In recent years,radiomics has been developed rapidly in the field of clinical medicine,and the artificial intelligence(AI)technology has been utilized to assist diagnosis.This paper introduced the background of radiomics,analyzed the basic research process of radiomics,and looked forward to its application in the identification of bone and joint injuries in the field of forensic medicine.Reviewing the three aspects is expected to provide a theoretical foundation of radiomics,which will be helpful to develop its application in forensic medicine.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

【Objective】 Diabetic mice could show learning and memory dysfunction, and we aimed to investigate the effect of Sigma-1 receptor agonist, PRE-084, on neurons and cognitive impairment in mice with type 1 diabetes (T1DM). 【Methods】 Twenty mice with T1DM induced by streptozocin, aged 8-10 weeks, and 20 control mice (CON) were randomly divided into four groups (CON+Vehicle, CON+PRE-084, T1DM+Vehicle and T1DM+PRE-084). Mouse primary neurons were cultured in high glucose medium with PRE-084 and control solvent, respectively. The body weight, food and water intake, and fasting blood glucose level of mice in each group were detected and recorded. The learning and memory abilities of mice were detected by new object recognition experiment. The mitochondria-associated endoplasmic reticulum membrane (MAM) structure of neurons in hippocampal CA1 area of mice was detected by transmission electron microscope. And the expression levels of ATP and reactive oxygen species (ROS) in hippocampus of mice were detected by biochemical kit. Cell viability and ROS level of primary neurons were detected by CCK8 and cellular ROS kit. 【Results】 PRE-084 reduced the increase of body weight, food and water intake, and blood glucose caused by diabetes. PRE-084 significantly ameliorated the learning and memory impairment of the mice with T1DM, improved the changes of MAM structure in neurons of hippocampal CA1 area of diabetic mice, increased the level of ATP in hippocampus of diabetic mice, and decreased the increase of ROS expression in diabetic hippocampus and neurons under high glucose conditions. 【Conclusion】 Sigma-1 receptor agonist, PRE-084, could improve learning and memory impairment in the mice with T1DM, which might be related to the structural changes of MAM, the increase of ATP production, and the decrease of ROS production in hippocampal neurons.

【Objective】 To explore the effect of high-fat and high-fructose diet on mouse intestinal barrier function, as well as the role of ketohexokinase (KHK), the key enzyme in fructose metabolism, in intestinal barrier impairment. 【Methods】 Eight-week-old male control C57BL/6J mice and Khk^-/- mice were randomly divided into control + normal diet (ND), control + high-fat and high-fructose diet (HFHFD), Khk^-/-+ normal diet (ND+Khk^-/-), and Khk^-/-+ high-fat and high-fructose diet (HFHFD+Khk^-/-) groups, with eight mice in each group. During the high-fat and high-fructose diet and normal diet, the body weight changes of mice in different groups were recorded. After the intervention, the blood glucose and insulin levels of mice in each group were detected. The intestinal barrier function and inflammation level of mice were evaluated by detecting intestinal water content, permeability, tight junction protein expression, serum and intestinal inflammatory factor levels. 【Results】 Compared with ND group, HFHFD group significantly increased the body weight, blood glucose and insulin levels of mice, increased the intestinal water content and permeability, decreased the expression of tight junction proteins, and increased inflammatory factors of the serum and intestines. In the two groups fed with high-fat and high-fructose diet, the body weight, blood glucose and insulin levels of the HFHFD+Khk^-/- group were significantly lower than those of HFHFD group, and the intestinal barrier dysfunction and inflammation were significantly improved. 【Conclusion】 KHK, a key enzyme in fructose metabolism, is involved in the impairment of intestinal barrier caused by high-fat and high-fructose diet. Knockout of Khk gene significantly improved intestinal barrier dysfunction and the inflammation level.

Helicobacter pylori (H. pylori), creating a global infection rate over 50%, presents great challenges in clinical therapies due to its complex pathological microenvironment in vivo. To improve the eradication efficacy, herein we fabricated a pharmaceutical vesicle RHL/Cl-Ch-cal where cholesterol-PEG, calcitriol and first-line antibiotic clarithromycin were co-loaded in the rhamnolipid-composed outer lipid layer. RHL/Cl-Ch-cal could quickly penetrate through gastric mucus layer to reach H. pylori infection sites, and then effectively destroyed the architecture of H. pylori biofilms, killed dispersed H. pylori and inhibited the re-adhesion of residual bacteria (called biofilms eradication tetralogy). Moreover, RHL/Cl-Ch-cal activated the host immune response to H. pylori by replenishing cholesterol to repair lipid raft on the cell membrane of host epithelial cells. Finally, RHL/Cl-Ch-cal killed the intracellular H. pylori through recovering the lysosomal acidification and assisting degradation. In experiments, RHL/Cl-Ch-cal demonstrated prominent anti-H. pylori efficacy in the classical H. pylori-infected mice model. Therefore, the study provides a "comprehensive attack" strategy for anti-H. pylori therapies including biofilms eradication tetralogy, immune activation and intracellular bacteria killing.

Objective:To evaluate the effectiveness of digital orthognathic surgery in the surgical treatment of patients with hemifacial microsomia (HFM) and patients’ satisfaction.Methods:The clinical data of HFM patients admitted to the Department of Orthognathic & Cleft Lip and Palate Plastic Surgery, Hospital of Stomatology, Wuhan University, from January 2017 to May 2020 were retrospectively analyzed. The digital orthognathic surgery was used to design surgical protocols before surgery. The intermediate wafer and terminal wafer by three-dimensional printing were applied to determine the position of maxillary and mandible bone blocks. The distance change between landmarks in maxillary and chin and the reference planes was measured. The skull CT and face photographs were taken 5 days after surgery to compare the distance between the actual position and the designed position. Data were expressed as the Mean±SD and analyzed by the pairing t-test with P<0.05 considered statistically. The patients’ satisfaction was investigated by interval scale method on day 7 and 6 months after operation. Results:There were 9 HFM patients in this study, included 5 men and 4 women, and the average age was 25.8±3.8 years old. 6 patients were affected on the left side and 3 patients was affected on the right side. All the operations were processed successfully. The wafers were in good position that the maxillary and mandible blocks were moved precisely according to the digital design. There were no accidental fractures of the jaw during the operation. The post-operative photographs and CT showed the stomatognathic system recovered well without serious postoperative complications. The errors between postoperative situation and preoperative designed situation in maxillary and chin were no statistically difference ( P>0.05). The maximum movement error of the maxillary bone block was the mark point of the first molar on the left, with an average error of (0.92 ± 0.34) mm. The patients’ satisfaction scores were averaged 83.2±2.7 points on day 7 after surgery, while the score dropped to 73.8±2.5 points after 6 months. Conclusions:The digital orthognathic surgery technology can satisfy the accuracy requirement of the surgical plan design for HFM patients in correcting the deflect of dental middle line, occlusal plane and chin point. High postoperative satisfaction can be achieved, which may decrease slightly 6 months after operation.

Objective:To evaluate the effectiveness of digital orthognathic surgery in the surgical treatment of patients with hemifacial microsomia (HFM) and patients’ satisfaction.Methods:The clinical data of HFM patients admitted to the Department of Orthognathic & Cleft Lip and Palate Plastic Surgery, Hospital of Stomatology, Wuhan University, from January 2017 to May 2020 were retrospectively analyzed. The digital orthognathic surgery was used to design surgical protocols before surgery. The intermediate wafer and terminal wafer by three-dimensional printing were applied to determine the position of maxillary and mandible bone blocks. The distance change between landmarks in maxillary and chin and the reference planes was measured. The skull CT and face photographs were taken 5 days after surgery to compare the distance between the actual position and the designed position. Data were expressed as the Mean±SD and analyzed by the pairing t-test with P<0.05 considered statistically. The patients’ satisfaction was investigated by interval scale method on day 7 and 6 months after operation. Results:There were 9 HFM patients in this study, included 5 men and 4 women, and the average age was 25.8±3.8 years old. 6 patients were affected on the left side and 3 patients was affected on the right side. All the operations were processed successfully. The wafers were in good position that the maxillary and mandible blocks were moved precisely according to the digital design. There were no accidental fractures of the jaw during the operation. The post-operative photographs and CT showed the stomatognathic system recovered well without serious postoperative complications. The errors between postoperative situation and preoperative designed situation in maxillary and chin were no statistically difference ( P>0.05). The maximum movement error of the maxillary bone block was the mark point of the first molar on the left, with an average error of (0.92 ± 0.34) mm. The patients’ satisfaction scores were averaged 83.2±2.7 points on day 7 after surgery, while the score dropped to 73.8±2.5 points after 6 months. Conclusions:The digital orthognathic surgery technology can satisfy the accuracy requirement of the surgical plan design for HFM patients in correcting the deflect of dental middle line, occlusal plane and chin point. High postoperative satisfaction can be achieved, which may decrease slightly 6 months after operation.

Objective:To explore the effect of rapamycin on 1-methyl-4-phenylpyridinium iodide (MPP+ )-induced activation of Nod-like receptor protein 3 (NLRP3) inflammasome in microglia.Methods:The BV2 microglia cells were divided into control group, model group and rapamycin group.The model group and rapamycin group were treated by MPP+ to activate NLRP3 inflammasome, and rapamycin group was pretreated with rapamycin.Quantitative real-time PCR (RT-qPCR) was used to detect the mRNA levels of NLRP3, apoptosis-associated speck-like protein (ASC) and caspase-1.Immunofluorescence was used to detect the protein expression of NLRP3 and interleukin-1β (IL-1β). Western blot was carried out to assess the protein expression of NLRP3, ASC, caspase-1, beclin1 and microtubule-associated protein 1 light chain 3 (LC3).Results:The mRNA levels of NLRP3, ASC and caspase-1 in model group were higher than those in control group ( t=4.825, 3.015, 5.853, all P<0.05). The mRNA levels of NLRP3 and caspase-1 in rapamycin group were lower than those in model group ( t=2.75, 2.89, both P<0.05). In model group, the protein expressions of NLRP3 (1.54±0.22), ASC (1.02±0.13) and caspase-1 (1.42±0.30) were higher than NLRP3 (0.66±0.15), ASC (0.41±0.14) and caspase-1 (0.70±0.10) in control group ( t=5.653, 5.602, 3.964, all P<0.01), while the protein expression of beclin1 (0.28±0.09) and LC3II/LC3I ratio(0.69±0.14) were lower than beclin1 (0.60±0.11) and LC3II/LC3I (1.29±0.23) in control group ( t=4.010, 3.982, both P<0.01). The protein expressions of NLRP3 (0.80±0.18) and ASC (0.68±0.14) in rapamycin group were lower than those in model group ( t=4.413, 3.077, both P<0.05), while the protein expression of beclin1 (0.65±0.20) and LC3II/LC3I ratio(1.42±0.36) were higher than those in model group ( t=2.965, 3.278, both P<0.05). Conclusion:MPP+ activates NLRP3 inflammasome and impairs autophagic function in microglia.Rapamycin inhibits MPP+ -induced activation of NLRP3 inflammasome by restoring autophagic impairment in microglia.

Objective To evaluate the efficacy of antiplatelet agents in patients with Kawasaki dis-ease (KD) by using thrombelastography (TEG). Methods A retrospective study of KD patients admitted in our hospital from May 2016 to December 2016 was conducted. Platelet inhibition rates of Arachidonic acid pathway(AA％ ) and Adenosine diphosphate pathway were assessed using TEG platelet mapping. The effects of aspirin and dipyridamole on platelet inhibition were compared,and the differences of platelet inhibition rates in different aspirin dose and duration of medication were determined. Results There were significant individual differences in the inhibition of platelets by aspirin and dipyridamole. The inhibition rate of aspirin on platelets[M(P25 ,P75 )] was 62. 45％ (35. 58％ ,90. 95％ ),which was higher than that of dipyridamole [23. 75％ (11. 60％ ,48. 38％ )],there was significant difference (P < 0. 01). The incidence of dipyridamole resistance in children with KD ( 56. 75％ ) was higher than that in patients with resistance to aspirin (35. 71％ ),and there was significant difference (P < 0. 01). There was a linear correlation between platelet inhibition rates of two antiplatelet agents in children with KD (r = 0. 351,P < 0. 01). There was no significant difference in the effect of aspirin and dipyridamole on platelet inhibition rate after 4 days of administration. There was no significant difference in the effect of different doses of aspirin on AA％ . Conclusion TEG is an effective way to evaluate the efficacy of antiplatelet therapy in children with KD.

Objective:To measure the safe range from the foramen rotundum to the siphon of internal carotid artery using three-dimensional reconstruction technique, and to provide guidance for operation through pterygopalatine fossa.Methods:The skulls of 121 volunteers were scanned to get the final results with thin-section computed tomographic images.The position of the siphon of internal carotid artery (point A)and foramen rotundum (pointB)were ascertained.Three-dimensional reconstruction technique was used to build a coordinate system paralleled to the frankfort horizontal plane and the nasal septum plane.The coordinate system took point A as the coordinate origin.Point C and point D were the projections of point A in two planes parallel with frankfort horizontal plane and nasal septum plane which included point B.The distances of AC,AB,and BC were measured. The angles of the line went through A and B to the three planes were also measured.Results:The distance of AC was measured as 13.22 (3.79)mm (range,8.33 - 105.67 mm;95%CI:8.55 - 21.39 mm).The angle to the sagittal plane was measured as 33.54 (9.23)° (range,5.38- 66.58°;95%CI:30.88 - 34.20°). The angle to the coronal plane was measured as 53.17 (10.48)°(range,5.60-75.02°;95%CI:51.29-55.06°).The angle to the horizontal plane was measured as 9.43 (12.91 ) mm (range,- 28.44 - 82.22;95% CI:7.11 - 11.76 ). Conclusion:The safety distance from foramen rotundum to the siphon of internal carotid artery in the operation through pterygopalatine fossa (PPF) under nasoendoscope is obtained by thin-section computed tomographic images.