Objective To assess the value of CT image texture features in predicting the occurrence of hemorrhagic transformation(HT)in ischemic stroke,and to compare it with the traditional clinical prediction scores.Methods A total of 73 patients with acute anterior circulation ischemic stroke were enrolled in this study.All patients received reperfusion treatment.The region of interesting(ROI)of the infarction area was outlined according to the diffusion restricted area displayed on the follow-up ADC images,which were matched to the corresponding ischemic region on computed tomographic angiography(CTA)and on plain CT scan(non-contrast CT,NCCT).Five patients with HT and 5 patients with non-HT were randomly selected and used as the test set,and the remaining patients were assigned to the train set.The 6 texture features that had the most predictive value were separately selected from the CTA sets and NCCT train set,then the training of classifiers was earried out by using the 5-fold cross-validation method.Finally,the test set was evaluated according to the trained classifier.Besides,the determination of four clinical scores(HAT,SEDAN,HIAT2,THRIVE-c)was performed for all patients in the train set.Results The trained classifiers model performed well in not only CTA but also NCCT.In the CTA prediction model,linear SVM was chosen as the final classifier with 0.816 validation accuracy and 0.890 AUC value;and with 0.800 test accuracy,0.600 sensitivity,and 1.000 specificity in external test set Logistic regression(LR)was the best-performing classifier in NCCT.The predicted performance of HT was slightly worse than that of CTA,which had 0.697 validation accuracy and 0.763 AUC value.The test set of NCCT achieved 0.700 accuracy with 0.600 sensitivity and 0.800 specificity.Compared to the texture analysis models,all the four clinical scores showed a modest prediction efficiency in HT and AUC values,which were no more than 0.700.Conclusion Texture analysis of cerebral ischemic area based on CT images(CTA and NCCT)has the ability to predict HT after reperfusion treatment in AIS patients,and it is superior to traditional clinical scoring methods.(J Intervent Radiol,2024,33:230-235)

Malocclusion,identified by the World Health Organization(WHO)as one of three major oral diseases,profoundly impacts the dental-maxillofacial functions,facial esthetics,and long-term development of～260 million children in China.Beyond its physical manifestations,malocclusion also significantly influences the psycho-social well-being of these children.Timely intervention in malocclusion can foster an environment conducive to dental-maxillofacial development and substantially decrease the incidence of malocclusion or reduce the severity and complexity of malocclusion in the permanent dentition,by mitigating the negative impact of abnormal environmental influences on the growth.Early orthodontic treatment encompasses accurate identification and treatment of dental and maxillofacial morphological and functional abnormalities during various stages of dental-maxillofacial development,ranging from fetal stages to the early permanent dentition phase.From an economic and societal standpoint,the urgency for effective early orthodontic treatments for malocclusions in childhood cannot be overstated,underlining its profound practical and social importance.This consensus paper discusses the characteristics and the detrimental effects of malocclusion in children,emphasizing critical need for early treatment.It elaborates on corresponding core principles and fundamental approaches in early orthodontics,proposing comprehensive guidance for preventive and interceptive orthodontic treatment,serving as a reference for clinicians engaged in early orthodontic treatment.

Malocclusion is an oral disease with a high prevalence. The goal of orthodontic treatment is health, aesthetics, function and stability. The transmission straight wire appliance and technique is an innovative orthodontic system with independent intellectual property rights invented by Professor Jiuxiang Lin′s team based on decades of clinical experience, which provides a new solution for the non-surgical correction of skeletal malocclusions, especially class Ⅲ malocclusion, and it is also a good carrier for the implementation of the concept of healthy orthodontics. Due to the lack of guidelines, how to implement standardized application of transmission straight wire technique remains a problem to be solved. This technical specification was formed by combining the guidance from Professor Jiuxiang Lin and joint revision by a number of authoritative experts from the Orthodontic Special Committee, Chinese Stomatological Association, with reference to relevant literatures, and combined with abundant clinical experience of many experts. This specification aims to provide reference to standardize the clinical application of transmission straight wire technique, so as to reduce the risk and complications, and finally to improve the clinical application level of this technique.

OBJECTIVE To expl ore the clinical significance of folic acid metabolic gene detection in methotrexate （MTX） treatment of acute myeloid leukemia （AML）. METHODS Therapeutic drug monitoring （TDM）pharmacists participated in the treatment process of an AML patient who had neurotoxic side effects such as dizziness ，headache，and vomiting after intrathecal injection of MTX. According to the results of the test of the folic acid metabolic gene MTHFR C677T（rs1801133）（mutant homozygous）and the results of MTX blood concentration monitoring （＜0.05 μmol/L），combined with clinical manifestations ，it was recommended to stop MTX ，give intravenous drip of calcium folinate for rescue ，and consider using azacytidine for follow-up treatment. RESULTS The doctor took the advice of TDM pharmacist ，and the above symptoms were significantly relieved after the patient rescued for 2 times and successfully discharged from the hospital. CONCLUSIONS For AML patients who meet the indications and receive intrathecal injection of MTX ，drug metabolism genetics testing and MTX drug concentration monitoring can be performed before medication ，which helps doctors and pharmacists evaluate the feasibility of drug treatment options and reduce medical risks.

Objective:To analyze the etiological characteristics and molecular epidemiological correlation of five cases of typhoid fever during the same period in yantai city.Methods:Six S. Typhis strains were isolated from 5 typhoid patients and epidemiological samples in Yantai city in 2018. The onset time of the cases were from May 26, 2018 to July 24, 2018, distributed in Shuidao Town of Muping District, Dengzhou Street of Penglai District, Donglai Street of Longkou District, Wenhua Street of Muping District and Fulaishan Street of zhifu District. S. Typhis strains were analyzed by conventional bacterial isolation method and XbaⅠ/BlnⅠ double-enzyme digestion pulse-field gel electrophoresis (PFGE). Meanwhile, ViaB virulence gene detection and 27 common antibiotics sensitivity tests were conducted to study the etiology of S. Typhis.Results:Six strains of S. Typhi were isolated from 5 patients and the domestic egg of one patient, which were divided into 4 PFGE patterns by PFGE-XbaⅠ and PFGE-BlnⅠ and among which 3 strains had the same PFGE patterns.One multi-drug resistant strain (foreign patient), one single-drug resistant strain (patient with a history of provincial retention), and one completely sensitive strain were detected. The three strains of the same PFGE pattern exhibit the same drug-sensitive phenotype which were intermediate against aminoglycosides and quinolones and susceptibility against the other antibiotics.All of the strains carried the ViaB virulence factor except the strain from the foreign patient.Conclusion:Local S. Typhi is susceptibility or intermediate against antibiotics commonly used in clinic.Sporadic cases of typhoid fever and typhoid imported infections still need attention.

Objective:To analyze the etiological characteristics and molecular epidemiological correlation of five cases of typhoid fever during the same period in yantai city.Methods:Six S. Typhis strains were isolated from 5 typhoid patients and epidemiological samples in Yantai city in 2018. The onset time of the cases were from May 26, 2018 to July 24, 2018, distributed in Shuidao Town of Muping District, Dengzhou Street of Penglai District, Donglai Street of Longkou District, Wenhua Street of Muping District and Fulaishan Street of zhifu District. S. Typhis strains were analyzed by conventional bacterial isolation method and XbaⅠ/BlnⅠ double-enzyme digestion pulse-field gel electrophoresis (PFGE). Meanwhile, ViaB virulence gene detection and 27 common antibiotics sensitivity tests were conducted to study the etiology of S. Typhis.Results:Six strains of S. Typhi were isolated from 5 patients and the domestic egg of one patient, which were divided into 4 PFGE patterns by PFGE-XbaⅠ and PFGE-BlnⅠ and among which 3 strains had the same PFGE patterns.One multi-drug resistant strain (foreign patient), one single-drug resistant strain (patient with a history of provincial retention), and one completely sensitive strain were detected. The three strains of the same PFGE pattern exhibit the same drug-sensitive phenotype which were intermediate against aminoglycosides and quinolones and susceptibility against the other antibiotics.All of the strains carried the ViaB virulence factor except the strain from the foreign patient.Conclusion:Local S. Typhi is susceptibility or intermediate against antibiotics commonly used in clinic.Sporadic cases of typhoid fever and typhoid imported infections still need attention.

Objective To investigate the clinical effect of facial dermabrasion by microcrystal combined with red blue light in the treatment of acne pitting scar.Methods Selected from June 2013 to April 2016 hospital dermatology outpatients,98 cases of facial acne pitting scar were retrospectively analyzed,in which 50 cases of patients with facial acne dermabrasion were treated with red and blue light treatment (combined group),48 patients only choose facial acne dermabrasion treatment (control group),then treatment effect was compared between the two groups.Results At 3 months after operation,the ECCA score and mean sag depth of the two groups were significantly lower than those of the preoperative (t=23.208 and 18.586,P＜0.001).The ECCA score of the combined group was significantly lower than that of the control group (t=7.039,P＜0.05);The healing rate was 80％,which was significantly higher than those in the control group (56.25％) (x2 =6.387,P＜0.05);after 1 months and 3 months;the subjective satisfaction scores of the patients in the combined group were significantly higher than those in the control group (t=3.318 and 3.776,P＜0.05);Patients in the combined group were significantly earlier than the control group (t =4.419,P＜0.05);the incidence of edema and erythema was significantly lower in the combined group than in the control group (x2 =5.096,P＜0.05).Conclusions Facial acne dermabrasion by microcrystal combined with red and blue light treatment is superior to the single use of dermabrasion.

To explore the clinical effect of microsurgery in the treatment of the tumor which was diagnosed with the plexiform neurofibroma (PN) of the forearm and palm. Methods From January, 2014 to June, 2017, 6 cases of the PN in the forearm and palm were removed by microsurgery such as neurovascular transplantation, separation and anastomosis under microscope, etc. There were 4 males and 2 females, with an average age of 9.2 (range, 2-18 )years. There was 1 case with PN of the median nerve, ulnar nerve and their branches in the right fore-arm and palm, 2 cases with PN of the median nerve and its branches in the right forearm and palm, 2 cases with PN of the median nerve and its branches in the left forearm and palm, and 1 case with PN of the ulnar nerve and its branches in the left forearm and palm.The postoperative function and feeling of the patients were evaluated by outpa-tient followed-up. Results The pathological results of 6 patients all showed PN, and their incisions healed primari-ly.The patients were followed-up for 6 to 36 months, with an average of 18 months. No obvious scar formation was observed in all incisions. Among them, PN of the palmar of the youngest patient recurred after the operation, and it was resected in a second operation.The remaining 5 patients had no recurrence during follow-up.The 2 point resolu-tion of each fingertip of the affected limb of the patients who had median and ulnar PN was 2-5 mm, with an average of 3.30 mm; the 2 point resolution of the thumb, indicator, middle and ring fingers of the affected limbs of the patients who had median PN was 2-5 mm, with an average of 2.95 mm; the 2 point resolution of the ring and little fingers of the affected limbs of the patients who had ulnar PN was 3-4 mm, with an average of 3.50 mm.According to the related evalu-ation criteria made by the American Orthopedic Foot and Ankle Surgery Society (AOFAS), the results of the forearm and hand functions were excellent in 5 cases, good in 1 case. Conclusion The application of microsurgical techniques in the treatment of PN in the forearm and palm can be effective separation of tumor and nerve fibers, effectively protect the branches of the median nerve and ulnar nerve and their blood circulation, prevent recurrence and reduce nerve damage after operation.

Objective This study was to evaluate the long-term clinical efficiency of allogeneic corneal intrastromal lenticule inlay for correction of moderate and high hyperopia.Methods A prospective self-controlled case series study was adopted.Twenty-nine hyperopic patients (53 eyes) were performed with allogeneic corneal intrastromal lenticule inlays.The range of preoperative spherical equivalent was +3.75 to + 10 D,with the mean value of (+6.84±2.95)D.All the cases were followed up for 1 year.Uncorrected and best corrected visual acuity and refraction were compared between before and after operation.Corneal topography and optical coherence topography were used to examine corneal topography.Ocular response analyzer was used to evaluate the shifts of corneal hysteresis.This study followed the Helsinki declaration,and the research process was approved by the Ethic Committee of Beijing Tongren Hospital,and informed consent was signed by each donor and receptor.Results Compared with the before surgery,the uncorrected distance visual acuity (UDVA) and uncorrected near visual acuity (UNVA) were obviously improved and the spherical equivalent (SE) was obviously decresed in 3 months,6 months and 1 year after surgery,with significant differences between them (all at P＜0.05),but no significant differences were found between each postoperative time points (all at P＞0.05).One year after surgery,14 eyes (26.4％) gained one line of best corrected distance visual acuity (BCDVA),and 12 eyes (22.6％) gained two lines of BCDVA.Only 2 patients (5.66％) lost lines due to opaque lenticules,and no eye lost lines after changing the opaque lenticules.There was no obvious hyperopic fallback phenomenon.Compared with the before surgery,the average corneal curvature value (Avek) was obviously improved,the surface regularity index (SRI),surface asymmetry index (SAI) and central corneal thickness (CCT) were obviously increased in 3 months,6 months and 1 year after surgery,with significant differences between them (all at P＜0.05),but no significant differences were found between each postoperative time points (all at P ＞ 0.05).The cornea optical coherence tomography (OCT) examination showed that,after the operation,the corneal stromal implant was in place and clear.One year after surgery,the dividing line of corneal graft was still clearly visible.No significant changes of corneal hysteresis (CH) and corneal resistance factor (CRF) were seen among different time points before and after surgeries (F =1.443,P =0.216;F =1.744,P =0.128).Conclusions Allogeneic corneal small incision intrastromal lenticule inlays can be used to correct moderate and high hyperopic eye with good safety,effectiveness and predictability.It provides a new choice for hyperopic patients.

The therapeutic approaches for non-small cell lung cancer (NSCLC)patients with solitary bone metastases include surgery,radiotherapy,chemotherapy and so on.Recently,molecular targeted therapy such as the Denosumab has become a new option.Though there are so many options,the outcomes of the NSCLC with bone metastases are not so good.But for those with solitary bone metastases,radical treatment is necessary to improve the survival time and prognosis.