Purpose To explore the feasibility of artificial intelligence compressed sensing(ACS)technique in ankle joint MRI.Materials and Methods From September to October 2023,32 healthy volunteers who underwent ankle joint scanning in Beijing Friendship Hospital,Capital Medical University were prospectively collected.MRI of the ankle joint based on ACS and parallel imaging(PI)technology was performed on 3.0T MR.The sagittal proton density weighted imaging(PDWI),coronary PDWI,transverse PDWI and sagittal T1WI were acquired,and all data were divided into test group and control group,with ACS to accelerate the multiples of 5(ACS 5.0)in test group,whereas PI speed ratio of 2(PI 2.0)in control group,respectively.The signal intensity of talus,achilles tendon and cartilage were measured,the signal intensity and standard deviation of the long hallux flexor were obtained,and the signal noise ratio(SNR)and contrast to noise ratio(CNR)were calculated via long hallux flexor as background noise.The data of objective and subjective evaluation of the two sequences were statistically analyzed,and the image quality of each sequence was evaluated via the standard reference of PI 2.0.Results SNR and CNR in ACS group were higher than those in PI group,and the anatomical structure of sagittal PDWI sequence between the two groups had statistical significance(t=-2.937,-1.981,-4.058,-3.879,P<0.05).There were significant differences in cartilage SNR and talus CNR in coronal PDWI sequence(t=-3.310,-3.567;P=0.002,P<0.001).In terms of axial PDWI sequence,there were statistically significant differences in talus CNR and cartilage CNR between ACS and PI groups(t=-4.270,-4.382,P<0.05).The subjective evaluation of the image quality scores of the two groups by the two diagnostic imaging doctors showed a strong observer consistency(Kappa=0.977,P=0.009).There was no significant difference in image quality scores between the two groups(Z=-0.248,-0.747,<0.001,-0.071,P>0.05).The total collection time of ACS group and PI group was 337 s and 610 s,respectively.Compared with PI group,the total scanning time of ACS group was shortened by 44.8%.Conclusion ACS based MRI of the ankle joint can not only shorten the scan time,but also ensure and further improve the image quality,with feasibility.

Objective:To investigate the effect of visceral obesity on the short-term curative effect of Da Vinci robotic-assisted radical resec-tion for rectal cancers.Methods:Clinical and pathological data of patients with rectal cancer undergoing Da Vinci robotic-assisted surgery,admitted to People's Hospital of Zhengzhou University and Cancer Hospital of Zhengzhou University from November 2019 to June 2022 were retrospectively analyzed.Visceral fat area(VFA)≥100 cm2 was used as the standard to define visceral obesity.Patients were categorized in-to visceral and non-visceral obesity groups.The short-term efficacy of the two groups was evaluated,and the influencing factors of post-operative complications were analyzed using univariate and multivariate Logistic regression.Results:Among a total of 169 patients,93 were included in the visceral obesity group and 76 in the non-visceral obesity group.There was no significant difference in the baseline data between the two groups(P>0.05).There was no conversion to laparotomy in the non-visceral obesity group,and the conversion rate was 1.1%(1/93)in the visceral obesity group.The second operation rate was 2.2%(2/93)in the visceral obesity group and 1.3%(1/76)in the non-visceral obesity group with no statistical difference between the two groups.There were no significant differences in the operation dur-ation,intraoperative blood loss,number of lymph node dissections,and total postoperative complication rate between the two groups(P>0.05).Multivariate Logistic regression analysis revealed that an NRS≥3 independently contributed as a risk factor for postoperative com-plications(OR=3.190,95%CI:1.240-8.210,P=0.016).Conclusions:An NRS≥3 is an independent risk factor for complications post-robotic rad-ical rectal cancer surgery.The robotic surgical platform can overcome obesity-related limitations and is equally safe and effective for pa-tients with visceral obesity presenting with rectal cancer.

Objective:To explore the effect of hallux nail flap design assisted with 3D printing in reconstruction of thumb defect in degloving injury.Methods:From January 2020 to March 2022, 16 patients with thumb defect caused by degloving injury with intact digit flexor and extensor tendons were treated. The patients were 11 males and 5 females, aged 20 to 52 years old, with an average age of 31 years old. The injured patient's hands were firstly scanned by CT and the 3D models were created to map the profile of the tissues required for reconstruction. Photopolymer templates for the defects in thumb were then 3D printed. The printed templates were put on the great toes and accordingly the hallux nail flaps were designed and harvested. The degloving wound of thumb was repaired by the hallux nail flap. Donor sites were repaired with artificial dermis in 6 patients and with ilioinguinal flaps in 10 patients. The effect of surgery was observed at outpatient clinic during postoperative follow-up. The survival of the hallux nail flap and the recovery of the donor site were observed. Function recovery were evaluated according to the Evaluation Standard of Finger Replantation and Reconstruction of Hand Surgery Society of Chinese Medical Association.Results:All the harvested hallux nail flaps matched with the profiles of recipient sites. All the hallux nail flaps survived over 4 to 30 months of follow-up, in an average of 16 months. Appearance of all hallux nail flaps was similar to normal thumbs, with good fingerprint and nails. Sensation recovery were S 3-S 4, with TPD at 4-7 mm. According to the Evaluation Trial Standards of Upper Limb Partial Functional of Hand Surgery of Chinese Medical Association, 15 thumbs were excellent and 1 was good. Conclusion:Application of 3D printing assisted hallux nail flap transfer in reconstruction of defect of thumb in degloving injury can precisely design and harvest the required tissue and minimise a damage to the donor great toe. It improves the appearance of thumb as well as patient satisfaction. It is practical in reconstruction of the defect of thumb in degloving injury.

Objective:To explore the value and significance of sensorimotor cortex (SMC) in the recovery of upper limb motor function after cerebral infarction in the striatum with blood oxygenation level dependent functional magnetic resonance imaging (BOLD-fMRI).Methods:A total of 17 patients with primary onset of striatal intracapsular infarction (SCI) with unilateral severe upper limb paralysis, who were strictly screened from the Department of Neurology, Affiliated Hospital of Yangzhou University from June 2015 to December 2017, were selected as research subjects, and 15 healthy volunteers were selected as controls. BOLD-fMRI under the passive finger extension (FE) task on the hemiplegic side was performed within one week, one month and three months after the onset of the disease. The activation of SMC was observed by SPM8 software. The activation of corresponding brain activation areas in BOLD-fMRI was observed by Xjview software and compared with the standard brain activation areas dynamically. The upper limb section of the Fugl-Meyer Scale (FM-UL) was used to track the motor function of the upper limb. The upper limb motor function of the selected patients was evaluated before functional magnetic resonance imaging (fMRI) scanning, at one month and three months after onset of the disease.Results:In the controls, fMRI showed that the main brain activation areas were located in the contralateral SMC and bilateral supplementary motor area. According to the activation time course of the affected side SMC and the comparison results with the standard brain activation area, the study patients were divided into three groups: group 1 (six patients), in which the activation intensity of SMC was stronger than that of standard brain activation area in the early stage of onset; group 2 (five patients), in which the activation intensity of SMC in the affected side was stronger than that in the standard brain activation area at one month after onset; group 3 (six patients), in which the activation intensity of SMC in the affected side increased gradually in three months, but still did not exceed the standard brain activation area. The activated voxel values of the affected side SMC in group 1 patients at the first time, one month and three months were 3 570.2±1 125.9, 1 205.8±328.2 and 1 121.5±407.5, respectively, the difference within the group being statistically significant ( F=12.8, P=0.001); the activated voxel values of the affected SMC in group 2 patients were 556.2±171.7, 648.6±177.3 and 993.2±182.9, respectively, and the differences within the group were statistically significant ( F=6.5, P=0.018); the activated SMC values of the affected SMC in group 3 patients were 520.0±375.9, 573.5±375.0 and 680.9±359.8, respectively, and there was no statistically significant difference within the group ( P>0.05). The three times FM-UL scores corresponding to group 1 patients were (10.0±3.3) points, (52.3±4.6) points and (63.7±2.9) points; the three times FM-UL scores corresponding to group 2 patients were (10.6±5.7) points, (36.6±2.4) points and (59.2±3.1) points; and the three times FM-UL scores corresponding to group 3 patients were (9.2±4.0) points, (12.5±3.0) points and (13.3±5.0) points; FM-UL scores in group 1 and group 2 patients showed statistically significant differences within the groups ( F=348.4, 183.6; P<0.001), whereas that in group 3 patients showed no statistically significant difference within the group ( P>0.05). There was no statistically significant difference in the initial FM-UL score among the groups ( P>0.05), while the differences among the groups at one month and three months were statistically significant ( F=191.7,304.5; P<0.001). Conclusions:The survival of SMC on the affected side after cerebral infarction is a prerequisite for the rehabilitation of limb motor function. Its early activation cannot predict the clinical prognosis, but the dynamic enhancement of SMC activation on the affected side is related to the rehabilitation speed of the affected limb.

Objective To understand the exposure level of disinfection by-products (DBPs) in drinking water in Xiangyang City and to evaluate the health risks of the population, so as to provide reference for the safety risk control of drinking water. Methods Sampling and laboratory testing were conducted according to national standard methods. The risk assessment model provided by USEPA was used to evaluate the health risks. Results Trichloromethane (TCM), bromodichloromethane (BDCM), dibromochloromethane (DBCM) and tribromomethane (TBM) were detected in drinking water in Xiangyang City. The contents of halogenated hydrocarbon DBPs in water disinfected with liquid chlorine were higher than those with chlorine dioxide. The contents of three DBPs were higher in wet season than those in dry season except TBM. The content of TCM in pipe network terminal water and secondary water supply disinfected with chlorine dioxide was higher than that in factory water. The carcinogenic risk of DBPs in drinking water disinfected with liquid chlorine was 4.33×10^-5, and the non-carcinogenic risk was 0.114. The carcinogenic risk of DBPs in drinking water disinfected with chlorine dioxide was 1.24×10^-6, and the non-carcinogenic risk was 3.15×10^-3. Conclusion The health risk of DBPs in drinking water in Xiangyang City is acceptable, but TCM produced by liquid chlorine disinfection should be paid more attention. It is recommended that chlorine dioxide disinfection be used to reduce the health risks of halogenated hydrocarbon DBPs.

Objective:To study the dynamic changes of cortical functional reorganization in striatocapsular infarction (SCI) by blood oxygenation level dependent-functional MR imaging (BOLD-fMRI) and its relation with recovery of motor function in the upper extremity of the hemiplegia.Methods:A total of 17 patients with SCI at first onset and combined with upper extremity of the hemiplegia, admitted to our hospital from June 2015 to December 2017, were included; 15 healthy volunteers recruited at the same time were selected as control group. Within 1 week of onset, and 1 and 3 months after onset, BOLD-fMRI was performed under passive finger flexion and extension task on hemiplegia side, and the activation of brain functional areas at different stages was observed by SPM8 software. The Xjview software was used to observe the activation of the corresponding brain activation areas in BOLD-fMRI and make dynamic comparison with the standard brain activation areas. The upper limb part of Fugl-Meyer (FM-UL) scale was used to track the motor function of the upper limb.Results:The activation in the control group was mainly located in the contralateral sensorimotor cortex (SMC) and bilateral supplementary motor area (SMA). The regions of interest in early BOLD-fMRI for stroke patients at early stage can be divided into 3 types. The activation in patients with type I was mainly at the affected side, enjoying bilateral SMC and SMA activation; 1 and 3 months after onset, activation at the contralateral SMC decreased gradually, and activation at the ipsilateral SMC region gradually increased. The activation in patients with type Ⅱ was merely at the ipsilateral SMC and SMA regions; 1 month after onset, bilateral SMC area and SMA area were significantly activated, mainly at the contralateral side; 3 months after onset, the SMC area was further activated at the ipsilateral side and weakened at the ipsilateral side. The activation in patients with type Ⅲ was only at SMC or M1 at the ipsilateral side; 1 month after onset, activation at the ipsilateral SMC area increased slightly; 3 months after onset, activation at the ipsilateral SMC area further enhanced, and SMA area was without activation performance. The FM-UL scores of the affected limbs of patients with type I, type II and type III at the early onst were 10.0±3.3, 10.6±5.7 and 9.2±4.0, respectively, without statistical differences ( P>0.05); 1 month after onset, the FM-UL scores of patients with type I, type II and type III were 52.3±4.6, 36.6±2.4 and 12.5±3.0, respectively, with significant differences ( P<0.05); 3 months after onset, FM-UL scores of patients with type I, type II and type III were 63.7±2.9, 59.2±3.1 and 13.3±5.0, respectively, with statistical differences ( P<0.05). Conclusions:Intracranial functional reorganization is a dynamic process. The early and dynamic activation of the affected SMC region and the early activation of the contralateral SMC region and bilateral SMA regions are of great significance in the process of stroke rehabilitation.

Objective:To analyze the pathogenic bacteria and epidemiological characteristics in children with respiratory tract infection in Tianjin area.Methods:Retrospective case analysis was performed on 2 392 hospitalized children in the wards of respiratory diseases, intensive care unit and special care ward of Tianjin Children′s Hospital from June 2018 to May 2019. Thirteen pathogenic bacteria in deep sputum and bronchoalveolar lavage fluid samples were detected by loop-mediated isothermal amplification. The laboratory data and clinical characteristics of the infected children were analyzed, and the comparison between groups was performed by t test or χ 2 test. Results:Among 2 392 cases, 1 407 were males and 985 females. There was no significant difference in the detection rate between males and females (72.5% (1 020/1 407) vs.74.2% (731/985), χ 2=0.87, P=0.35). A total of 1 751 strains and 12 kinds of positive respiratory pathogens were detected, with a detection rate of 73.2%. Among them, 913 (38.2%) strains were Mycoplasma pneumoniae (MP), 514 (21.5%) were Streptococcus pneumoniae (Sp), 381 (15.9%) were Methicillin-resistant Staphylococcus aureus (MRSA) and 279 (11.7%) were Hemophilus influenzae (Hi). There was significant difference in the detection rate of pathogens among different age groups (χ2=83.67, P<0.01). The positive rate of alveolar lavage fluid group was higher than that of deep sputum fluid group [81.6% (614/752) vs. 69.3% (1 137/1 640), χ 2=39.89, P<0.01]. The length of hospital stay of children infected with different pathogens was significantly different (all P<0.01). There was significant difference in duration of fever among children infected with different pathogens (χ2=228.69,103.56, 3.96, 27.38,24.50,41.66, all P<0.05). There were 63 (7.7%) cases of atelectasis, 260 (31.9%) cases of pleurisy and 120 (14.7%) cases of pleural effusion in MP children. Children with Sma were most likely to involve the heart system (2/9), and children with Eco infection had a higher incidence of complications such as those of blood (3/19), urinary (2/19), digestive systems(4/19), systemic inflammatory response syndrome and sepsis (1/19). Conclusions:The main bacterial pathogens of respiratory tract infection in children in Tianjin were MP, Sp, MRSA and Hi. It is suggested that clinicians should not only pay attention to the respiratory symptoms of children, but also pay attention to the complications caused by bacterial pathogen infection, so as to prevent the deterioration of the disease and improve the prognosis.

Objective:To investigate the regulatory effect of blue light on the expression of brain derived neurotrophic factor (BDNF) in the habenula nucleus of depression-like rats induced by light deprivation.Methods:male SD rats were exposed to white light (white light control group, 20 rats) and constant darkness (depression model group, 60 rats), respectively. 18 days later rats in depression model group were randomly divided into three groups: depression model group (treated with constant darkness), blue light group (treated with blue light) and red light group (treated with red light). Rats in white light control group were kept in white light. All rats exposed to light were in a standard 12∶12 h Light/Dark condition at 20 lx for 36 days. Sucrose preference test was applied to evaluate depression-like symptoms of rats. The c-fos +cells in the habenula nucleus, intergeniculate leaflet and ventral lateral geniculate nucleus were detected. The phosphoylation of cAMP-response element binding protein (CREB) and the relative BDNF protein level in the habenula nucleus were measured. Results:Sucrose intake per kg body weight increased in rats exposed to blue light and returned to the level of control group ( P>0.05). Sucrose intake per kg body weight in red light group and depression model group were lower than control group ( P<0.05). More c-fos +cells were detected in the habenula nucleus, intergeniculate leaflet and ventral lateral geniculate nucleus from blue light group than those from depression model group ( P<0.05). The relative BDNF protein level and the phosphoylation of CREB in the habenula nucleus from blue light group were higher than those from depression model group ( P<0.05). Conclusion:Blue light could relieve depression-like symptoms in light-deprived rats. Exposure to blue light could activate neurons in the habenula nucleus to which intrinsically photosensitive retinal ganglion cells projected. Blue-light-mediated antidepressant effect might involve in the activation of CREB/BDNF signal transduction pathways in the habenula nucleus.

Objective:To investigate the regulatory effect of blue light on the expression of brain derived neurotrophic factor (BDNF) in the habenula nucleus of depression-like rats induced by light deprivation.Methods:male SD rats were exposed to white light (white light control group, 20 rats) and constant darkness (depression model group, 60 rats), respectively. 18 days later rats in depression model group were randomly divided into three groups: depression model group (treated with constant darkness), blue light group (treated with blue light) and red light group (treated with red light). Rats in white light control group were kept in white light. All rats exposed to light were in a standard 12∶12 h Light/Dark condition at 20 lx for 36 days. Sucrose preference test was applied to evaluate depression-like symptoms of rats. The c-fos +cells in the habenula nucleus, intergeniculate leaflet and ventral lateral geniculate nucleus were detected. The phosphoylation of cAMP-response element binding protein (CREB) and the relative BDNF protein level in the habenula nucleus were measured. Results:Sucrose intake per kg body weight increased in rats exposed to blue light and returned to the level of control group ( P>0.05). Sucrose intake per kg body weight in red light group and depression model group were lower than control group ( P<0.05). More c-fos +cells were detected in the habenula nucleus, intergeniculate leaflet and ventral lateral geniculate nucleus from blue light group than those from depression model group ( P<0.05). The relative BDNF protein level and the phosphoylation of CREB in the habenula nucleus from blue light group were higher than those from depression model group ( P<0.05). Conclusion:Blue light could relieve depression-like symptoms in light-deprived rats. Exposure to blue light could activate neurons in the habenula nucleus to which intrinsically photosensitive retinal ganglion cells projected. Blue-light-mediated antidepressant effect might involve in the activation of CREB/BDNF signal transduction pathways in the habenula nucleus.

OBJECTIVE：To prepare cell penetrating peptide PFV-modified paclitaxel （PTX）/artesunate（ART）co-loaded targeting micelles ，and to investigate in vitro anti-tumor activity. METHODS ：According to optimal technology ，PFV-modified PTX/ ART co-loaded targeting micelles were prepared by membrane hydration method ，and were characterized. Using blank micelle as blank control ，sulforhodamine B （SRB）method was used to evaluate the toxicity of PTX micelles ，ART micelles ，PTX/ART micelles and PFV-modified PTX/ART co-loaded targeting micelles to human gastric cancer BGC- 823 cells. The coumarin was used as fluorescent probe replacing PTX to prepare corresponding micelles. Then ，the uptake of BGC- 823 cells to corresponding micelles and targeting effect were observed and determined by flow cytometry and fluorescence microscope. The effects of PTX micelles ， ART micelles ，PTX/ART micelles and PFV-modified PTX/ART co-loaded targeting micelles on the invasion of BGC- 823 cells were investigated by Transwell chamber method. RESULTS ：Average particle size of PFV-modified PTX/ART co-loaded targeting micelles was （51.30±3.95）nm；PDI was 0.19±0.01，and Zeta potential was （0.21±0.02）mV. The encapsulation efficiency of PTX and ART were higher than 90％. The shape of micelles were spherical. The blank micelles had no obvious toxicity to BGC-823 cells. The IC 50 value of PTX micelles ，PTX/ART micelles and PFV-modified PTX/ART co-loaded targeting micelles to BGC-823 cells were （3.09±0.22），（1.93±0.24），（1.11±0.15）μmol/L，respectively. The distribution amount of different micelles in BGC- 823 cell nucleus in the descending order were PFV-modified coumarin/ART micelles ＞coumarin/ART micelles ＞coumarin micelles＞blank control. The order of inhibitory effect was PFV-modified PTX/ART co-loaded targeting micelles ＞PTX/ART micelles＞ART micelles ＞PTX micelles ＞blank control. CONCLUSIONS： Prepared PFV-modified PTX/ART No.81874347） co-loaded targeting micelles are in line with the quality of 1915286446@qq.com Chinese Pharmacopoeia . It shows strong cytotoxicity to BGC-823 cells，can improve the drug targeting and the cell uptake，and inhibit the inv asion and metastasis of BGC- 823 cells.