Objective To establish a model of combined injury of thermal radiation and blast wave of gas explosion in closed pipeline,and investigate the characteristics of important organ injury induced by burn-blast combined injury in rats.Methods A total of 72 male SD rats(aged 8～10 weeks,weighing 200～10 g)were randomly divided into control group and mild and severe injured groups.After the model rats were inflicted with blast wave and thermal radiation,their physical parameters were detected and measured.The respiratory function of the survival rats was tested.In 24 h later,arterial blood gas analysis,blood biochemical tests,and detection for serum inflammatory factors and lung injury related protein levels were performed,and the pathological changes in the lung tissue and trachea were observed.Results The peak range of explosive blast wave overpressure was 209～493 kPa,and the temperature was 152～258 ℃.The mortality rate was 8.3％in the mild group and 53.1％in the severe group.Compared with the control group,longer inspiratory time(Ti)and relaxation time(Tr)and larger tidal volume(TV)(P＜0.05),while lower respiratory frequency(f)were observed in the 2 injured groups within 6 h after injury(P＜0.05).At 24 h after injury,the values of partial pressure of carbon dioxide(PaCO2),residual base value(BE)and bicarbonate(HCO3-)were increased significantly(P＜0.05),while partial pressure of oxygen(PaO2)was decreased(P＜0.05).The serum levels of alanine transaminase(ALT),aspartate aminotransferase(AST),alkaline phosphatase(ALP),total bilirubin(TBI)and total bile acid(TBA)were notably elevated(P＜0.05).So were the levels of IL-1 β,TNF-α and IL-6(P＜0.01).Various severities of hyperemia foci and inflammation in the tracheal mucosa were observed in the injured rats.The incidence of lung injury was high,and the pathological manifestations were dot-shaped hemorrhage to diffuse hemorrhage of the whole lobe,rupture of alveolar septum,thickening of septum,and infiltration of red blood cells and inflammatory cells.The levels of serum lung injury-related proteins were significantly increased(P＜0.05).Conclusion A rat model which can highly simulate mild to severe burn-blast combined injury is constructed,which can meet the needs for rat model in study of explosive burn-blast compound injury.The main characteristics of the injury are lung injury,respiratory dysfunction,liver damage and secondary infection.

Objective:To compare the efficacies of robot-assisted unilateral and manual unilateral/bilateral puncture kyphoplasty (PKP) for the treatment of osteoporotic thoracolumbar fracture (OTLF).Methods:A retrospective cohort study was conducted to analyze the clinical data of 64 OTLF patients admitted to First Affiliated Hospital of Kunming Medical University from April 2021 to May 2022. The patients included 28 males and 36 females, aged 57-88 years [(74.5±5.6)years]. Fracture segments were 12 patients from T 1-T 9, 32 from T 10-L 2, and 20 from L 3-L 5. All the patients were treated with PKP. Among them, 25 patients underwent manual unilateral puncture (manual unilateral group), 18 patients underwent manual bilateral puncture (manual bilateral group), and 21 patients underwent robot-assisted unilateral puncture (robot-assisted unilateral group). The operation time, channel establishment time, intraoperative blood loss, intraoperative fluoroscopy times, bone cement injection volume, and bone cement spatial distribution score were compared among the three groups. The visual analogue score (VAS), Oswestry disability index (ODI) and Cobb angle of kyphosis were compared among the three groups before operation, at 3 days and 3 months after operation, and at the last follow-up. The incidence of complications was compared. Results:All the patients were followed up for 6-10 months [(7.0±0.9)months]. The operation time of the manual unilateral group was (30.2±6.1)minutes, which was shorter than (37.9±8.9)minutes of the robot-assisted unilateral group and (49.0±10.2)minutes of the manual bilateral group; the operation time of the robot-assisted unilateral group was markedly shorter than that of the manual bilateral group (all P<0.05). The channel establishment time of the robot-assisted unilateral group was (4.7±1.4)minutes, which was markedly shorter than (10.4±4.4)minutes of the manual unilateral group and (21.7±6.2)minutes of the manual bilateral group (all P<0.05). The intraoperative blood loss of the robot-assisted unilateral group was (23.8±7.2)ml, which was less than (34.3±7.7)ml of the manual unilateral group and (55.9±18.7)ml of the manual bilateral group (all P<0.05). The number of intraoperative fluoroscopy of the robot-assisted unilateral group was (12.1±2.5)times, which was markedly less than (21.2±5.9)times of the manual unilateral group and (39.6±9.5)times of the manual bilateral group (all P<0.05). The channel establishment time, intraoperative blood loss and intraoperative fluoroscopy times of the manual unilateral group were markedly shorter or less than those of the manual bilateral group (all P<0.05). The bone cement injection volume and bone cement distribution score of the robot-assisted unilateral group were (4.7±1.3)ml and (7.9±1.2)points, which were not statistically different from (5.7±1.3)ml and (8.7±1.1)points of the manual bilateral group (all P>0.05), but were markedly higher than (3.0±1.3)ml and (5.1±1.8)points of the manual unilateral group (all P<0.05). There were no significant differences in VAS, ODI and Cobb angle among the three groups at 3 days, 3 months after operation and at the last follow-up (all P>0.05), but which were all lower than those before surgery (all P<0.05). There were no significant differences in VAS, ODI and Cobb angle among three groups before operation, at 3 days, 3 months after surgery and at the last follow-up (all P>0.05). The complication rate was 4.8% (1/21) of the robot-assisted unilateral group, 32.0% (8/25) of the manual unilateral group, and 33.3% (6/18) of the manual bilateral group, with no significant difference between the manual unilateral group and the manual bilateral group ( P>0.05), but both of which was markedly higher than that of the robot-assisted unilateral group ( P<0.05). Conclusion:Robot-assisted unilateral puncture and manual unilateral/bilateral puncture PKP can both achieve satisfactory results for the treatment of OTLF, but robot-assisted unilateral puncture has shorter channel establishment time, less intraoperative blood loss and intraoperative fluoroscopy times, and lower complication rate.

Objective To establish a UHPLC method for the determination of zolpidem tartrate tablets after radiation, and to investigate the effect of different radiation doses on the content of zolpidem tartrate tablets. Methods Ultra high performance liquid chromatography was used. The content of zolpidem tartrate tablets irradiated by γ-ray was determined. Using C₁₈ column, acetonitrile methanol-0.05 mol/L phosphoric acid solution (the pH value as 5.5 with triethylamine) (18∶26∶56) was used as the mobile phase. The flow rate was 0.7 ml/min, and the detection wavelength was 254 nm. Results The method validation showed good linearity in the concentration range of 5-80 μg/ml (r=0.999 6); The average recovery was 98.2%, RSD was 1.72%, and the repeatability was 0.87%. The contents of zolpidem tartrate were 105.1%, 106.4%, 102.7% and 105.4% under 0, 8, 25 and 80 kGy radiation. Conclusion UHPLC has accurate results with short analysis cycle in this study. It is suitable for the determination of zolpidem tartrate tablets after radiation. The content of zolpidem tartrate tablets remained basically unchanged after radiation.

Objective:To explore the value of diffusion tensor imaging (DTI) in evaluating the effects of hyperbaric oxygen therapy (HOT) in treating spinal cord injury.Methods:The modified Allen′s method was used to induce a traumatic spinal cord injury in 30 rats who were then divided randomly into an injured group and a treatment group, each of 15. The treatment group was given HOT twice a day for 3 days, then once a day for a total of 4 weeks. The injured group did not receive HOT. DTI was performed (along with Basso-Beattie-Bresnahan (BBB) evaluation) at 0h, 6h, 24h, as well as 3, 7, 14, 21 and 28 days after the operation. Two-factor repeated measures ANOVA was conducted to analyze any differences in the DTI results: the fractional anisotropy, mean apparent diffusivity, radial diffusivity and axial diffusivity, as well as the BBB scores. LSD t-tests were performed to analyze the significance of the differences at different time points.Results:At each time point after 24h the average FA value of the treatment group was significantly higher than the injured group′s average, while its average MD and RD values were significantly lower. Beyond 14 days the average AD value of the treatment group was significantly higher than that of the injured group. The treatment group′s average BBB score was also significantly higher at all the time points beyond 3 days.Conclusions:DTI results can evaluate spinal cord function and provide valuable information for the dynamic assessment of hyperbaric oxygen therapy after a traumatic spinal cord injury, and the therapy promotes the recovery of motor function, at least in rats.

Methods:Two thousand standard sections images werre collected from 2 000 clinical retrospective pediatric hip ultrasound videos from January 2019 to January 2021. All standard sections were annotated by the annotation team through the self-designed software based on Python 3.6 environment for image cross-media data annotation and manual review standardization process with unified standards. Among them, 1 753 were randomly selected for training the deep learning system, and the remaining 247 were used for testing the system. Further, 200 standard sections were randomly selected from the test set, and 8 clinicians independently completed the film reading annotation. The 8 independent results were then compared with the AI results.Results:The testing set consists of 247 patients. Compared with the clinician's measurements, the area under the receiver operating characteristic curve (AUC) of diagnosing hip joint maturity was 0.865, the sensitivity was 76.19%, and the specificity was 96.9%. The AUC of AI system interpretation under Graf detailed typing was 0.575, the sensitivity was 25.90%, the specificity was 89.10%. The 95% LoA of α-angle determined by Bland-Altman method, of -4.7051° to 6.5948° ( Bias -0.94, P<0.001), compared with clinicians' measurements. The 95% LoA of β-angle, of -7.7191 to 6.8777 ( Bias -0.42, P=0.077). Compared with those from 8 clinicians, the results of AI system interpretation were more stable, and the β-angle effect was more prominent. Conclusion:The AI system can quickly and accurately measure the Graf correlation index of standard DDH ultrasonic standard diagnosis plane.

Objective:To conduct interviews from the perspective of caregivers of children with autism spectrum disorders (ASD) and to conduct a multi-level and multi-dimensional strategy to provide help for families of children with ASD by exploring the experience of oral health care of such children.Methods:Using the purposive sampling method, a total of 11 family caregivers of children with ASD aged 12 and below who visited Outpatient Department of Pediatric Dental Prevention in Affiliated Stomatological Hospital of Nanjing Medical University from May 2020 to May 2021 were selected for semi-structured interviews. The subject was finally determined using Colaizzi's 7-step analysis method and assisted by Nvivo 12 software.Results:The current situation of oral care for children with ASD had three themes, namely, caregiver emotion, care dilemma and needs.Conclusions:More attention should be paid to the mental health of family caregivers with ASD. The oral health of children with ASD not only needs family caregivers, but also needs the common attention and support of the whole society, including multi-disciplinary and multi-department, to provide effective oral health management programs for children with ASD, so as to promote the oral health of this group of children.

Objective:To compare the therapeutic outcomes of anterior cruciate ligament (ACL) reconstruction between small-sized and normal-sized patients using grafts of different diameters.Methods:The data of 63 patients were selected who had undergone ACL reconstruction at Department of Joint/Sports Medicine, The Third Affiliated Hospital to Southern Medical University from January 2018 to December 2018. They were divided into 2 groups according to body size. In the observation group of 26 small-sized patients who were shorter and lighter, there were 18 males and 8 females with an age of (29.4±8.5) years and a graft of 7.5 mm in diameter was used. In the control group of 37 normal-sized patients, there were 26 males and 11 females with an age of (28.8±8.2) years and a graft of 8.0 mm in diameter was used. The 2 groups were compared in terms of failure rate, kinematic changes in the affected knee joint (taking the 63 normal knee joints in the 2 groups as controls), isokinetic muscle strength and Lysholm knee score.Results:There was no significant difference in the general data or follow-up time between the 2 groups other than height and weight ( P>0.05), indicating comparability between the 2 groups. In the control and observation groups, the failure rates were 2.7% (1/37) and 3.8% (1/26), and the Lysholm knee scores 2 years after surgery (86.6±10.1) points and (90.2±6.9) points, respectively, showing no statistical significance ( P>0.05). The range of flexion and extension was 56.30° (51.10°, 58.10°) in the observation group, significantly smaller than that in the control group [60.15°(58.95°, 63.08°)] and that for a normal knee joint [59.00° (56.45°, 63.00°]; the internal and external displacement in the observation group [7.30 (5.30, 8.30) mm] was significantly smaller than that for a normal knee joint [9.00 (7.00, 12.00) mm]; the external rotation in the observation group [0.97°(-1.59°, 3.01°)] was significantly larger than that for a normal knee joint [-1.54°(-5.30°, 2.28°)]; the knee extension muscle strength at 60°/s in the observation group was (65%±19%), significantly smaller than that in the control group (78%±18%) (all P<0.05). Conclusion:When small-sized and normal-sized patients use a 7.5 mm graft and a 8.0 mm graft respectively in ACL reconstruction, similar therapeutic outcomes can be expected.

There are abundant cancer stem cells (CSCs) in triple-negative breast cancer TNBC).CSCs can maintain their phenotype by unique molecular mechanism and tumor microenvironment,and can promote the chemotherapy resistance and recurrence of TNBC.Blocking these key molecules or altering tumor microenvironment can reduce CSCs,and then inhibited cancer growth and reverse chemotherapy resistance of TNBC.

Objective: To investigate the effects of human umbilical cord mesenchymal stem cells (MSCs) on the proliferation, apoptosis, migration, invasion and stemness of esophageal cancer EC1 cells. Methods: Human umbilical cord mesenchymal stem cells were isolated and cultured in vitro, and cell phenotype was identified by flow cytometry. MSCs or their conditioned medium were co-cultured with esophageal cancer EC1 cells. The effects on the proliferation, apoptosis, migration, invasion and stemness of EC1 cells were examined by cell counting kit-8 (CCK-8), flow cytometry, Transwell, quantitative real-time polymerase chain reaction (RT-qPCR) and spheroid formation assays. Results: MSCs inhibited the proliferation of EC1 cells in a concentration dependent manner. When the ratio of MSCs to EC1 cells was 0∶1, 1∶1, 2∶1, 5∶1, the apoptotic rates of EC1 cells were (4.07±0.34)%, (8.90±0.36)%, (10.80±0.50)% and (15.23±1.06)%, respectively, suggesting that MSCs promoted the apoptosis of EC1 cells in a concentration dependent manner (all P<0.05). The expression levels of OCT2, SOX2, KLF4, CXCR4 and CXCR7 in EC1 cells cultured in 80% conditioned medium were 0.53±0.03, 0.49±0.02, 0.73±0.09, 0.57±0.05 and 0.24±0.02, respectively, which were lower than those in the regular medium group (all P<0.05). The numbers of migrated cells in regular medium as well as 10%, 40%, and 80% conditioned medium were 287.3±21.6, 280.7±15.5, 264.3±16.8, and 257.7±8.0, respectively. Meanwhile, the numbers of invasive cells were 194.3±16.6, 213.7±24.3, 221.0±16.0, (252.0±20.4), respectively. There was no significant difference between the groups (all P>0.05). Conclusion Human umbilical cord mesenchymal stem cells can inhibit the proliferation, promote apoptosis and reduce the stemness, and have no significant effect on the migration and invasion of EC1 cells.

Objective To investigate the effects of OB built-in tampon indwelled in anus combined with acupoint massage in ICU patients with incontinence-associated dermatitis (IAD). Methods 100 patients with incontinence hospitalized in ICU were randomly assigned to control group (n=50) versus combined therapy group (n=50). The patients in the control group accepted routine nursing while the patients in the combined therapy group were treated with OB built-in tampon indwelled in anus combined with acupoint massage besides the routine nursing care. The two groups were compared in terms of incidence rate of IAD, IAD occurrence time, severity of IAD and incontinence-related nursing workload. Results The incidence rate of IAD and the severity of IAD in the combined therapy group were lower than those of the control group.The IAD in the combined therapy group occurred later than in the control group. Thetime for incontinence-related nursing and the frequency of perineum washing in the combined therapy group were shorter and lower than in the control group. Conclusions The application of OB built-in tampon indwelled in anus combined with acupoint massage in ICU patients with incontinence can not only reduce the incidence rate and severity of IAD but also lower the workload of nursing.The therapy is worthy of clinical application.