BACKGROUND:Avascular necrosis of the femoral head is a refractory orthopedic disease that seriously affects the normal life of patients.Hip preservation is recommended for young patients due to the limited prosthesis longevity and revision.Accurate prediction of the mechanical properties of the necrotic area in the early stage and then intervention is the key to hip preservation. OBJECTIVE:To establish a dynamic contact mechanics finite element model of necrotic femoral head based on human hip CT data and predict effects of both necrotic volume magnitude and its position on biomechanics of the necrotic region under walking movement. METHODS:CT data of a volunteer were collected and then geometry model of the hip was rebuilt.Finite element model of the necrotic femoral head was established using the Abaqus software.Nine different necrotic femoral models were constructed by combined both three different necrotic volume magnitudes(small,medium and big volume)and three different necrotic positions(coincided with,medium deviated with and kept away from the line of the force).The Von Mises of the necrotic region for all models were predicted under both 3 000 N static load and dynamical loads of one whole ISO walking gait cycle.The collapse risk for all models was evaluated based on collapse criterion. RESULTS AND CONCLUSION:(1)More approaching of the necrotic region to the line of force and bigger collapse volume made the maximum Von Mises increasing.This also enlarged the collapse risk of the necrotic region.(2)For different load types,walking movement increased the maximum Von Mises of the necrotic region than that of the value under static load under the same necrotic volume and location.(3)In conclusion,dynamic load would result in increasing of the maximum Von Mises of the necrotic region comparing to static load during exercise.Therefore,the risk of local collapse will increase due to greater Von Mises.However,the overall collapse risk is lower than that of static load due to the dynamic change of bearing area.This factor should be carefully considered by surgeons when they evaluate the mechanical performance of the necrotic femoral head.

Objective:To investigate the risk factors and clinical significance of lymph nodes metastasis between sternocleidomastoid and sternohyoid muscle lymph node (LNSS) metastasis in thyroid cancer patients, so as to guide the reasonable dissection of LNSS region and lateral cervical lymph node in patients with papillary thyroid carcinoma (PTC) .Methods:We selected 111 PTC patients with lateral cervical lymph node metastasis who underwent radical thyroidectomy and lateral cervical lymph node dissection from Nov. 2018 to Dec. 2021 in China-Japan Union Hospital of jilin university. All patients were treated with low collar arc incision. Radical thyroidectomy and lateral cervical lymph node dissection were performed according to the guidelines, and lymph nodes in each district were grouped for pathological examination. According to whether LNSS metastasis occurred, they were divided into two groups: LNSS positive group (LNSS metastasis occurred) and LNSS negative group (LNSS metastasis did not happen). We collected the basic information of all 111 PTC patients with lateral lymph node metastasis (LLNM), preoperative color Doppler ultrasound examination and paraffin-embedded pathology and other related clinical case data. Then we described the clinicopathological features of cervical lymph node metastasis. Independent sample t test and Mann-Whitney U test were used for continuous variables, and Fisher exact test was used for data analysis for classified variables. Correlation analysis adopted binary logistics regression model, and analyzed the regularity and risk factors of LNSS metastasis. Results:In this study, the detection rate of LNSS was 64.9% (72/111), the overall LNSS metastasis rate was 7.2% (8/111), and the number of lymph node metastasis was 0-5. Univariate analysis showed that the location of LNSS metastasis was related with the cancer focus ( P<0.001), the preoperative serum thyroglobulin (Tg) level ( P=0.002), the number of lymph node metastasis in lateral cervical level Ⅳ ( P=0.001), the longest diameter of the cancer focus ( P=0.003) and the longest diameter of metastatic lymph nodes ( P=0.001) However, age, sex, whether there is lymph node metastasis in the central region (central lymph node metastasis ,CLNM), and whether there is multifocal cancer were not related to LNSS metastasis ( P≥0.05). Further multivariate analysis and work curve analysis of subjects showed that the tumor located in the lower pole ( P=0.014) and the number of lymph node metastasis in level Ⅳ more than 3 ( P=0.027) were independent risk factors for LNSS metastasis. It was found that the risk of LNSS metastasis increased when the cancer focus was located at the lower pole relative to the upper pole or middle part of the cancer focus ( OR=74.508, 95% CI: 2.373-2339.544). The number of lymph node metastasis in level Ⅳ had a positive effect on LNSS metastasis. The more lymph node metastasis in level Ⅳ, the higher the risk of LNSS metastasis ( OR=1.556; 95% CI=1.051-2.303) . Conclusions:In PTC patients with LLNM, the LNSS metastasis rate was 7.2%, and the advantages of LNSS cleaning outweigh the disadvantages. When the cancer focus is located at the lower pole and the number of lymph node metastasis in region Ⅳ is more than 3, it is necessary to pay attention to the dissection of this group of lymph nodes.

Objective:To investigate the feasibility of simultaneous arteriovenous enhancement of neck CT with two-stage injection of contrast agent and its effect on image quality and radiation dose.Methods:A total of 30 patients undergoing neck CT enhancement scan due to space-occupying lesions in Beijing Tongren Hospital, Capital Medical University from February to April 2022 were prospectively included as the experimental group. The neck CT enhancement scan was performed with two-stage injection of contrast agent and arteriovenous simultaneous enhancement. The dosage of contrast agent was calculated according to the patient′s body weight, and the method of two-stage injection was adopted. The dosage of contrast agent in the first stage was 0.7 ml/kg, with normal saline in the middle stage, and the second stage (began at 35 s) was 0.3 ml/kg. A total of 30 patients with gender and age matching with the experimental group from December 2021 to January 2022 were retrospectively collected as the control group. The control group was treated with the traditional arterial phase and venous phase scanning method with the dosage of 1.0 ml/kg contrast agent. The arterial phase was scanned at the 30 s and the venous phase was scanned at the 60 s. The CT values of bilateral carotid arteries and jugular veins in the experimental group were measured, the CT values of bilateral carotid arteries in the arterial phase were measured in the control group, and the CT values of bilateral carotid arteries and jugular veins in the venous phase were measured. Carotid artery enhancement score was performed for images of experimental group and control group in arterial and venous phase, and jugular vein and lesion enhancement score was performed for images of experimental group and control group in venous phase. The effective dose was calculated for both groups. The difference of carotid artery CT values between images was compared by one-way analysis of variance, and LSD method was used for pairwise comparison. The CT values of jugular vein were compared using independent sample t test. Kruskal-Wallis test was used to compare carotid artery enhancement scores, and Nemenyi method was used for pairwise comparison. Jugular vein and lesion enhancement scores and effective dose were compared by Mann-Whitney U test. Results:The CT value of carotid artery of experimental group [left (276±24) HU, right (273±25) HU] was lower than that of control group in arterial phase [left (329±33) HU, right (327±32) HU], and higher than that in the venous phase [left (147±15) HU, right (148±16) HU]. All the differences were statistically significant ( P<0.001). The CT value of jugular vein of experimental group [left (206±18) HU, right (203±19)] was higher than that of control group in the venous phase [left (154±15) HU, right (151±15)], the difference was statistically significant ( t=11.88, 11.76, both P<0.001). There was no significant difference in carotid artery enhancement score between experimental group and control group in arterial phase ( P=0.624), but the carotid artery enhancement score of the experimental group was higher than that of the control group in the venous phase, and the difference was statistically significant ( P<0.001). The scores of jugular vein and lesion enhancement in experimental group were higher than those of control group in venous phase, and the difference was statistically significant ( Z=5.01, P<0.001). The effective dose of the experimental group [2.41(2.04, 2.72) mSv] was decreased by 52.2% compared with the control group [5.04(4.18, 5.44) mSv], and the difference was statistically significant ( Z=-6.24, P<0.001). Conclusions:The neck CT enhanced scan with two-stage injection of contrast agent and arteriovenous simultaneous enhancement method can obtain comprehensive images of arterial and venous phases, and realize simultaneous enhancement of carotid artery, jugular vein and lesions, and reduce radiation dose.

Objective:To investigate the value of the size-specific dose estimate (SSDE) on dose estimations of children's head CT scans.Methods:A retrospective study was conducted on plain head CT scans of 252 patients with the 64-row detector CT device of Discovery 750HD in the Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from January to September in 2019. The volume CT dose index (CTDI vol)values were recorded. The head circumference (HC), area, and CT value were measured using a self-developed computer program, and the water equivalent diameter (WED), size-specific conversion factors ( f293 and f220), and absorbed dose (SSDE 293 and SSDE 220) were calculated according to the AAPM reports 293 and 220.The patients were divided into three groups by the quartering meth odaccording to their HC(<47.8 cm, 47.8-52.7 cm, >52.7 cm)and four groups based on their ages(0-2, 3-6, 7-10 and 11-14 years old). The difference between parameters ( f220 and f293, SSDE 220 and SSDE 293、SSDE 293 and CTDI vol) were compared for different groups, and the correlation of HC with f293 and SSDE 293 was analyzed. Results:There was an overestimation of f220 by 11.11% ( t=252.61, P<0.05) compared with f293. SSDE 220 was overestimated by 10.31% ( t=228.21, P<0.05) compared with SSDE 293, and SSDE 293 was underestimated by 9.60% ( t=-31.34, P<0.05)compared with CTDI vol. For the three HC groups, SSDE 220 was overestimated by 8.54%, 10.37%, and 11.57% ( t=73.73, 438.58, 275.52, P<0.05)compared with SSDE 293, and SSDE 293 was underestimated by 1.30%, 9.79%, and 14.61% ( t=-1.91, -60.95, -47.64, P<0.05)compared with CTDI vol. For the four age groups SSDE 220 was overestimated by 8.45%, 10.00%, 10.57%, and 11.36% ( t=63.58, 232.29, 247.84, 302.95, P< 0.05)compared with SSDE 293, and SSDE 293 was underestimated by 1.49%, 8.27%, 10.63%, and 13.78% ( t=-1.83, -28.27, -37.30, -49.80, P< 0.05)compared with CTDI vol. Furthermore, HC was highly correlated with f293 and SSDE 293 ( r2=0.88 and 0.76, respectively, P< 0.05). Conclusions:The radiation dose in children′s head CT scanning can be more accurately estimated according to the AAPM Report 293, while it can be overestimated by CTDI vol. Meanwhile, the CT radiation dose can be patently overestimated with the AAPM Report 220 compared with Report 293.HC is closely correlated with f293 and SSDE 293 and it can be used to estimatee more accurately for SSDE and the radiation dose received by children during head CT scanning.

Echinococcosis is an age-old disease that causes serious damage to the animal husbandry and the human health perennially. As a newly discovered species of Echinococus, E. shiquicus has the potential public health significance and could be a potential parasitic zoonosis. In this review, its etiology, life cycle, epidemiology, detection and diagnoses, public health etc. are discussed or summarized. Also, a series of comparisons among E. granulosus, E. multilocularis and E. shiquicus are made.

Objective To study the inhibitory effect of phloroglucinols in Mianma Guanzhong(Dryopteris crassirhizoma Nakai,Basket Fern Nakai)on neuraminidase(NA)of H1N1 influenza virus.Methods A library of 34 phloroglucinols ligands was established through retrieving, and X-ray three-dimensional crystal structure file of NA(H1N1)was downloaded from Protein Data Bank.The phloroglucinols possessing lower binding energy and stronger hydrogen bond interaction with NA were screened by using AutoDock Vina software and LigPlot +software, and the inhibitory effect of candidate phloroglucinols on NA was verified by using fluorometric assay.Results There were 4 phloroglucinols(filixic acids ABA, ABB, ABP and ABBA)with better combination with NA screened through molecular docking.The results of fluorometric assay showed that dryocrassin ABBA had the strongest inhibitory effect on NA [(IC50)=(26.73 ±0.57)μmol/L].Conclusion Dryocrassin ABBA in Mianma Guanzhong has higher effect of anti-NA of H1N1 influenza virus, which lays a foundation for further study on new anti-influenza drugs.

To identify SJCHGC01743 gene of Schistosoma japonicum and evaluate the potential of the recombinant protein as a new vaccine candidate for schistosomiasis, polymerase chain reaction (PCR) technique was used to amplify the cDNA of the gene and real-time RT-PCR was used to analyze the transcription profiles of SJCHGC01743 at different development stages. Recombinant plasmid was successfully constructed and transformed into competent Escherichia coli BL21 (DE3). Then the recombinant protein was expressed, purified and emulsified with ISA206 adjuvant to immunize BALB/c mice for three times. The immunogenicity was confirmed by Western blotting and tissue localization was detected by indirect immunofluorescent assay. The specific antibody level was detected by ELISA. The immunoprotection of rSjOST48 was evaluated by the reduction in worm and egg counts in mice. A cDNA with 1 248 nucleotides was isolated from 28-day-old schistosomes cDNAs by PCR. Sequence analysis revealed that SJCHGC01743 was a 48-kDa subunit of the oligosaccharyltransferase complex (OST48) and named as SjOST48. Real-time PCR analysis indicated that this gene was expressed in all investigated stages and had the highest expression level in 28 d worms, the level of gene transcription in female worms was significantly higher than that of male worms. Then recombinant plasmid pET28a(+)-SjOST48 was successfully constructed and expressed in E. coli BL21 (DE3). Western blotting analysis showed that rSjOST48 had good immunogenicity. Indirect immunofluorescent analysis revealed that SjOST48 was mainly distributed on the tegument of the worms. The result of ELISA indicated that the rSjOST48 vaccinated group could induce a significant increase in the level of specific IgG, IgG1 and IgG2a. An immunoprotection experiment showed that the vaccination of rSjOST48 in mice induced 32.62% (P < 0.05) reduction in the numbers of worms and 57.61% (P < 0.01) in eggs in liver, compared with that of the control group. This study provides the foundation for proceeding further research on the biological function of SjOST48 and screening new vaccine candidates for schistosomiasis.
Animals ; Antibodies, Helminth ; blood ; Cloning, Molecular ; DNA, Complementary ; Escherichia coli ; Female ; Genes, Helminth ; Helminth Proteins ; genetics ; immunology ; Immunoglobulin G ; blood ; Male ; Mice ; Mice, Inbred BALB C ; Real-Time Polymerase Chain Reaction ; Recombinant Proteins ; immunology ; Schistosoma japonicum ; genetics ; Schistosomiasis japonica ; prevention & control ; Vaccination

Objective To discuss the effective factors and metastasis rules of cervical lymph node of papillary thyroid microcarcinoma,aimed to provide references for indications and range of lymph node dissection.Methods Reviewed the clinical information and pathological material of primary treatment of 1 180 cases of papillary thyroid microcarcinoma patients in China-Japan Union Hospital of Jilin University from June 2008 to December 2011 by retrospective analysis,futher summared cervical lymph node metastasis rules and effective factors.Results The lymph node metastasis rate of 1 180 patients with papillary thyroid microcarcinoma was 29.6％,which of these of the central and lateral region were 26.4％ and 15.2％.Central region lymph nodes metastasis rates in male and female were respectively 44.9％,21.8％ (P ＜ 0.05),and were 39.8％,9.0％ in lateral region (P ＜ 0,01).Lymph node metastasis rates of patients whose age ≤45years old and ＞45 years old were 30.3％,17.9％ (P ＜0.05).The lymph mode metastasis rate which diameter of tumour(D) ≤0.5 cm or 0.5 cm ＜ D ≤ 1 cm in central region were 20.2％,33.2％ (P ＜ 0.05).The lymph node metastasis rate of single and more nidi respectively were 15.7％,45.0％ in central region.The lymph node metastasis rate of tumors invasion or not were 44.4％ and 14.2％ in central region (P ＜0.05).The metastasis rates were 45.5％ and 4.3％ in the lateral region when the lymph node infringe or not in central region.Conclusions Lymph node metastasis happens relatively more common in papillary thyroid microcarcinoma patients with the factors such as male,young age,multiple nidi,long diameter of tumor and invasion of tumor envelope.So when doctors establish the indications and range of lymph node dissection,it's need to pay attention to the high risk factors seriously which effect lymph node metastasis of papillary thyroid carcinoma,and establish the lymph node dissection strategy individually.

To study the characteristics of traditional Chinese medicine (TCM) syndrome factors of patients from different areas of China with human immunodeficiency virus (HIV) infection or acquired immunodeficiency syndrome (AIDS).

ObjectiveTo investigate the mechanism and prevention of invisible injury of recurrent laryngeal nerve (RLN) system in thyroid surgery, with the application of intraoperative neuromonitoring ( IONM ) system. MethodsThe type of invisible RLN injury and its protection with the application of IONM system were analyzed. ResultsThe causes of invisible RLN injury mainly included stretching of Berry ligament or the tumor,contusion, thermal injury, cutting of silk and suction injury. RLN invisible injury was recoverable through neurotrophic and symptomatic treatment. No permanent vocal cord paralysis occurred. ConclusionsWith the application of IONM system, some invisible type of RLN injuries can be found. The risk of RLN injury can be reduced if the surgical techniques are improved with the development of study on mechanism of IONM system.