Objective To explore the impact of contrast agent concentration on the excimer laser's effect on plaque ablation.Methods Using a laser catheter with a diameter of 0.9 mm,we conducted plaque model ablation experiments employing a 308-nanometer xenon chloride excimer laser.During the excimer laser ablation process,five groups were formed based on the injected contrast agent concentrations:a saline group,25%concentration group,50%concentration group,75%concentration group,and 100%concentration group.Optical coherence tomography was utilized to assess the changes in plaque lumen area after excimer laser ablation,evaluating the impact of contrast agent concentration on the excimer laser's ablation efficacy.Simultaneously,a water manometer was used to measure the shockwave pressure generated by the excimer laser in liquids with different contrast agent concentrations,aiming to explore the correlation between the shockwave pressure of the excimer laser and its ablative effect.Results The ablation areas in the 75%concentration group and the 100%concentration group were similar(P＞0.05),both exceeding those in the 50%concentration contrast agent group,25%concentration group,and saline group(all P＜0.001).Specifically,the ablation area in the 50%concentration group was significantly larger than that in the 25%concentration group and saline group(both P＜0.001),while the 25%concentration group was larger than the saline group(P＜0.001).The influence of contrast agent concentration on the shockwave pressure of the excimer laser exhibited a similar trend.Additionally,there was a significant positive correlation between the shockwave pressure generated by the excimer laser and its ablation area(r=0.9987,P＜0.001).Conclusions The intensity of excimer laser ablation on plaque tissue can be modulated by altering the contrast agent concentration.These findings offer guidance for the application of excimer laser in conjunction with contrast agent injection techniques in the treatment of coronary artery disease.

Ankylosing spondylitis (AS) combined with lower cervical fracture is often categorized into unstable fracture, with a high incidence of neurological injury and a high rate of disability and morbidity. As factors such as shoulder occlusion may affect the accuracy of X-ray imaging diagnosis, it is often easily misdiagnosed at the primary diagnosis. Non-operative treatment has complications such as bone nonunion and the possibility of secondary neurological damage, while the timing, access and choice of surgical treatment are still controversial. Currently, there are no clinical practice guidelines for the treatment of AS combined with lower cervical fracture with or without dislocation. To this end, the Spinal Trauma Group of Orthopedics Branch of Chinese Medical Doctor Association organized experts to formulate Clinical guidelines for the treatment of ankylosing spondylitis combined with lower cervical fracture in adults ( version 2024) in accordance with the principles of evidence-based medicine, scientificity and practicality, in which 11 recommendations were put forward in terms of the diagnosis, imaging evaluation, typing and treatment, etc, to provide guidance for the diagnosis and treatment of AS combined with lower cervical fracture.

Humans ; Adolescent ; Fractures, Avulsion ; Fractures, Bone ; Fracture Fixation, Internal ; Ischium/surgery*

Objective To analyze the clinical characteristics of high energy metabolism in lung cancer patients and its correlation with body composition,nutritional status,and quality of life,and to develop a corresponding risk prediction model.Methods Retrospectively analyzed 132 primary lung cancer patients admitted to the First Hospital of Shanxi Medical University from January 2022 to May 2023,and categorized into high(n=94)and low energy metabolism group(n=38)based on their metabolic status.Differences in clinical data,body composition,Patient Generated Subjective Global Assessment(PG-SGA)scores,and European Organization for Research and treatment of Cancer(EORTC)Quality of Life Questionnaire-Core 30(QLQ-C30)scores were compared between the two groups.Logistic regression was used to identify the risk factors for high energy metabolism in lung cancer patients,and a risk prediction model was established accordingly;the Hosmer-Lemeshow test was used to assess the model fit,and the ROC curve was used to test the predictive efficacy of the model.Results Of the 132 patients with primary lung cancer,94(71.2%)exhibited high energy metabolism.Compared with low energy metabolism group,patients in high-energy metabolism group had a smoking index of 400 or higher,advanced disease staging of stage Ⅲ or Ⅳ,and higher levels of IL-6 level,low adiposity index,low skeletal muscle index,and malnutrition(P<0.05),and lower levels of total protein,albumin,hemoglobin level,and prognostic nutritional index(PNI)(P<0.05).There was no significant difference in age,gender,height,weight,BMI and disease type between the two groups(P>0.05).Logistic regression analysis showed that smoking index≥400,advanced disease stage,IL-6≥3.775 ng/L,and PNI<46.43 were independent risk factors for high energy metabolism in lung cancer patients.The AUC of the ROC curve for the established prediction model of high energy metabolism in lung cancer patients was 0.834(95%CI 0.763-0.904).Conclusion The high energy metabolic risk prediction model of lung cancer patients established in this study has good fit and prediction efficiency.

Objective To develop an MRI-based habitat radiomics model for the preoperative prediction of endometrial cancer(EC)molecular subtypes.Methods Patients with pathologically proven EC from two hospitals were included in the training(n=270)and testing(n=70)cohorts.All patients had preoperative MRI and histological and molecular diagnoses.First,the tumor was divided into habitat subregions based on diffusion-weighted imaging(DWI)and contrast-enhanced(CE)images.Subsequently,habitat radiomic features were extracted from different subregions of T1-weighted imaging(T1WI),T2-weighted imaging(T2WI),DWI,and CE images.Three machine learning classifiers,including logistic regression,support vector machines,and random forests,were applied to develop predictive models for p53-abnormal endometrial cancer,with model performance validated.The model demonstrating the best overall predictive performance was selected as the habitat radiomics model.Using the same procedure,a whole-region radiomics model based on T1WI,T2WI,DWI,and CE sequences and a clinical model were constructed.The performance of the models was evaluated using receiver operating characteristic curves,and DeLong's test was employed to compare differences between the models.Decision curve analysis was used to assess the clinical benefits of the models'application.Results After feature selection,eight habitat radiomic features were retained to construct the habitat radiomics model,ten features for the whole-region radiomics model,and three clinical features for the clinical model.The habitat radiomics model achieved the highest area under the curve(AUC),with 0.855(0.788-0.922)in the training cohort and 0.769(0.631-0.907)in the testing cohort.DeLong's test showed that the habitat radiomics model outperformed the whole-region radiomics model in the training cohort(P=0.001),but there was no significant difference in the testing cohort(P=0.543).In both cohorts,the habitat radiomics model outperformed the clinical model(P=0.007,training cohort;P=0.038,testing cohort).Decision curve analysis(DCA)demonstrated that this model provided clinical benefit for diagnosis within a threshold probability range of approximately 0.2-0.8.Conclusion The MRI-based habitat radiomics model can accurately predict p53-abnormal EC,outperforming both the whole-region radiomics model and the clinical model,and is useful for the non-invasive molecular subtyping of endometrial cancer before surgery.

Objective To design a nuclear emergency medical rescue simulation platform to solve the problmes in nuclear accident scenario simulation,fidelity of on-site medical treatment training and training organization.Methords A nuclear emergency medical rescue simulation platform was developed with the technologies of virtual reality(VR),augmented reality(AR),spatial positioning,full-body motion capture,gesture simulation and three-dimensional modeling,Unity3D platform,3D Studio Max software and Visual Studio,which mainly consisted of a hardware system and a software system.The hardware system was composed of the AR training equipment and VR training equipment,of which,the AR training equipment included a surface contamination detector simulator,an individual decontaminator simulator and AR glasses,and the VR training equipment was made up of VR glasses,large-space localization equipment,backpack computers,data gloves and full-body motion capture equipment.The software system involved in several modules for theoretical knowledge teaching and assessment,VR/AR practical teaching training and VR/AR evaluation.Results The system realized simulated collaborative training and evaluation for medical emergency response to nuclear accidents.Conclusion The platform constructed contributes to solving the practical problems in organizing and implementing education and training for nuclear emergency medical rescue,and the education and training are both enhanced greatly.[Chinese Medical Equipment Journal,2024,45(9):50-56]

Objective To design a hyperbaric oxygen chamber ambulance to meet the requirements for on-site hyperbaric oxygen treatment and transport of casualties.Methods A hyperbaric oxygen chamber ambulance was formed based on a YJ2080 wheeled armored vehicle,which had the components of a chamber,a gas source,an oxygen source,a control system and a power source.The chamber had a 3-layer composite structure,with a high-strength metal frame in the outer layer,a capsule made of polyurethane material bound with nylon pressure-resistant tape in the inner layer and a layer of thermal insulation material filled between the chamber and the vehicle;the gas source was composed of the oil-free air compressor,gas cylinder and pressure reducer;the oxygen source was made up of the 20 L oxygen generator,oxygen booster pump and 40 L oxygen cylinder;the control system involved in an EX2N-100HA series touch screen programmable logic controller(PLC)all-in-one(AIO);an ACD-15.0DR/48-H generator system was used as the power source.Results The hyperbaric oxygen chamber ambulance could stably control the chamber pressure when the therapeutic pressure was set as 1.3,1.6 and 1.8 ATA(1 ATA=0.1 MPa),the volume fraction of oxygen in the chamber could be limited within the required range under the low oxygen volume fraction mode and high oxygen volume fraction mode,and the emergency decompression time could be restrained within 60 s.Conclusion The hyperbaric oxygen chamber ambulance behaves well in maneuverability,and can be used for on-site hyperbaric oxygen treatment and transport of casualties.[Chinese Medical Equipment Journal,2024,45(10):25-30]

The effect of porcine SIRT5 on replication of foot and mouth disease virus type O(FMDV-O)and the underlying regulatory mechanism were investigated.Western blot and RT-qPCR analyses were employed to monitor expression of endoge-nous SIRT5 in PK-15 cells infected with FMDV-O.Three pairs of SIRT5-specific siRNAs were synthesized.Changes to SIRT5 and FMDV-O protein and transcript levels,in addition to virus copy numbers,were measured by western blot and RT-qPCR analyses.PK-15 cells were transfected with a eukaryotic SIRT5 expression plasmid.Western blot and RT-qPCR analyses were used to explore the impact of SIRT5 overexpression on FMDV-O replication.Meanwhile,RT-qPCR analysis was used to detect the effect of SIRT5 overexpression on the mRNA expression levels of type I interferon-stimulated genes induced by SeV and FMDV-O.The results showed that expression of SIRT5 was up-regulated in PK-15 cells infected with FMDV-O and siRNA interfered with SIRT5 to inhibit FMDV-O replication.SIRT5 overexpression promoted FMDV-O replication.SIRT5 over-expression decreased mRNA expression levels of interferon-stimulated genes induced by SeV and FMDV-O.These results suggest that FMDV-O infection stimulated expression of SIRT5 in PK-15 cells,while SIRT5 promoted FMDV-O rep-lication by inhibiting production of type I interferon-stimula-ted genes.These findings provide a reference to further ex-plore the mechanism underlying the ability of porcine SIRT5 to promote FMDV-O replication.

Objective:To explore the clinical characteristics,molecular characteristics,treatment and prognosis of pediatric Philadelphia chromosome-like acute lymphoblastic leukemia(Ph-like ALL)with a therapeutic target.Methods:A total of 27 patients of Ph-like ALL with targeted drug target were initially diagnosed in Children's Hospital of Soochow University from December 2017 to June 2021.The data of age,gender,white blood cell(WBC)count at initial diagnosis,genetic characteristics,molecular biological changes,chemotherapy regimen,different targeted drugs were given,and minimal residual disease(MRD)on day 19,MRD on day 46,whether hematopoietic stem cell transplantation(HSCT)were retrospective analyed,and the clinical characteristics and treatment effect were summarized.Survival analysis was performed by Kaplan-Meier method.Results:The intensity of chemotherapy was adjusted according to the MRD level during induced remission therapy in 27 patients,10 patients were treated with targeted drugs during treatment,and 3 patients were bridged with HSCT,1 patient died and 2 patients survived.Among the 24 patients who did not receive HSCT,1 patient developed relapse,and achieved complete remission(CR)after treatment with chimeric antigen receptors T cells(CAR-T).The 3-year overall survival,3-year relapse-free survival and 3-year event-free survival rate of 27 patients were(95.5±4.4)％,(95.0±4.9)％and(90.7±6.3)％respectively.Conclusion:Risk stratification chemotherapy based on MRD monitoring can improve the prognosis of Ph-like ALL in children,combined with targeted drugs can achieve complete remission as soon as possible in children whose chemotherapy response is poor,and sequential CAR-T and HSCT can significantly improve the therapeutic effect of Ph-like ALL in children whose MRD is continuously positive during induced remission therapy.

The incidence of osteoporotic thoracolumbar vertebral fracture (OTLVF) in the elderly is gradually increasing. The kyphotic deformity caused by various factors has become an important characteristic of OTLVF and has received increasing attention. Its clinical manifestations include pain, delayed nerve damage, sagittal imbalance, etc. Currently, the definition and diagnosis of OTLVF with kyphotic deformity in the elderly are still unclear. Although there are many treatment options, they are controversial. Existing guidelines or consensuses pay little attention to this type of fracture with kyphotic deformity. To this end, the Lumbar Education Working Group of the Spine Branch of the Chinese Medicine Education Association and Editorial Committee of Chinese Journal of Trauma organized the experts in the relevant fields to jointly develop Clinical guidelines for the diagnosis and treatment of osteoporotic thoracolumbar vertebral fractures with kyphotic deformity in the elderly ( version 2024), based on evidence-based medical advancements and the principles of scientificity, practicality, and advanced nature, which provided 18 recommendations to standardize the clinical diagnosis and treatment.