Objectives:To examine the feasibility of using foundation model in computer vision for echocardiographic left ventricular ejection fraction measurement. Methods:Based on the most extensive publicly accessible repository of echocardiographic loops,EchoNet-Dynamic,featuring 10024 recordings from individual patients,a foundation model in computer vision,VideoMAE V2,was fine-tuned,validated,tested using 7460,1288,and 1276 echocardiographic loops,respectively. Results:The mean absolute error between left ventricular ejection fraction measurements of VideoMAE V2 and expert's measurements was 3.94％ (95％CI:3.79％-4.11％).The Pearson's correlation coefficient was 0.91 (95％CI:0.89-0.92).Additionally,VideoMAE V2 demonstrated exceptional accuracy in identifying patients with a left ventricular ejection fraction below 50％,achieving an AUC of 0.96 (95％CI:0.95-0.97). Conclusions:This study validates the feasibility of using foundation model in computer vision for measuring left ventricular ejection fraction in echocardiographic loops and lays the foundation for the development of a generalized multimodal automated interpretation system for echocardiography.

Purpose: The interval between neoadjuvant chemotherapy (NAC) and surgery for locally advanced breast cancer (LABC) remains controversial. At the same time, the prognostic effect of delayed surgery in patients with poor responses is currently unclear. Methods: Data was collected from patients who had poor responses to NAC and underwent modified radical surgery from January 2013 to December 2018. The interval from completion of NAC to surgery was divided into two groups: a longer (greater than four weeks) or shorter (four weeks or less) interval. The associations of these interval groups with overall survival (OS) and recurrence-free survival (RFS) were evaluated by multivariable Cox models adjusting for the existing prognostic factors. Propensity score matching (PSM) was used to minimize election bias. Results: A total of 1,229 patients (mean age, 47.2 ± 8.9 years; median follow-up duration, 32.67 [6.57–52.63] months) were included. The 5-year OS rates were 73.2% and 60.8% in the shorter (n = 171) and longer interval group (n = 1,058), respectively, while the 3-year RFS rates were 80.8% and 71.7%, respectively. In multivariate Cox analysis, the longer interval was associated with an increased risk of mortality (hazard ratio [HR], 1.43; 95% confidence interval [CI], 1.01–2.02; p = 0.046) and recurrence (HR, 1.50; 95% CI, 1.12–1.99; p = 0.006).There was an interaction between the molecular subtype and the surgery interval for OS (pinteraction = 0.014) and RFS (pinteraction = 0.027). After PSM, no significant difference in OS (p = 0.180) and RFS (p = 0.069) was observed between the two groups. Conclusion Among LABC patients with a poor response, those with a longer interval between NAC and surgery had worse OS and RFS. The results indicate that these patients should receive modified radical surgery timely, which may in turn improve their prognosis.

Background Plateau environment may pose a serious impact on the physiological and psychological stress of people stationed on a plateau, especially for those engaged in military training and occupational activities. There is an urgent need to find drugs to prevent and treat injuries caused by high-altitude environment. Objective To analyze the current status, hotspots, and future trends of domestic and international research in the field of prevention and treatment of high-altitude disease (HAD) by traditional Chinese medicine (TCM), and provide references for scientific research. Methods Web of Science Core Collection (WOSCC) and China National Knowledge Infrastructure (CNKI) were searched for literature on TCM and HAD published from inception to 2022. Excel, CiteSpace, VOSviewer, and RStudio softwares were used to conduct visual analysis on the number of publications, types of publications, journals, authors, research institutions, and keywords. Results A total of 501 publications were evaluated in the present study, including 443 Chinese publications and 58 English publications. The annual number of publications showed a rising trend. MA Huiping was the leading author in number of publications in Chinese (37 publications), and ZHANG Yi and MENG Xianli were the leading authors in the number of publications in English (both 8 publications), respectively. The institutions with the most publications in Chinese were The 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army and Lanzhou General Hospital of Lanzhou Military Region (both 32 publications), and the institution with the most publications in English was Chengdu University of Traditional Chinese Medicine (8 publications), respectively. The Chinese and English journals with the largest number of publications were the Journal of High Altitude Medicine (39 publications) and the Journal of Ethnopharmacology (10 publications), respectively. The most highly cited Chinese and English literature included Effects of rhodiola on the free radical metabolism and serum creatine kinase after exercise at plateau (61 citations) and Anti-hypoxic activity at simulated high altitude was isolated in petroleum ether extract of Saussurea involucrate (68 citations) , respectively. The most frequent keywords in the Chinese and English literature were high altitude polycythemia and oxidative stress, respectively. The keyword time zone and emergence maps showed that the research hotspots in this field shifted from prevention and treatment of HAD to animal experiments, and then to mechanisms of action, in which oxidative stress, hypoxic injury, inflammation, and apoptosis were the main focuses. Conclusion The research of TCM against HAD is identified from early clinical observation to associations between clinical outcome variation and pharmacological mechanisms, and further to applying multi-omics techniques to explore the physical basis of TCM efficacy and mechanisms of action with focuses like TCM formula and single herb active ingredients, so as to elaborate potential scientific connotation of TCM against HAD.

Objective Through bibliometrics and visual analysis of the related studies on traditional Chinese medicine (TCM) treatment of immune thrombocytopenia (ITP), this study aims to sort out the overall research progress, hotspots, and trends in this field, and provide reference for further research in ITP. Methods The articles on ITP treated by TCM were retrieved from China National Knowledge Infrastructure (CNKI), Wanfang Database, China Science and Technology Journal Database (VIP), Web of Science Core Collection (WOSCC), and PubMed. The retrieval time was from the establishment of the databases to July 31, 2022. VOSviewer, CiteSpace, Carrot2, and NoteExpress were used for data analysis of the articles in terms of their quantities, types, and journals, and for visualization of research hotspots, authors, institutions, and keywords. Results 1 493 Chinese articles and 40 English articles were included. The articles in Chinese mainly focus on clinical trial research and clinical experience summary, while the English articles mainly focus on clinical trial research and animal research. The Chinese articles were published in 317 Chinese journals, while English articles were published in 29 English journals. Research hotspots include the clinical syndrome differentiation of ITP, the therapeutic effect of TCM compounds on ITP, and the mechanism of ITP treatment. Keyword analysis shows that there are many research achievements in integrated traditional Chinese and western medicine treatment, clinical research, famous doctors’ experience, TCM treatment, cellular immunity, and humoral immunity. The authors with the most articles in Chinese and English are Professor CHEN Xinyi and Professor MA Rou, respectively, and the research institutions with the most articles are Dongzhimen Hospital of Beijing University of Chinese Medicine and Xiyuan Hospital of China Academy of Chinese Medical Sciences. Chinese herbs often used to treat ITP clinically include Xianhecao (Agrimoniae Herba), Nvzhenzi (Ligustri Lucidi Fructus), Mohanlian (Ecliptae Herba), Zhongjiefeng (Sarcandrae Herba), etc., and the prescription usually used to treat ITP include Guipi Decoction (归脾汤), Xijiao Dihuang Decoction (犀角地黄汤), Bazhen Decoction (八珍汤), Erzhi Pill (二至丸), and Xiaochaihu Decoction (小柴胡汤). The main development trends toward retrospective study, TCM treatment mechanism, and data mining. Conclusion The research on TCM treatment of ITP has progressed steadily, but in-depth studies and close cooperation between research institutions are necessary for the modernization of TCM in treating ITP.

Objective: To investigate the smartphone addiction among college students during the Coronavirus Disease 2019 (COVID-19) pandemic and its association with daily behaviors and mental health,and to provide reference for heath education and psychological counseling for college students. Methods: An observational study using online quyestionnaire was conducted among 10 357 college students of two provincial medical schools in Guangdong and Shanxi Province from February 24th to March 4th in 2020. Participants were investigated on demographic information, smartphone addiction, daily routine, physical activity, weight status, anxiety, and other health information. Logistic regression with inverse probability treatment weighting (IPTW) based on propensity score was used to analyze the association between smartphone addiction with daily behavior and mental health. Results: The prevalence of smartphone addiction was 59.42%. The prevalence of phone addiction was higher in postgraduates, senior undergraduates, students with non-medical major, students living in GuangDong and those without regular exercise habit before vacation(χ 2=47.91，17.78，42.75，138.58，P<0.05). With IPTW, there were significant associations between smartphone addiction and late bedtimes (OR=1.82, 95%CI=1.66-1.98) and wake-up times (OR=1.55, 95%CI=1.44-1.68), more sedentary behaviors (OR=1.21, 95%CI=1.12-1.31), less moderate to vigorous physical activity (OR=1.33, 95%CI=1.22-1.44), anxiety (OR=2.98, 95%CI=2.52-3.40), weight gain(OR=1.27，95%CI=1.17-1.37) and other detrimental daily behavior and feelings. Conclusion High prevalence of smartphone addiction has been observed during the COVID-19 pandemic, with impaired daily behavior and mental health.

OBJECTIVETo compare the difference in CT manifestations between primary colorectal mucinous adenocarcinoma and signet ring cell carcinoma in order to improve radiologic diagnosis.

METHODSClinicopathological data and CT findings of 109 patients with colorectal mucinous adenocarcinoma and 46 patients with primary colorectal signet-ring cell carcinoma confirmed by surgery and pathology from March 2008 to February 2015 in the Tumor Hospital of Yunnan Province were retrospectively collected. Differences in age, gender, tumor location, length and thickness of the involved intestinal wall, thickening pattern of the intestinal wall, lesion density, calcification, contrast-enhanced form, peri-intestinal invasion, occurrence of intestinal obstruction and metastasis of other organs were compared between the two groups.

RESULTSAmong 109 patients with colorectal mucinous adenocarcinoma, 68 were men and 41 were women with a mean age of (56.8±15.4) years. Among 46 patients with primary colorectal signet-ring cell carcinoma, 26 were men and 20 were women with a mean age of (42.9±15.6) years. Compared with mucinous adenocarcinoma group, signet-ring cell carcinoma group showed more concentric bowel-wall thickening[93.5%(43/46) vs. 81.6%(89/109), χ=9.19, P=0.030], higher lesion density [(42.0±3.0) Hu vs. (28.5±1.5) Hu, t=37.30, P=0.000], more marked enhancement [54.3%(25/46) vs. 12.8%(14/109), χ=35.21, P=0.000], less vast-low-density region in enhanced CT imaging[2.2%(1/46) vs. 45.0%(49/109), χ=73.31, P=0.000] and more severe peri-intestinal invasion [41.3% (19/46) vs. 17.4%(19/109), χ=10.25, P=0.006]. Calcification was found in 18.3%(20/109) of mucinous adenocarcinoma cases, but was not found in signet-ring cell carcinoma cases (χ=9.69, P=0.002). Target ring sign in contrast-enhanced scan was observed in 15.2%(7/46) of signet-ring cell carcinoma cases, while in none of mucinous adenocarcinoma cases (χ=17.37, P=0.000). There were no statistically significant differences in lesion location, length and thickness of the involved intestinal wall, occurrence of intestinal obstruction, lymph node metastasis, liver or peritoneum metastasis between two groups(all P>0.05).

CONCLUSIONSSignet-ring cell carcinoma is often found in younger patients, whose CT manifestation is characterized by the target ring sign in contrast-enhanced scan, while primary colorectal mucinous adenocarcinoma is often in older patients, whose CT manifestation is characterized by calcification in unenhanced scan and low density region in enhanced CT show.

Adenocarcinoma, Mucinous ; diagnostic imaging ; pathology ; Adult ; Age Factors ; Aged ; Calcinosis ; diagnostic imaging ; pathology ; Carcinoma, Signet Ring Cell ; diagnostic imaging ; pathology ; China ; Colorectal Neoplasms ; diagnostic imaging ; pathology ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Retrospective Studies ; Tomography, X-Ray Computed ; methods

Objective: To explore the prevalence and risk factors of mitral regurgitation (MR) in the population ≥35 years in China in order to provide prevention reference for high risk crowd. Methods: The residents ≥35 years were taken by a stratified multistage sampling method. General information of crowd was collected by predesigned questionnaire and physical examination including life style, disease history, body weight and height. Echocardiography was conducted, fasting blood glucose and blood lipid levels were measured. Results: A total of 28814 subjects were enrolled. The overall MR detection rate was 18.4%, the detection rate in male and female were both 18.4%. The detection rates of moderate and severe MR were 0.3% in the paticipants at (35-50) years, 0.9% at (51-64) years and 2.2% at ≥65 years. MR prevalence showed an increasing trend with aging. Multivariate Logistic regression analysis indicated that age, systolic blood pressure, urban and rural, district, left atrial front and back diameter, left ventricular end diastolic front and back diameter, left ventricular ejection fraction, stroke, atrial fibrillation and heart failure were the risk factors for MR occurrence. Conclusion: MR detection rate was rather high in China. Specific prevention action should be taken for those with theabove risk factors.

Objective To obtain a thyroid cancer cell line integrated with luciferase and fluorescence,and to establish a metastatic nude mouse model of papillary thyroid cancer monitored with in vivo imaging system. Methods Lentivirus carrying recombinant plasmid containing luciferase gene and mCherry gene infected high malignant papillary thyroid cancer cell line (BHP10-3SCmice). The stable thyroid cancer cell line (BHP10-3mluc) labeled with luciferase and mCherry selected by hygromycin, analyzed for fluorescence with fluorescence microscopy and bioluminescence with in vitro analysis and in vivo imaging. 0.25 ml(5×106/ml)BHP10-3mluc cell suspension were injected into the left thigh intramuscular tissue of 5-week-old nude mice to establish BALB/C nude mice metastatic tumor model. The growth and metastasis of the tumors were monitored weekly with in vivo imaging system. The nude mice were sacrificed on the 42th day and the tissues with metastatic tumors were analyzed by fluorescent imaging ex vivo. The ectopic implanted tumors and metastatic lesions were verified by tissue sections with Hematoxylin and Eosin staining. Results BHP10-3mluc cells showed similar growth characteristics to the original BHP10-3SCmice cells and stably expressed luciferase and mCherry. At the end of the first week after ectopic implantation,the xenograft tumors were found and in the 6th week,the tumors were found to metastasized to adjacent lymph nodes and lungs,which was consistent with the results of pathology.The growth and metastasis of tumors can be accurately monitored with in vivo imaging system. Conclusions A PTC cell line stably expressing bioluciferase and fluorescence was successfully established.The nude mouse model of PTC metastatic tumor generated by intramuscular inoculation of those cells can be well monitored with in vivo imaging system, which provides ideal models for researches on tumor growth, metastasis,and drug treatment.

Purpose The study about the CT manifestations of primary colorectal signet-ring cell carcinoma is rarely reported by now, the purpose of this study is to explore the CT findings of primary colorectal signet-ring cell carcinoma, to improve the radiology acknowledge about it. Materials and Methods CT findings of 46 patients with primary colorectal signet-ring cell carcinoma and 46 patients with colorectal adenocarcinoma confirmed by surgery and pathology were retrospectively analyzed, the differences of age, gender, tumor location, length and thickness of the involved intestinal wall, the thickening pattern of the intestinal wall, the contrast-enhanced form, the peri-intestinal invasion, the occurrence of intestinal obstruction and metastasis of other organs were compared between the two groups. Results Compared with the colorectal adenocarcinoma group, patient age of colorectal signet-ring cell carcinoma group was younger (t=5.23, P<0.001), and involved intestinal wall was longer and thicker (t=4.78 and 5.76, P<0.001). There were statistically significant differences of focal thickening form, contrast-enhanced level, peri-intestinal invasion, with or without peritoneal metastasis difference between the two groups (χ2=54.29, 11.89, 30.17 and 16.51, P<0.01 and P<0.001), while in gender, lesion location, occurrence of intestinal obstruction, lymph node metastasis, or liver metastasis, there was no statistically significant difference (χ2=0.18, 8.33, 0.10, 0.18 and 0.50, P>0.05). Conclusion Signet-ring cell carcinomas are often found in younger patients, their CT manifestations including a long length of concentric bowel wall thickening and is characterized by the target ring sign in contrast-enhanced scan, which often involves the peri-intestinal space with peritoneal metastasis and peri-intestinal lymph node metastasis.

Objective To evaluate the value of echocardiography in transcatheter closure of ruptured sinus of Valsalva aneurysm(TC-RSVA).Methods TC-RSVA was attempted in 11 patients.The location,shape,size of defects and its relationship with the neighbor structures were revealed before the procedure.Then the deployment of occluder was monitored during the procedure,and the effectiveness was observed in the follow-up.Results Eleven patients were diagnosed as the isolated RSVA by echocardiography.The size of defects was 2 - 13 mm estimated by echo.The procedures were successful in all patients.Usually the Amplatzer duct occluders were chosen to be 1 to 5 mm larger than the size of defects.Three patients had mild residual shunt during the procedure,which all dispeared in the first month of follow-up,but one of them demonstrated recurrent mild residual shunt in the 32nd month of follow-up.There was no aggravating aortic regurgitation in the follow-up.Conclusions TC-RSVA is relatively safe and effective.Observation of long-term effectiveness is still necessary.Echocardiagraphy plays an important role in TC-RSVA.