Objective:To establish an accurate retinal vascular network segmentation method for multiple fundus diseases, and to investigate the changing patterns of retinal vascular morphological parameters in these diseases.Methods:A retrospective study was conducted.Color fundus photography data of 829 patients with fundus diseases and 146 healthy adults were collected at Zhongshan Ophthalmic Center, Sun Yat-sen University from January 2020 to December 2023.The multi-path segmentation network was fine-tuned, and the color fundus photography data of diabetic retinopathy (DR), glaucoma and age-related macular degeneration (AMD) patients and healthy adults in the fundus image vessel segmentation public dataset were input for training until the loss value of the model stopped decreasing, and finally the trained multi-disease retinal vascular segmentation model was obtained.The retinal blood vessel morphological characteristics analysis method previously developed by our research group was used to analyze the subjects' color fundus images centered on the macula, the retinal blood vessel fractal dimension (D f), vascular area ratio (VAR), mean diameter (D m), tortuosity (τ) and other morphological characteristics parameters were extracted and compared among various disease groups.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Zhongshan Ophthalmic Center, Sun Yat-sen University (No.2023KYPJ344).Written informed consent was obtained from each subject. Results:The accuracy of the multi-disease color fundus photography vessel segmentation model on the test set was 0.987, and the area under the receiver operating characteristic curve was 0.995.After adjustment for age and sex, there were statistically significant differences in adjusted D f, adjusted VAR, adjusted D m and τ among different groups ( F=27.87, 47.60, 26.48, 4.63; all at P<0.001).Adjusted D f in AMD group, DR group, diabetic macular edema (DME) group, retinitis pigmentosa (RP) group, branch retinal vein occlusion (BRVO) group and central retinal vein occlusion (CRVO) group was significantly decreased than in normal control group, and the differences were statistically significant (all at P<0.05).Adjusted VAR in all disease groups except optic neuritis group and central serous chorioretinopathy group was significantly decreased compared with normal control group, and the differences were statistically significant (all at P<0.05).The adjusted D m in DME, glaucoma, RP, BRVO and CRVO groups was significantly decreased than that in normal control group, and the differences were statistically significant (all at P<0.05).τ was not affected by age or sex and did not require adjustment.τ in DR group and DME group was significantly increased compared with normal control group, and the differences were statistically significant (both at P<0.05). Conclusions:An accurate retinal blood vessel segmentation method for various fundus diseases was successfully constructed.This method shows high accuracy in retinal blood vessel segmentation in color fundus photographs of various retinal diseases.There are significant differences in the morphological characteristics of retinal blood vessels among different retinal diseases.

Objective: To summarize the clinical manifestations of IgG4-related diseases in the head and neck, explore treatment methods. Methods : The clinical data of 21 patients diagnosed with IgG4-related diseases were retrospectively analyzed. The clinical data and the results of glucocorticoid and immunosuppressive therapy were studied retrospectively. Results: All patients had swollen sclerotic masses, and CT showed irregular high-density masses with uniform enhancement in the enlarged glands. Some patients had mucosal thickening and mass-like changes in theoral cavity, nose, sinuses, throat and other tissues, and most of the patients had cervical lymphadenopathy and elevated serum IgG4 levels (≥ 1.35 g/L). Histopathological examination of affected exosine glands and affected mucosa and lymph nodes in all patients showed infiltration of lymphocytes, plasma cells and IgG4+ plasma cells. In 21 patients, the mass in the affected glands and mucosa (including head, neck and other tissues) disappeared, and the clinical symptoms were relieved after the application of glucocorticoids. However, with a reduction in glucocorticoids, the mass recurred or even worsened. Conclusion For patients with a single mass in the submandibular gland, parotid gland and other salivary glands, as well as lymph node enlargement, CT is the first choice to identify the nature of gland neoplasms. Combined with pathological examination, related auxiliary examination and peripheral blood examination are also needed to obtain a definitive diagnosis. Glucocorticoid therapy is used to achieve a good prognosis, and long-term follow-up and timely adjustment of medication regimens are required.

Objective:To explore the clinical effects of axillary propeller flaps in reconstructing the axillary fold scar contracture.Methods:A retrospective cohort study was conducted. From July 2016 to January 2020, 11 patients with anterior axillary fold or anterior and posterior axillary fold scar contractures after burns were admitted to Xiangya Hospital of Central South University, including 7 males and 4 females, aged 8 to 48 years. The lesions involved unilateral axilla in 9 cases and bilateral axilla in 2 cases, with the joint abduction angle of the affected shoulder ranging from 25 to 100°. The axillary fold contracture scars were excised and released, resulting in wound of 8 cm×5 cm-24 cm×20 cm. According to the condition of the residual normal skin in axilla, 2, 3, and 4-leaf propeller flaps with area of 5 cm×3 cm-24 cm×10 cm were designed to repair the wounds after scar excision and release. The donor site wound was closed by suturing directly, and the residual wound that could not be completely sutured was transplanted with free full-thickness skin grafts from the inner thigh or abdomen. The application of 2, 3, and 4-leaf propeller flaps, the joint abduction angle of the affected shoulder immediately after operation, and the survival of the flaps and skin grafts after operation were recorded. The recurrence of scar contracture, the appearance of the flaps, the joint abduction angle of the affected shoulder, and the functional recovery of the affected shoulder joint and upper arm were observed through a follow-up.Results:Among the 13 axillary propeller flaps transplanted in the 11 patients in this group, there were 9 double-leaf propeller flaps, two 3-leaf propeller flaps, and two 4-leaf propeller flaps. The joint abduction angle of the affected shoulder reached 110-165° immediately after operation. All the flaps survived after operation. Nine flap donor sites were repaired with free skin grafts, with skin grafts survived in 7 flap donor sites after operation. Scar erosion in incision and small area of skin graft necrosis developed in 2 flap donor sites. One of the wounds was debrided and repaired by transplantation of split-thickness skin grafts from inner thigh, and the other wound was healed after dressing changes. A follow-up of 6 to 24 months was conducted after surgery, and all the patients had no recurrence of axillary scar contracture; the color of the flap matched the receiving area; the elasticity of flap was good; the joint abduction angle of the affected shoulder reached 120-165°, and the joint pronation and supination, upper arm lifting and circular rotation of the affected shoulder were all good.Conclusions:Reconstruction of the axillary fold scar contracture with axillary propeller flaps has good result, with better flap appearance and recovery of the shoulder joint activity and upper arm function after operation.

Objective: To investigate the effect of different negative pressure of wound negative pressure dressing (NPD) on the survival of full-thickness skin grafts of patients. Methods: One hundred and eleven patients who need skin grafting, conforming to the inclusion criteria were hospitalized in our unit from August 2012 to March 2017, and their clinical data were retrospectively analyzed. Forty-seven patients hospitalized from August 2012 to October 2015 were assigned into traditional treatment group. Sixty-four patients hospitalized from November 2015 to March 2017 were divided into -9.975 kPa negative pressure treatment group (n=34) and -13.300 kPa negative pressure treatment group (n=30). Patients in traditional treatment group received conventional dressing after full-thickness skin grafting. Patients in -9.975 kPa and -13.300 kPa negative pressure treatment groups received -9.975 kPa and -13.300 kPa NPD based on traditional treatment after vacuum sealing, respectively. Dot necrosis area of skin grafts and erosion and escharosis of graft edges of patients in the three groups on post operation day 10 were observed. The percentage of dot necrosis area of skin grafts and occurrence rate of erosion and escharosis of skin graft edges were calculated, respectively. Data were processed with chi-square test, Fisher′s exact test, and Kruskal-Wallis H test. Results: Percentages of dot necrosis area of skin grafts of patients in traditional treatment group and -9.975 kPa and -13.300 kPa negative pressure treatment groups were 17.81%, 3.20%, and 3.00%, respectively. Percentage of dot necrosis area of skin grafts of patients in traditional treatment group was significantly higher than that in -9.975 kPa and -13.300 kPa negative pressure treatment groups (Z=-5.770, -4.690, P<0.001). Percentages of dot necrosis area of skin grafts of patients in -9.975 kPa and-13.300 kPa groups were close (Z=-0.619, P>0.05). The occurrence rates of erosion and escharosis of skin graft edges of patients in traditional treatment group and -9.975 kPa and -13.300 kPa negative pressure treatment groups were 78.7% (37/47), 32.4 (11/34), and 36.7% (11/30), respectively. Erosion and escharosis of skin graft edges of patients in -9.975 kPa and -13.300 kPa negative pressure treatment groups were better than those in traditional treatment group (P<0.001). Erosion and escharosis of skin graft edges of patients in -9.975 kPa and -13.300 kPa negative pressure treatment groups were close (P>0.05). Conclusions The use of -9.975 kPa and -13.300 kPa NPD in skin grafts after full-thickness skin grafting significantly diminishes the occurrence rates of dot necrosis area of skin grafts and erosion and escharosis of graft edges.

Objective To study the value of MRI in the diagnosis of diabetic foot(DF)ulcer.Methods MRI data of 29 cases with DF ulcer were analyzed retrospectively,among which 8 showed neuropathic osteoarthropathy (Charcot’s joint)on X-ray radiographs. To analyze the correlation of MRI features and MRA results of DF ulcer patients.Results All patients displayed with soft tissue cellulitis,and 1 6 cases suffered with osteomyelitis as well.8 cases were Charcot’s joint,and 2 cases were confirmed by biopsy for false positive osteomyelitis.8 cases of MRA could not meet the diagnostic requirements due to the contamination of the inferior genicular vein.There were no obvious difference among the incidence of Charcot’s joint,sinus,abscess and tenosynovitis between lower extremity artery stenosis and not(P=0.06;χ2=0.07, P=0.79;χ2=2.15,P=0.14;χ2=2.29,P=0.13),but the difference of incidence of osteomyelitis was obvious(χ2=4.88,P=0.03). Conclusion MRI can display osteomyelitis,neuropathic osteoarthropathy,cellulitis of the tissue,sinus,abscess,tenosynovitis and lower extremities arterial disease (LEAD)of the DF ulcer patients,and the incidence of osteomyelitis was associated with LEAD.

Objective To detect the long term effect of pure and multiple concussions on spatial cognitive of rats.Methods One hundred and eighty 7-week-old Spragne-Dawley male rats with weight of 280 ± 30g were chosen and randomly divided into a control group and a concussion group.The cerebral concussion was induced in the rats using a metallic pendulum striker concussive device.After the first strike,the brain injury group was randomly divided into a pure cerebral concussion(PCC)group and a multiple cerebral concussion(MCC) group.After the second strike,the MCC group was randomly divided into two-fold cerebral concussion(2MCC) group and three-fold cerebral concussion(3MCC) group.The striking interval was 24h.One,3 and 6 months after trauma,their cognitive function was tested using Morris water maze.Results One month later after injury,there was no significant difference in the escape latency between the control group and PCC group.Significant differences in the measurement were observed between the control/PCC group and 2MCC group on the 7th day after the injury,also between the control/PCC and 3MCC groups on the 6th and 7th day.And there were significant differences between the 2MCC and 3MCC groups on the 6th and 7th days.The non-platform test did not observe any significant differences among the four groups.Three months after injury,there was still no significant difference between the control group and PCC group,PCC and 2MCC groups,as well as 2MCC and 3MCC groups in the escape latency.However,there was significant difference between the control group and 2MCC group on the 5th,6th and 7th days,between the control group and 3MCC group on the 4th,5th,6th and 7th days,as well as between PCC group and 3MCC group on the 6th and 7th days.In the non-platform test,there was no significant difference between the control group and PCC group,between PCC group and 2MCC group,as well as between 2MCC group and 3MCC group.However,2MCC and 3MCC groups spent significantly less time in the former platform quadrant,when compared with the control group and 3MCC group spent significantly less time than PCC group.Six months after injury,significant differences in the escape latency were observed between the control group and PCC group on the 6th and 7th days,and 2MCC group on the 5th,6th and 7th days,also and 3MCC groups on the 2nd,3rd,4th,5th,6th and 7th days,still between PCC group and 2MCC group on the 6th and 7th days,as well as between PCC group and 3MCC group on the 4th,5th,6th and 7th days.Moreover,there was significant difference between 2MCC and 3MCC groups only on the 7th day.In the non-platform test,PCC group,2MCC group and 3MCC group spent significantly less time in the former platform quadrant compared with the control group.Moreover,in this test significant differences were found between PCC group and 2MCC/3MCC group,but not between 2MCC group and 3MCC group.Conclusion With the increase of cerebral concussion times,earlier and more serious damage of spatial cognition will appear,with a significant cumulative effect in rats.Such rat model can be used to study the pathological changes of cognitive impairment in chronic traumatic encephalopathy.

OBJECTIVE To analyze the correlation between number of tissue eosinophils(Eos) and blood Eos levels in patients with chronic rhinosinusitis with nasal polyps(CRSwNP), and to investigate if tissue and blood eosinophilia predicts disease severity and prognosis in CRSwNP. METHODS A retrospective analysis of 102 patients, who diagnosed with CRSwNP was carried out in this study. Surgical specimens were evaluated for degree of tissue Eos, which was compared with blood Eos. Patients were divided into two groups according to the results of endoscopy one year after surgery: recurrent and non-recurrent group. Statistical analysis was performed to compare tissue and blood Eos and CT Lund-Mackay scores. RESULTS Blood and tissue Eos in recurrent group was significantly higher than that in non-recurrent group(P=0.032, 0.033, 0.017). There was not a statistical difference of CT scores between two groups(P =0.089). There was a significant correlation between tissue Eos and absolute number of blood Eos(r=0.637, P=0.000) as well as between tissue Eos and percentage of blood Eos(r=0.542, P=0.000). However Eos and CT scores were not correlated statistically(P>0.05). CONCLUSION Blood Eos levels can predict the degree of Eos infiltration in nasal polyps. Blood and tissue Eos correlate with prognosis.

The composition of S95-100 field mobile medical system was introduced, and some practices were summarized such as rational grouping, enhanced organization, proper allocation and etc. The problems of the system were analyzed from three aspects of the fixation of the internal devices, the rapid deployment in the plateau and maintenance in field conditions, and some measures were put forward to improve the medical support ability of the system in the plateau.

Objective To define the optimal process for spray drying of shengrnaisan prescription granule.Methods The optimal process for spray drying was investigate by single factor experiment.Results The optimal process for spray drying of shengmaisan prescription granule involved temperature of liquid feedstock of 30 ～ 40℃,relative density of extract of 1.10,the rate of liquid feedstock of 50 ～ 60 ml/min,inlet temperature of 175 ～ 180℃,and outlet temperature of 85 ～ 90℃.Conclusion The optimized process is rational and feasible.

OBJECTIVE: To evaluate the accuracy with which auditory steady-state response (ASSR), tone burst auditory brain stem response (Tb-ABR) and click-evoked auditory brainstem response (c-ABR) thresholds predict behavioral thresholds, using a within-subjects design. METHOD: ASSR, Tb-ABR and c-ABR thresholds were recorded in a group of adults with normal hearing (58 ears). Evoked-potential thresholds were recorded and compared with behavioral, pure-tone thresholds. RESULT: The results suggested both ASSR and Tb-ABR thresholds had high correlations to pure-tone thresholds. Tb-ABR thresholds were recorded much closer to behavioral threshold than ASSR thresholds. There was a linear relation between c-ABR thresholds and average thresholds of 2 kHz, 4 kHz pure tone audiometry. CONCLUSION Both the ABR and the ASSR provided reasonably accurate predictions of multifrequencies behavioral threshold. Tb-ABR combined with c-ABR may take the accuracy predicted behavioral threshold.
Acoustic Stimulation ; Adolescent ; Adult ; Audiometry, Evoked Response ; methods ; Audiometry, Pure-Tone ; Auditory Threshold ; Evoked Potentials, Auditory, Brain Stem ; physiology ; Humans ; Young Adult