Objective To investigate the efficacy of Amplatzer duct occluder-Ⅱ device(ADO-Ⅱ)in treating ventricular septal detect(VSD)with aortic sinus prolapse(ASP)in child patients.Methods The clinical data of 94 child patients with VSD complicated by ASP,who were admitted to the Hunan Provincial Children's Hospital of China between January 2018 and September 2022,were retrospectively collected.The child patients included 60 males and 34 females with a mean age of(4.7±3.1)years.Mild-moderate ASP was seen in 83 child patients,with a mean(4.12±0.97)mm-sized VSD.Severe ASP was seen in 11 child patients,with a mean(4.95±0.51)mm-sized VSD.Perimembrane VSD was observed in 54 child patients and intracristal VSD in 40 child patients.The relationship of VSD size and degree of ASP to the selection of ADO-Ⅱ,postoperative middle period aortic valve regurgitation and residual leakage was analyzed,so as to clarify the applicability of ADO-Ⅱ to such child patients.Results In the postoperative middle period,6 child patients had mild aortic valve regurgitation,most seen in the child patients who received 4-4 mm or 5-4 mm ADO-occluder;and 10 child patients had residual leakage,mainly seen in the child patients who received 5-4 mm or 6-4 mm occluder.Conclusion In the condition when the ADO-Ⅱ occluder shows satisfactory placement pattern,this treatment is suitable for the child patient having＜6 mm VSD with ASP.Although there are some residual leakage and aortic valve regurgitation after surgery,this interventional therapy still meets the clinical requirements.(J Intervent Radiol,2024,32:17-21)

Objective:To effectively quantify and evaluate the quality of different deformation registration algorithms, in order to enhance the possibility of implementing deformation registration in clinical practice.Methods:The Jacobian determinant mean (JDM) is proposed based on the Jacobian determinant (JD) of displacement vector field (DVF), and the Jacobian determinant error (DJDE) is introduced by incorporating the JD of the inverse DVF. The optical flow method (OF-DIR) and fast demons method with elastic regularization (FD-DIR) were tested on nasopharyngeal and lung cancer datasets. Finally, JDM and DJDE with the Jacobian determinant negative percentage (JDNP), inverse consistency error (ICE) and normalized mean square error (NMSE) were used to evaluate the registration algorithms and compare the differences evaluation indicators in different tumor images and different algorithms, and the receiver operating curve (ROC) was analyzed in evaluation.Results:In lung cancer, OF-DIR outperformed FD-DIR in terms of JDM, NMSE, DJDE and ICE, and the difference was statistically significant( z = -2.24, -4.84, t = 4.01, 6.54, P<0.05). In nasopharyngeal carcinoma, DJDE, ICE and NMSE of OF-DIR were superior to FD-DIR, and the difference was statistically significant ( t = 4.46, -7.49, z = -2.22, P<0.05), but there was no significant difference in JDM ( P>0.05). In lung cancer and nasopharyngeal carcinoma, JDNP of OF-DIR was worse than that of FD-DIR, and the difference was statistically significant ( z = -4.29, -4.02, P<0.01). In addition, DJDE is more specific and sensitive on ROC curve (AUC=0.77), and has different performance result for tumor images at different sites. Conclusions:The JDM and DJDE evaluation metrics proposed are effective for deformation registration algorithms. OF-DIR is suitable for both lung cancer and nasopharyngeal carcinoma, while the influence of organ motion on the registration effect should be considered when using FD-DIR.

Objective To study the effect of Honokiol(HKL)on pulmonary microvascular endothelial cells in lipopolysaccharide(LPS)-induced acute respiratory distress syndrome(ARDS)and its potential mechanism.Methods Mouse lung microvascular endothelial cells(PMVECs)were cultured with DMEM+10％FBS in a six-well plate and divided into control(Con)group 1,Honokiol(HKL)group 1,LPS treated(LPS)group 1,and LPS+HKL treatment(HKL+LPS)group 1.The levels of malondialdehyde(MDA)and reactive oxygen species(ROS)in cell lysates were determined by lipid peroxidation assay kit and H2DCF-DA,respectively.TUNEL/DAPI double staining was used to detect apoptosis.Cell junctions were visualized via VE-cadherin/DAPI and Claudin-5/DAPI double staining.Western blot was used to detect caspase-3,cleaved caspase-3,Sirt3,SOD2,and acetylated SOD2(Ac-SOD2)expression.Thirty-two mice were randomly divided into control(Con)group 2,Honokiol(HKL)group 2,LPS treated(LPS)group 2,and LPS+HKL treatment(HKL+LPS)group 2.Hematoxylin and eosin(HE)staining was used to observe pathological changes to the lung tissue.Results HKL pretreatment significantly reversed the LPS-induced increase in ROS and MDA levels(P＜0.05),SOD2 acetylation and Sirt3 down-regulation(P＜0.05).TUNEL and caspase analysis showed that HKL protected against the apoptosis of PMVECs induced by LPS.VE-cadherin fluorescence staining demonstrated that HKL pretreatment prevented LPS from disrupting cell adhesion junctions.Claudin-5 fluorescence staining showed that HKL pretreatment prevented LPS from disrupting the tight junctions between cells.In the animal experiments,HE staining showed that HKL significantly inhibited the typical pathological changes of ARDS in the lung tissue of mice in the LPS group.Conclusions HKL can significantly inhibit the LPS-induced oxidative stress,apoptosis,and cell-connection breakdown of PMVECs,thereby alleviating ARDS symptoms.

Silk fibroin (SF) as a natural biopolymer has become a popular material for biomedical applications due to its minimal immunogenicity, tunable biodegradability, and high biocompatibility. Nowadays, various techniques have been developed for the applications of SF in bioengineering. Most of the literature reviews focus on the SF-based biomaterials and their different forms of applications such as films, hydrogels, and scaffolds. SF is also valuable as a coating on other substrate materials for biomedicine; however, there are few reviews related to SF-coated biomaterials. Thus, in this review, we focused on the surface modification of biomaterials using SF coatings, demonstrated their various preparation methods on substrate materials, and introduced the latest procedures. The diverse applications of SF coatings for biomedicine are discussed, including bone, ligament, skin, mucosa, and nerve regeneration, and dental implant surface modification. SF coating is conducive to inducing cell adhesion and migration, promoting hydroxyapatite (HA) deposition and matrix mineralization, and inhibiting the Notch signaling pathway, making it a promising strategy for bone regeneration. In addition, SF-coated composite scaffolds can be considered prospective candidates for ligament regeneration after injury. SF coating has been proven to enhance the mechanical properties of the substrate material, and render integral stability to the dressing material during the regeneration of skin and mucosa. Moreover, SF coating is a potential strategy to accelerate nerve regeneration due to its dielectric properties, mechanical flexibility, and angiogenesis promotion effect. In addition, SF coating is an effective and popular means for dental implant surface modification to promote osteogenesis around implants made of different materials. Thus, this review can be of great benefit for further improvements in SF-coated biomaterials, and will undoubtedly contribute to clinical transformation in the future.
Biocompatible Materials/chemistry* ; Silk/chemistry* ; Fibroins/pharmacology* ; Dental Implants ; Osteogenesis ; Tissue Scaffolds/chemistry* ; Tissue Engineering/methods*

Objective:To investigate the risk factors of diabetic kidney disease (DKD) in type 2 diabetes mellitus (T2DM) patients in plain-sand areas and loess hilly areas of Gansu province.Methods:A total of 1 599 T2DM patients who participated in chronic disease and risk factors monitoring and basic public health service management were selected by multi-stage stratified random sampling method in the sandy plain areas and loess hilly areas of Gansu province. Questionnaire survey, physical measurement and laboratory tests were performed. Multivariate binary logistic model was used to analyze the influencing factors.Results:The prevalence of DKD was 22.1% (174/787) among T2DM patients in the sandy plain areas and 19.1%(155/812) in the loess hilly area, respectively. Hypertension ( OR=3.022), hyperuricemia ( OR=2.114) and HbA1c≥7%( OR=2.231) were the risk factors for DKD in the plain-sand areas, and the risk of DKD increased with age. In the loess hilly areas, female sex ( OR=0.379) was the protective factor for DKD; while duration of disease≥10 years ( OR=2.476), hyperuricemia ( OR=1.907), HbA1c≥7% ( OR=1.927) were the risk factors for DKD; and the risk of DKD increased with the increase of age, and decreased with the increase of per capita monthly income. Conclusions:The prevalence of DKD and its influencing factors are different between sandy plain areas and loess hilly areas in Gansu province. The prevention and treatment of hypertension should be given more attention in sandy plain areas. In addition, the screening of DKD should be conducted among T2DM patients, particularly for those with old age, hyperuricemia and HbA1c≥7% in both areas of the province.

Objective To design an automated detection protocol for morphological detection of sperm head based on deep learning and evaluate its efficiency,accuracy and reliability.Methods Fourteen pictures for each of 1 000 samples were analyzed by using the pre-trained YOLO target detection model and VGG16 classification model.At least 200 sperm were detected for each sample.Equal amount of samples were analyzed by manual microscope examination,and the efficiency,accuracy and correlation between the two methods were compared.Results The morphology of sperm heads which were manually classified but untrained was detected by pre-trained classification model,and the prediction accuracy reached to 95.5％.The detection time for clinical each sample was only 10 seconds,and its accuracy and efficiency were higher than those of manual microscope examination.The percentages of the sperms with normal morphology were significantly positively correlated(r=0.84,P＜0.01)in the detections of both the methods.Conclusion The detec-tion protocol proposed in this study can greatly improve work efficiency,and its reliability and accuracy exceed those of manual micro-scope examination.

Objective:To analyze the dosimetric differences of volumetric modulated arc therapy (VMAT) plans for lung cancer caused by different dose calculation algorithms and radiation field settings and thus to provide a reference for designing clinical VMAT plans for lung cancer.Methods:This study randomly selected 20 patients with lung cancer and divided them into four groups of VMAT plans, namely, a group adopting two fields and two arcs based on the AAA algorithm (2F2A_AAA), a group employing two fields and two arcs based on the AXB algorithm (2F2A_AXB), a group using two fields and two arcs based on the MC algorithm (2F2A_MC), and a group adopting one field and two arcs based on the MC algorithm (1F2A_MC). Then, this study evaluated the target coverage, high-dose control, dose homogeneity index (HI), conformity index (CI), and organs at risk (OARs) of the plans using different algorithms and radiation field settings.Results:The planning target volume (PTV) results of two fields combined with two arcs (2F2A) of three groups using different algorithms are as follows. 2F2A_MC achieved better results in both D1% and V 95% (the relative volume of the target volume surrounded by 95% of the prescribed dose) of planning gross target volume (PGTV) than 2F2A_AAA (D1%: t=-2.44, P=0.03; V95%:z=-2.04, P=0.04) and 2F2A_AXB (D1%: t=2.34, P=0.03; z=-3.21, P < 0.01). 2F2A_AXB outperformed 2F2A_AAA ( z=-3.66, P < 0.01) and was comparable to 2F2A_MC in terms of the CI of PGTV. Regarding OARs, 2F2A_AXB and 2F2A_MC decreased the V5 Gy of the whole lung by 0.68% ( z=-2.69, P=0.01) and 3.05% ( z=-3.52, P < 0.01), respectively compared to 2F2A_AAA. 2F2A_AXB achieved a whole-lung Dmean of 1776.44 cGy, which was superior to that of 2F2A_MC ( t=2.67, P=0.02) and 2F2A_AAA ( t=8.62, P < 0.01). Compared to 2F2A_AAA and 2F2A_MC, 2F2A_AXB decreased the V20 Gy of Body_5 mm by 1.45% ( z=-3.88, P < 0.01) and 2.01% ( z=-3.66, P < 0.01), respectively. The results of the two groups with different field settings showed that 1F2A_MC was superior to 2F2A_MC in both the CI of PTV1 and the HI of PTV2 (CI: t=2.61, P=0.02; HI: z=-2.20, P=0.03). Moreover, 1F2A_MC increased the Dmean of the whole lung by 26.29 cGy compared to 2F2A_MC ( t=2.28, P=0.04). Conclusions:Regarding the design of VMAT plans for lung cancer, the MC algorithm is suitable for the target priority and the AXB algorithm is suitable for the OAR priority. When only the MC algorithm is available, it is recommended to choose 1F2A in the case of target priority and select 2F2A in the case of OAR priority.

Objective:To explore the mediating effect of medical coping style on psychological resilience and death anxiety in cancer patients.Methods:Using the convenient sampling method, a total of 330 inpatients from 2 cancer hospitals in Beijing were selected as the research objects from June to August 2020. The general information questionnaire, Chinese Version of Templer 's Death Anxiety Scale (C-T-DAS) , Medical Coping Modes Questionnaire (MCMQ) and the Connor-Davidson Resilience Scale (CD-RISC) were used to investigate them. Pearson correlation analysis and multiple linear regression were used to analyze the relationship between death anxiety, medical coping style and psychological resilience in cancer patients. AMOS 21.0 was used to establish the structural equation model and verify the mediation effect. A total of 330 questionnaires were sent out in this study, and 302 were effectively received, with the effective recovery of 91.5%. Results:The score of Chinese Version of Templer's Death Anxiety Scale for 302 cancer patients was (40.12±10.23) , the score of Connor-Davidson Resilience Scale was (70.97±13.43) and the scores of confrontation, avoidance and resighation dimension of Medical Coping Modes Questionnaire were (18.80 ±3.65) , (15.64±3.16) and (8.75±2.84) . The psychological resilience of cancer patients was negatively correlated with death anxiety and the resignation dimension in medical coping styles ( P<0.01) , and positively correlated with the facing and avoiding dimensions in medical coping styles ( P<0.05) . The face and yield dimensions in the medical coping style of cancer patients were positively correlated with death anxiety ( P<0.05) . Medical coping styles played a partial mediating role between psychological resilience and death anxiety, and the mediating effect accounted for 32.47% of the total effect. Conclusions:Clinical medical staff should pay attention to the death anxiety of cancer patients, improve their psychological resilience and encourage patients to actively cope with the disease, so as to reduce their death anxiety level and promote mental health.

Objective:To compare the therapeutic outcomes between use of antibiotic cement versus non-use of antibiotic cement in the treatment of tibial osteomyelitis after radical debridement.Methods:A retrospective analysis was made of the 68 patients with local tibial osteomyelitis of Cierny-Mader Type Ⅳ who had been treated at Department of Orthopaedic Trauma, The Second People’s Hospital of Shenzhen from January 2010 to June 2015. The dead space was filled with antibiotic-impregnated bone cement beans after radical debridement of the infected bone in 32 of them (cement group) but was not in 36 of them (no-cement group). The operations for both groups were performed by the same surgical team who filled the bone defects after excision of infected bone using Ilizarov bone transport. The 2 groups were compared in terms of Paley functional scores of bone and limb, external fixation index (EFI), infection recurrence rate, total hospital costs and other complications.Results:The 2 groups were comparable because there was no significant difference between them in the preoperative general data ( P>0.05). The cement group was followed up for (71.2±8.9) months and the no-cement group for (71.6±9.7) months, showing no significant difference ( P>0.05). By the Paley functional scores, the good to excellent rate for bone was 100% for both groups (32/32 versus 36/36) while the good to excellent rate for limb was 93.8% (30/32) for the cement group and 94.4% (34/36) for the no-cement group, showing no significant differences between them ( P>0.05). The EFI was (49.0±10.5) d/cm for the cement group and (49.5±11.4) d/cm for the no-cement group, showing no significant differences between them ( P>0.05). The infection recurrence rate at the final follow-up was 3.12% (1/32) for the cement group and 2.78% (1/36) for the no-cement group, showing no significant differences between them ( P>0.05). The total hospital cost was (70,944.1 ± 1,135.5) Yuan RMB for the cement group and (55,205.2 ± 897.3) Yuan RMB for the no-cement group, showing a significant difference ( P<0.05). No serious complications with sequelae were found in either of the 2 groups. Conclusion:In the treatment of local tibial osteomyelitis of Cierny-Mader Type Ⅳ, it is not necessary to fill the dead space with antibiotic cement when radical debridement is achieved.

Objective:To assess the risk of COVID-19 foreign imports cases to China.Methods:We collected epidemic data (cumulative daily confirmed cases in each country, cumulative confirmed imported cases), demographic data (population density, population) and information on potential source groups of tourists (the daily estimated number of overseas Chinese, overseas Chinese students, overseas workers, foreign students coming to China and flight passengers) and the global health security index (GHS) to assess and predict risk of imported cases for recent (February 1 st to April 25 th) and future (after April 26 th). Results:Strong positive correlation was found among variables including the number of imported cases, cumulative confirmed cases, attack rate, number of overseas Chinese, number of overseas Chinese students, number of foreign students coming to China, number of flight passengers and GHS. In the recent risk analysis, imported cases of Russian were the highest, followed by United Kingdom, United States, France and Spain. In the future risk prediction, 44 countries including United States and Singapore are evaluated as potential high-risk countries in the future through the attack rate index of each country and the estimated average number of daily passengers.Conclusion:The risk assessment of COVID-19 imported cases can be used to identify high-risk areas in recent and future, and might be helpful to strengthen the prevention and control of the epidemic and ultimately overcome the epidemic.