness and noisy label refine for hepatic vessel segmentation(HN-Seg)is proposed to achieve precise vessel segmentation while reducing dependency on high-quality labels.HN-Seg comprises of(1)hierarchical vascular morphology aware network which employs a multi-scale local morphology attention mechanism and a global morphology preservation loss function to ensure the integrity of overall vascular morphology,and(2)self-distillation noisy label refine module which leverages the uncertainty in model outputs to optimize noisy labels through uncertainty optimization and consistency regularization,thereby maximizing the knowledge extracted from images during training and refining noisy labels.Experimental results on the hepatic vessel dataset demonstrate that HN-Seg achieves superior segmentation performance,outperforming 6 methods(UNet,UNet++,UNETR,SwinUNetR,FRUNet,and MTCL).HN-Seg attains DSC and clDice scores of 0.727 and 0.773,showing improvements of 9.6%and 21.5%over the baseline method UNETR.

Skin graft and skin flap transplantation are the most widely used reparative and reconstructive method in plastic surgery. How to avoid the necrosis of skin graft and skin flap together with the improvement of survival quality of skin graft and skin flap have always been one of the basic problem in plastic surgery basic and clinical research. The emergence of adipose-derived stem cells has brought a new idea to solve this problem. In this paper, the isolation, identification and biological characteristics of adipose-derived stem cells, application of adipose-derived stem cells in skin graft and skin flap transplantation were reviewed. At the same time, the problems of adipose-derived stem cells and their future prospects were discussed.

The growth of puberty height is affected by many factors, among which the role of sex hormones is particularly important. The height increase in puberty accounts for about 20% of the final height in adulthood. It was previously believed that the final height of patients with disorders of sexual development was impaired due to the disorder of sex hormones. However, there are more classifications and subtypes of disorders of sexual development, and the growth patterns of patients with different subtypes of disorders of sexual development are also different. This article briefly reviews puberty bone growth, the effect of sex hormones on puberty bones, the sex hormone spectrum and growth pattern of patients with common disorders of sexual development, and the effect of growth hormone therapy.

Skin graft and skin flap transplantation are the most widely used reparative and reconstructive method in plastic surgery. How to avoid the necrosis of skin graft and skin flap together with the improvement of survival quality of skin graft and skin flap have always been one of the basic problem in plastic surgery basic and clinical research. The emergence of adipose-derived stem cells has brought a new idea to solve this problem. In this paper, the isolation, identification and biological characteristics of adipose-derived stem cells, application of adipose-derived stem cells in skin graft and skin flap transplantation were reviewed. At the same time, the problems of adipose-derived stem cells and their future prospects were discussed.

The growth of puberty height is affected by many factors, among which the role of sex hormones is particularly important. The height increase in puberty accounts for about 20% of the final height in adulthood. It was previously believed that the final height of patients with disorders of sexual development was impaired due to the disorder of sex hormones. However, there are more classifications and subtypes of disorders of sexual development, and the growth patterns of patients with different subtypes of disorders of sexual development are also different. This article briefly reviews puberty bone growth, the effect of sex hormones on puberty bones, the sex hormone spectrum and growth pattern of patients with common disorders of sexual development, and the effect of growth hormone therapy.

Objective:To explore the effect of oxidative stress on cognitive function following chest blast injury in mice.Methods:Sixty male C57BL/6 mice were divided into control group ( n=15) and chest blast group ( n=45) according to a random number table. The chest blast group was subgrouped at 1, 3, 7 days after injury for subsequent experiments. A self-developed blast injury device was used to prepare the mouse model of chest blast injury. Toklu score was used to evaluate the behavior changes in mice. Morris water maze test was used to evaluate the changes in spatial memory. HE staining was used to observe the pathological changes in the frontal cortex and hippocampus. Tissue reactive oxygen species (ROS) assay kit was used to detect ROS expression in the frontal cortex and hippocampus. Western blotting was used to assess changes of malondialdehyde (MDA) and cyclooxygenase-2 (COX2) in the frontal cortex and hippocampus. Results:The Toklu score of the chest blast group at 1 day after injury was (6.7±2.1)points, significantly higher than that of the control group [(2.0±0.0)points], as well as those of the chest blast group at 3 and 7 days after injury [(2.7±1.2)points and (2.0±0.0)points] (all P<0.01). There was no significant difference in the Toklu score between the control group and the chest blast group at 3 and 7 days after injury (all P>0.05). The Morris water maze test showed that the latency periods at 1 and 3 days after injury were 60.1(60.1, 60.1)seconds and 60.1(56.3, 60.1)seconds, significantly longer than that of the control group [10.1(3.9, 18.3)seconds] (all P<0.01). The latency period of the chest blast group at 7 days after injury was 60.1(30.5, 60.1)seconds, with no difference from the control group ( P>0.05). No significant differences were found in the latency periods of the chest blast group at 1, 3 and 7 days after injury (all P>0.05). In the control group, the pyramidal cells in the frontal cortex and hippocampus were regular in shape, with intensely-stained and clearly visible nuclei as well as uniform cytoplasm. In the chest blast group, diflerent degree of necrosis of pyramidal cells in the frontal cortex and strong cytoplasmic eosinophilia in the hippocampus were observed at different time points after injury. The levels of ROS in the frontal cortex of the chest blast group were (10.43±0.36)RFU/mg and (2.91±0.35)RFU/mg at 3 and 7 days after injury, which were significantly higher than that of the control group [(0.70±0.01)RFU/mg] ( P<0.05 or 0.01). The level of ROS in the frontal cortex of the chest blast group at 3 days after injury was significantly higher than that at 1 day [(2.13±0.65)RFU/mg] and that at 7 days after injury (all P<0.01). There were no statistical differences in the levels of ROS in the frontal cortex of the chest blast group at 1 and 7 days after injury ( P>0.05). The levels of ROS in the hippocampus of the chest blast group were (5.39±0.79)RFU/mg and (5.65±1.17)RFU/mg at 3 and 7 days after injury, which were significantly higher than those of the control group and of the chest blast group at 1 day after injury [ (0.73±0.06)RFU/mg and (2.33±0.02)RFU/mg] (all P<0.01). No significant differences were found between the levels of ROS in the hippocampus of the chest blast group at 3 and 7 days after injury and between the ROS levels of the control group and of the chest blast group at 1 day after injury (all P>0.05). The levels of ROS in the frontal cortex and hippocampus showed significant differences between the chest blast group at 3 and 7 days after injury (all P<0.01) but no significant differences between the control group and the chest blast group at 1 day after injury (all P>0.05). Western blotting showed that the levels of MDA in the frontal cortex of the chest blast group were 0.73±0.04, 0.83±0.04 and 0.99±0.06 at 1, 3 and 7 days after injury, which were significantly higher than that of the control group (0.56±0.04) ( P<0.05 or 0.01). The level of MDA in the frontal cortex of the chest blast group was significantly higher at 7 days after injury compared with that at 1 and 3 days after injury ( P<0.05 or 0.01), but there was no statistical difference between 1 day and 3 days after injury ( P>0.05). The levels of COX2 in the frontal cortex of the chest blast group were 2.93±0.02, 4.82±0.15 and 4.76±0.06 at 1, 3 and 7 days after injury, which were significantly higher than that of the control group (1.93±0.06) (all P<0.01). There were statistical differences in the levels of COX2 in the frontal cortex of the chest blast group at 3 and 7 days after injury compared with that at 1 day after injury (all P<0.01), but no statistical significance was found between 3 and 7 days after injury ( P>0.05). The levels of MDA in the hippocampus of the chest blast group were 0.92±0.11, 0.83±0.03 and 0.68±0.03 at 1, 3 and 7 days after injury, which were significantly higher than that of the control group (0.49±0.03) (all P<0.01). There was a significant difference in the level of MDA in the hippocampus of the chest blast group at 7 days after injury compared with those at 1 and 3 days after injury ( P<0.05 or 0.01), but the difference was not statistically significant among other groups (all P>0.05). The levels of COX2 in the hippocampus of the chest blast group were 0.88±0.06, 0.87±0.06 and 0.80±0.06 at 1, 3 and 7 days after injury, which were significantly higher than that of the control group (0.37±0.04) (all P<0.01). There were significant differences in the levels of COX2 of the chest blast group among 1, 3 and 7 days after injury (all P>0.05). Statistically significant differences were found between the levels of MDA in the frontal cortex and hippocampus of the chest blast group at 1 and 7 days after injury (all P<0.01), but no statistical significant difference between the control group and the chest blast group at 1 day after injury ( P>0.05). The levels of COX2 in the frontal cortex and hippocampus were significantly different among all groups (all P<0.01). Conclusions:In the short term after chest blast injury, there will be cognitive dysfunction in mice. Oxidative stress is one of the important contributing factors, and the cognitive damage in the frontal cortex is more serious than that in the hippocampus.