Objective To analyze the effect of different retained dosage of lauromacrogol within the thyroid cyst in the sclerotherapy of thyroid cysts.Methods A total of 200 patients with thyroid cysts,who were admitted to the Longyan Municipal First Hospital of China between August 2020 and August 2021,were enrolled in this study.The patients were randomly and equally divided into group zero(suctioning out all the amount of the injected lauromacrogol),and,according to the percentage of the retained lauromacrogol dosage to the total cystic fluid,group 10%,group 20%,group 30%and group 50%,with 40 patients in each group.Thyroid color ultrasound was reviewed at 1,3,6,and 12 months after treatment.The changes of capsule volume,curative efficacy,influencing factors,and adverse reactions after the cyst became sclerosis were analyzed.Logistic regression analysis was used to analyze the factors affecting the postoperative efficacy.Results In all the 5 groups,the suctioned fluid was dark red in colour,and the patients had cystic nodules.The preoperative mean cyst volume was(20.43±5.86)cm3.In all the 5 groups,the postoperative changes in cyst volume indicated that the postoperative one-month cyst volume significantly shrank when compared with the preoperative volume,the postoperative 3-month cyst volume remarkably shrank when compared with the postoperative one-month volume,and the postoperative 6-month cyst volume strikingly shrank when compared with the postoperative 3-month volume(all P＜0.05),while no statistically significant difference in the cyst volume existed between the postoperative 12-month value and the postoperative 6-month value(P＞0.05).The postoperative 6-month total effective rate of all the five groups was 87%(174/200),and no statistically significant differences in the postoperative 6-month curative effect existed between each other among the 5 groups(P＞0.05).Taking the postoperative 6-month curative effect as the dependent variable,and the age,sex,thick cystic wall,cystic septum,and preoperative cyst volume as independent variables,the binary logistic regression analysis was conducted,which revealed that the thick cystic wall(OR=0.24,95%CI=0.08-0.72,P=0.01)and the cystic septum(OR=0.21,95%CI=0.07-0.67,P=0.01)were the factors affecting the postoperative 6-month curative effect.The main side reaction was pain,which was tolerable by patients.There was no significant difference in the incidence of adverse reactions between each other among the five groups(all P＞0.05).Conclusion In treating thyroid cysts by using ultrasound-guided lauromacrogol sclerotherapy,there is no relationship between the curative effect and the percentage of the retained lauromacrogol dosage to the total cystic fluid.The best curative effect can be achieved at 6 months after injection of lauromacrogol,which can be used as the optimal time for follow-up check.The thick cystic wall and the cystic septum are the main factors that affect the curative effect of lauromacrogol sclerotherapy.For the treatment of thyroid cyst,lauromacrogol sclerotherapy carries reliable curative effect with few adverse reactions,therefore,this therapy is worthy of clinical application.(J Intervent Radiol,2024,32:69-73)

Objective To investigate the injury mechanisms of three-year-old child occupants by reconstructing a real traffic accident.Methods A traffic accident case from the CIREN database was reconstructed using a vehicle finite element model and a three-year-old child occupant injury bionic model(TUST IBMs 3YO-O).The Δv,mass of the vehicle,and deformation energy were comprehensively analyzed to calculate the collision velocity of the vehicle.This accident was simulated to present injuries to a child occupant,and the injury mechanisms were analyzed in depth.Results The TUST IBMs 3YO-O fully reconstructed the injuries of the child occupant in this case.The kinematic and biomechanical responses of the children's heads differed.The biomechanical response of the internal tissues and organs in the chest cavity showed no injury,however,the result ant chest acceleration at 3 ms reached 54 g,which exceeded the threshold.Conclusions In the future,it will be necessary to adopt biomechanical parameters for occupant safety evaluations.The application of human biomechanical models with high biofidelity to reconstruct occupant injuries in traffic accidents can not only be used to observe the kinematic responses of the occupant in the accident and analyze the injury mechanisms in depth,but also to provide references for virtual testing,as well as for the research and development of child occupant protection devices and the formulation of safety regulations.

Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in tertiary hospitals in major regions of China in 2022.Methods Clinical isolates from 58 hospitals in China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2022 Clinical &Laboratory Standards Institute(CLSI)breakpoints.Results A total of 318 013 clinical isolates were collected from January 1,2022 to December 31,2022,of which 29.5％were gram-positive and 70.5％were gram-negative.The prevalence of methicillin-resistant strains in Staphylococcus aureus,Staphylococcus epidermidis and other coagulase-negative Staphylococcus species(excluding Staphylococcus pseudintermedius and Staphylococcus schleiferi)was 28.3％,76.7％and 77.9％,respectively.Overall,94.0％of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 90.8％of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis showed significantly lower resistance rates to most antimicrobial agents tested than Enterococcus faecium.A few vancomycin-resistant strains were identified in both E.faecalis and E.faecium.The prevalence of penicillin-susceptible Streptococcus pneumoniae was 94.2％in the isolates from children and 95.7％in the isolates from adults.The resistance rate to carbapenems was lower than 13.1％in most Enterobacterales species except for Klebsiella,21.7％-23.1％of which were resistant to carbapenems.Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.1％to 13.3％.The prevalence of meropenem-resistant strains decreased from 23.5％in 2019 to 18.0％in 2022 in Pseudomonas aeruginosa,and decreased from 79.0％in 2019 to 72.5％in 2022 in Acinetobacter baumannii.Conclusions The resistance of clinical isolates to the commonly used antimicrobial agents is still increasing in tertiary hospitals.However,the prevalence of important carbapenem-resistant organisms such as carbapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a downward trend in recent years.This finding suggests that the strategy of combining antimicrobial resistance surveillance with multidisciplinary concerted action works well in curbing the spread of resistant bacteria.

The study presents a method for the personalized biomechanical modeling of the human head and validates the generated model.Based on the TUST 50th percentile head biomechanical model,the method utilizes head CT data of the target model,and employs three-dimensional point cloud registration and free-form deformation techniques to rapidly develop a personalized head finite element model with detailed brain tissue structures.By reconstructing classic cadaver tests,it is found that the personalized head biomechanical model created by the proposed method shows a good consistency with the results of cadaver tests in kinematic and biomechanical responses.Furthermore,no significant differences are observed when compared with the head biomechanical model developed using reverse engineering method,thus verifying the effectiveness of the developed model.Consequently,the proposed method can be used to quickly construct personalized head biomechanical models with detailed anatomical structures,providing a fundamental computational analysis tool for researches in injury biomechanics,clinical medicine,and forensic identification.

Objective:To investigate the effect of instantaneous flow rate on the consistency of diagnostic accuracy of severe degenerative mitral regurgitation (DMR) using proximal isovelocity surface area (PISA).Methods:From June 2019 to June 2021, 75 patients with DMR who underwent echocardiography in Department of Echocardiography of Zhongshan Hospital, Fudan University were prospectively enrolled. The instantaneous flow rate of DMR during the systolic phase was calculated using M-mode PISA(PISA M-mode), and a time-integrated curve was plotted. Regurgitant volume (RVol) and effective regurgitant orifice area (EROA) were calculated by traditional PISA (PISA max), pair PISA (PISA pair), and PISA M-mode, respectively. RVol acquired from cardiac magnetic resonance (CMR) volumetric method in 22 patients of the enrolled patients. The correlation and consistency of RVol acquired between the three PISA methods and CMR were compared. Agreement of diagnostic accuracy of severe mitral regurgitation (sMR) acquired between the three PISA methods and multi-parameter algorithm by American Society of Echocardiography (ASE) was analyzed using Cohen′s Kappa analysis. Results:The curve of instantaneous flow rate of DMR showed unimodal pattern with the peak at mid-late systolic phase. The correlation of RVol acquired between PISA methods and CMR was moderate for PISA max and PISA pair ( r=0.77, 0.80, both P<0.001), whereas PISA M-mode presented strong correlation with CMR ( r=0.87, P<0.001). RVol acquired from PISA max was larger than that of CMR[(69.1±37.1) ml vs (49.0±29.0)ml, P=0.002]. Both PISA max and PISA pair were shown moderate agreement of diagnostic accuracy of sMR with ASE multi-parameters algorithm (RVol: κ=0.496, 0.525, both P<0.001; EROA: κ=0.570, 0.578, both P<0.001), while PISA M-mode presented strong agreement (RVol: κ=0.867 and EROA: κ=0.802, both P<0.001). Conclusions:Based on the unimodal pattern of instantaneous flow rate in patients with DMR, PISA max may significantly overestimate RVol, exposing a significant proportion of patients with DMR to unnecessary MR surgery. PISA M-mode presents better correlation and consistency with CMR on the quantification of RVol compared with PISA max and PISA pair, and may improve the diagnostic accuracy of quantification of sMR using PISA.

Abstract: Objective To investigate the preventive and therapeutic effects of anti-idiotypic monoclonal antibodies (Ab2β) of lactadherin on neonatal mice infected with human rotavirus (HRV), and to analyze the underlying mechanism. Methods Hybridoma technology was used to prepare Ab2β of lactadherin. One hundred and twenty 7-day-old Kunming mice were randomly divided into groups A, B, C and control, each consisting of 30 mice. Groups A, B, and C were all infected with HRV via oral gavage. Group A received no treatment, group B was orally administered lactadherin for 7 days prior to infection, and group C was orally administered lactadherin for 7 days after infection, the control group was orally administered cell culture medium that did not contain the virus. The clinical manifestations (diarrhea, body weight) at different time points after infection of the neonatal mice in each group were observed, and the content of rotavirus antigen in the feces of neonatal mice was detected by enzyme-linked immunosorbent assay (ELISA). After HRV infection for 7 days, immunohistochemical staining was used to examine the expression level of intercellular adhesion molecule-1 (ICAM-1) in mouse small intestinal tissues in each group. Results No diarrhea occurred in the control group at any time point. Groups A, B, and C showed diarrhea symptoms after HRV challenge for 1 day. The degree of diarrhea in groups B and C was lower than that in group A at 2-4 days after HRV challenge, and the difference was statistically significant (P<0.05). The HRV antigen content in the feces of the neonatal mice in groups B and C was lower than that in group A at 1-5 days after HRV challenge, and the difference was statistically significant (P<0.05). There was no significant difference in the degree of diarrhea and HRV antigen content between groups B and C at each time point (P>0.05). There was no significant difference in the body weight of the neonatal mice in each group before infection and 1 day after infection (P>0.05); the weight of neonatal mice in groups B and C was higher than that in group A at 3, 5 and 7 days after HRV challenge, and the difference was statistically significant (P<0.05), and there was no significant difference in body weight between groups B and C at each time point after HRV challenge (P>0.05). The number of ICAM-1 expressing cells in the small intestine of the three groups A, B, and C was higher than that of the control group after HRV challenge for 7 days, and the difference was statistically significant (P<0.05). The cell number and gray value of ICAM-1 expressing cells in groups B and C were lower than those in group A, and the difference was statistically significant (P<0.05). Conclusions Anti-idiotypic monoclonal antibodies (Ab2β) of lactadherin has a good preventive and therapeutic effects on human rotavirus infection in neonatal mice, and can significantly improve diarrhea symptoms and reduce HRV viral load. Its specific mechanism may be related to the inhibition of ICAM-1.

Abstract: Objective To investigate the preventive and therapeutic effects of anti-idiotypic monoclonal antibodies (Ab2β) of lactadherin on neonatal mice infected with human rotavirus (HRV), and to analyze the underlying mechanism. Methods Hybridoma technology was used to prepare Ab2β of lactadherin. One hundred and twenty 7-day-old Kunming mice were randomly divided into groups A, B, C and control, each consisting of 30 mice. Groups A, B, and C were all infected with HRV via oral gavage. Group A received no treatment, group B was orally administered lactadherin for 7 days prior to infection, and group C was orally administered lactadherin for 7 days after infection, the control group was orally administered cell culture medium that did not contain the virus. The clinical manifestations (diarrhea, body weight) at different time points after infection of the neonatal mice in each group were observed, and the content of rotavirus antigen in the feces of neonatal mice was detected by enzyme-linked immunosorbent assay (ELISA). After HRV infection for 7 days, immunohistochemical staining was used to examine the expression level of intercellular adhesion molecule-1 (ICAM-1) in mouse small intestinal tissues in each group. Results No diarrhea occurred in the control group at any time point. Groups A, B, and C showed diarrhea symptoms after HRV challenge for 1 day. The degree of diarrhea in groups B and C was lower than that in group A at 2-4 days after HRV challenge, and the difference was statistically significant (P<0.05). The HRV antigen content in the feces of the neonatal mice in groups B and C was lower than that in group A at 1-5 days after HRV challenge, and the difference was statistically significant (P<0.05). There was no significant difference in the degree of diarrhea and HRV antigen content between groups B and C at each time point (P>0.05). There was no significant difference in the body weight of the neonatal mice in each group before infection and 1 day after infection (P>0.05); the weight of neonatal mice in groups B and C was higher than that in group A at 3, 5 and 7 days after HRV challenge, and the difference was statistically significant (P<0.05), and there was no significant difference in body weight between groups B and C at each time point after HRV challenge (P>0.05). The number of ICAM-1 expressing cells in the small intestine of the three groups A, B, and C was higher than that of the control group after HRV challenge for 7 days, and the difference was statistically significant (P<0.05). The cell number and gray value of ICAM-1 expressing cells in groups B and C were lower than those in group A, and the difference was statistically significant (P<0.05). Conclusions Anti-idiotypic monoclonal antibodies (Ab2β) of lactadherin has a good preventive and therapeutic effects on human rotavirus infection in neonatal mice, and can significantly improve diarrhea symptoms and reduce HRV viral load. Its specific mechanism may be related to the inhibition of ICAM-1.

The finite element method is a new method to study the mechanism of brain injury caused by blunt instruments. But it is not easy to be applied because of its technology barrier of time-consuming and strong professionalism. In this study, a rapid and quantitative evaluation method was investigated to analyze the craniocerebral injury induced by blunt sticks based on convolutional neural network and finite element method. The velocity curve of stick struck and the maximum principal strain of brain tissue (cerebrum, corpus callosum, cerebellum and brainstem) from the finite element simulation were used as the input and output parameters of the convolutional neural network The convolutional neural network was trained and optimized by using the 10-fold cross-validation method. The Mean Absolute Error (MAE), Mean Square Error (MSE), and Goodness of Fit ( R ²) of the finally selected convolutional neural network model for the prediction of the maximum principal strain of the cerebrum were 0.084, 0.014, and 0.92, respectively. The predicted results of the maximum principal strain of the corpus callosum were 0.062, 0.007, 0.90, respectively. The predicted results of the maximum principal strain of the cerebellum and brainstem were 0.075, 0.011, and 0.94, respectively. These results show that the research and development of the deep convolutional neural network can quickly and accurately assess the local brain injury caused by the sticks blow, and have important application value for understanding the quantitative evaluation and the brain injury caused by the sticks struck. At the same time, this technology improves the computational efficiency and can provide a basis reference for transforming the current acceleration-based brain injury research into a focus on local brain injury research.
Brain ; Brain Injuries ; Computer Simulation ; Finite Element Analysis ; Humans ; Neural Networks, Computer

Objective To study influencing factors of renal blunt impact injury by using finite element (FE) method. Methods Based on CT images of the kidney, the kidney FE models for different age groups were constructed. The renal blunt impact test was reconstructed, and the influence of kidney material constitutive parameters, kidney tissue structure, kidney size, impact position and impact velocity on injury severity were analyzed. Results Under the same impact condition, the stress of renal cortex decreased with the kidney mass increasing, and increased with the impact velocity of the hammer increasing. The renal capsule had a certain energy absorption effect, so as to reduce the kidney stress. When the kidney was impacted, the stress of renal cortex under side impact was significantly higher than that under frontal impact. Conclusions Compared with viscoelastic constitutive model, Mooney Rivlin material constitutive model is more suitable for FE evaluation on renal injury severity. The renal injury decreases with the kidney mass increasing. The increase of impact velocity will intensify the renal injury severity. Renal capsule will reduce renal injury to a certain extent, so the existence of renal capsule structure must be considered in FE modeling of the kidney. Compared with frontal and rear impact, the renal injury severity is greater when the kidney is impacted from the lateral side.

Objective To predict and assess biomechanical responses and injury mechanisms of the thorax and abdomen for small-sized females in vehicle collisions. Methods The accurate geometric model of the thorax and abdomen was constructed based on CT images of Chinese 5th percentile female volunteers. A thoracic-abdominal finite element model of Chinese 5th percentile female with detailed anatomical structure was developed by using the corresponding software. The model was validated by reconstructing three groups of cadaver experiments (namely, test of blunt anteroposterior impact on the thorax, test of bar anteroposterior impact on the abdomen, test of blunt lateral impact on the chest and abdomen). Results The force-deformation curves and injury biomechanical responses of the organs from the simulations were consistent with the cadaver experiment results, which validated effectiveness of the model. Conclusions The model can be used for studying injury mechanisms of the thorax and abdomen for small-sized female, as well as developing small-sized occupant restraint systems and analyzing the forensic cases, which lays foundation for developing the whole body finite element model of Chinese 5th percentile female.