Objective To design and construct a syndrome differentiation knowledge graph that integrates TCM facial color diagnosis information;To explore the hidden relationships between the knowledge.Methods The literature data came from ancient classics,textbooks,as well as standard literature related to inspection included in the CNKI,VIP and Wanfang Data from the establishment of the databases to December 31,2022.The clinical data was sourced from 30 elderly individuals who underwent TCM health examinations at the Community Health Service Center in Jiading Industrial Zone,Shanghai in September 2022.Facial image acquisition was performed using TFDA-1 digital tongue and facial diagnostic instrument.By following the steps of knowledge extraction,knowledge fusion and quality assessment to construct a graph,and with the assistance of TCM experts for interpretation,using Access 2019 to integrate qualitative textual data and quantitative objective image digital information,a syndrome differentiation knowledge graph integrating TCM facial diagnosis was designed and completed in the Neo4j graph database.In addition,a method was designed to shift facial diagnosis knowledge from qualitative to quantitative.Results There were a total of 194 nodes under 8 entity term types and 12 entity term labels,as well as 361 relationships under 13 semantic relationships in knowledge graph.The Neo4j graph database provided a visualized TCM facial color diagnosis and differentiation,which could be queried and fed back using Cypher language.Conclusion The knowledge graph constructed based on the theory of TCM facial color diagnosis visually shows the complex correlation between facial color diagnosis and syndrome differentiation diagnosis,with a knowledge representation model that forms qualitative data of image features → semantic relationships → syndrome differentiation diagnosis forms.

OBJECTIVE: To evaluate the feasibility of S₂ alar iliac screw insertion in Chinese children using computerized three-dimension reconstruction and simulated screw placement technique, and to optimize the measurement of screw parameters. METHODS: A total of 83 pelvic CT data of children who underwent pelvic CT scan December 2018 to December 2020 were retrospectively analyzed, excluding fractures, deformities, and tumors. There were 44 boys and 39 girls, with an average age of (10.66±3.52) years, and were divided into 4 groups based on age (group A:5 to 7 years old;group B:8 to 10 years old;group C:11-13 years old;group D:14 to 16 years old). The original CT data obtained were imported into Mimics software, and the bony structure of the pelvis was reconstructed, and the maximum and minimum cranial angles of the screws were simulated in the three-dimensional view with the placement of 6.5 mm diameter S2 alar iliac screws. Subsequently, the coronal angle, sagittal angle, transverse angle, total length of the screw, length of the screw in the sacrum, width of the iliac, and distance of the entry point from the skin were measured in 3-Matic software at the maximum and minimum head tilt angles, respectively. The differences among the screw parameters of S₂ alar iliac screws in children of different ages and the differences between gender and side were compared and analyzed. RESULTS: In all 83 children, 6.5 mm diameter S₂ iliac screws could be placed. There was no significant difference between the side of each screw placement parameter. The 5 to 7 years old children had a significantly smaller screw coronal angle than other age groups, but in the screw sagittal angle, the difference was more mixed. The 5 to 7 years old children could obtain a larger angle at the maximum head tilt angle of the screw, but at the minimum cranial angle, the larger angle was obtained in the age group of 11 to 13 years old. There were no significant differences among the age groups. The coronal angle and sagittal angle under maximum cephalic angle and minimum cranial angle of 5 to 7 years old male were (40.91±2.91)° and (51.85±3.75)° respectively, which were significantly greater than in female. The coronal angle under minimum cranial angle was significantly greater in girls aged 8-10 years old than in boys. For the remaining screw placement angle parameters, there were no significant differences between gender. The differences in the minimum iliac width, the screw length, and the length of the sacral screws showed an increasing trend with age in all age groups. The distance from the screw entry point to the skin in boys were significantly smaller than that of girls. The minimum width of the iliac in boys at 14 to 16 years of age were significantly wider than that in girls at the same stage. In contrast, in girls aged 5 to 7 years and 11 to 13 years, the screw length was significantly longer than that of boys at the same stage. CONCLUSION The pelvis of children aged 5 to 16 years can safely accommodate the placement of 6.5 mm diameter S₂ alar iliac screws, but the bony structures of the pelvis are developing and growing in children, precise assessment is needed to plan a reasonable screw trajectory and select the appropriate screw length.
Humans ; Male ; Female ; Child ; Adolescent ; Child, Preschool ; Ilium/surgery* ; Retrospective Studies ; Feasibility Studies ; Bone Screws ; Pelvis ; Sacrum/surgery* ; Spinal Fusion/methods*

Purpose: Systemic inflammatory response is a critical factor that promotes the initiation and metastasis of malignancies including pancreatic cancer (PC). This study was designed to determine and compare the prognostic value of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), and fibrinogen-to-albumin ratio (FAR) in resectable PC and locally advanced or metastatic PC. Materials and Methods: Three hundred fifty-three patients with resectable PC and 807 patients with locally advan-ced or metastatic PC were recruited in this study. These patients were classified into a training set (n=758) and a validation set (n=402). Kaplan-Meier survival plots and Cox proportional hazards regression models were used to analyze prognosis. Results: Overall survival (OS) was significantly better for patients with resectable PC with low preoperative PLR (p=0.048) and MLR (p=0.027). Low FAR, MLR, NLR (p < 0.001), and PLR (p=0.003) were significantly associated with decreased risk of death for locally advanced or metastatic PC patients. FAR (hazard ratio [HR], 1.522; 95% confidential interval [CI], 1.261 to 1.837; p < 0.001) and MLR (HR, 1.248; 95% CI, 1.017 to 1.532; p=0.034) were independent prognostic factors for locally advanced or metastatic PC. Conclusion The prognostic roles of FAR, MLR, NLR, and PLR in resectable PC and locally advanced or metastatic PC were different. FAR showed the most prognostic power in locally advanced or metastatic PC. Low FAR was positively correlated with OS in locally advanced or metastatic PC, which could be used to predict the prognosis.

ObjectivecircRNAs play an important role in tumor development, but the relationship between circRNAs and hepatocellular carcinoma remains to be further explored. The present study aimed to bioinformatically analyze the target gene of microRNA-1. Another aim was to screen circRNAs that are associated with target genes and differentially expressed in hepatocellular carcinoma cells, as well as provide theoretical basis for clinical screening of molecular markers and targeted therapies related to hepatocellular carcinoma.MethodsThe miRNA related database used for the prediction of microRNA-1 target genes, and the bioinformatic analysis of the target genes of microRNA-1 involved functional enrichment analysis and signal transduction pathway enrichment. Then, the circRNAs, which are related to the downstream target genes of microRNA-1, are screened through the circRNA database.ResultsThe number of microRNA-1 target genes was 230 in miRNA related database. Through GO analysis, it was found that the target genes of microRNA-1 had a strong tendency in regulation, and were mainly enriched in three aspects: biological function, biological process and cell localization.The target genes of microRNA-1 are involved in the function of proteins, regulation of biosynthesis, cofactor binding, enzyme regulation and other biological processes. Predicted target genes of miRNA-1 were significantly enriched in cancer signaling pathways, hepatitis B occurrence, endocytosis and splicing pathways. Further, 21 circRNAs related to the target gene of microRNA-1 were found in three circRNA databases, wherein hsa_circ_0004651 was highly expressed in hepatocellular carcinoma cell line HepG2 and its pavent gene was hnRNPD.ConclusionMicroRNA-1 influence the occurrence of hepatocellular carcinoma development through the regulation of protein and enzyme. Hsa_circ_0004651 may affect the development of hepatocellular carcinoma with microRNA-1 and its parental gene hnRNPD.

BACKGROUNDData on the epidemiology of hypertension in Chinese non-dialysis chronic kidney disease (CKD) patients are limited. The aim of the present study was to investigate the prevalence, awareness, treatment, and control of hypertension in the non-dialysis CKD patients through a nationwide, multicenter study in China.

METHODSThe survey was performed in 61 tertiary hospitals in 31 provinces, municipalities, and autonomous regions in China (except Hong Kong, Macao, and Taiwan). Trained physicians collected demographic and clinical data and measured blood pressure (BP) using a standardized protocol. Hypertension was defined as systolic BP ≥ 140 mmHg and/or diastolic BP ≥ 90 mmHg, and/or use of antihypertensive medications. BP < 140/90 mmHg and < 130/80 mmHg were used as the 2 thresholds of hypertension control. In multivariate logistic regression with adjustment for sex and age, we analyzed the association between CKD stages and uncontrolled hypertension in non-dialysis CKD patients.

RESULTSThe analysis included 8927 non-dialysis CKD patients. The prevalence, awareness, and treatment of hypertension in non-dialysis CKD patients were 67.3%, 85.8%, and 81.0%, respectively. Of hypertensive CKD patients, 33.1% and 14.1% had controlled BP to < 140/90 mmHg and < 130/80 mmHg, respectively. With successive CKD stages, the prevalence of hypertension in non-dialysis CKD patients increased, but the control of hypertension decreased (P < 0.001). When the threshold of BP < 130/80 mmHg was considered, the risk of uncontrolled hypertension in CKD 2, 3a, 3b, 4, and 5 stages increased 1.3, 1.4, 1.4, 2.5, and 4.0 times compared with CKD 1 stage, respectively (P < 0.05). Using the threshold of < 140/90 mmHg, the risk of uncontrolled hypertension increased in advanced stages (P < 0.05).

CONCLUSIONSThe prevalence of hypertension Chinese non-dialysis CKD patients was high, and the hypertension control was suboptimal. With successive CKD stages, the risk of uncontrolled hypertension increased.

Adult ; Aged ; Awareness ; Female ; Humans ; Hypertension ; complications ; epidemiology ; therapy ; Male ; Middle Aged ; Prevalence ; Renal Insufficiency, Chronic ; complications

OBJECTIVE: To explore the main problems and ideas in the death cases of medical tangles after trauma. METHODS: Twelve death cases of medical tangles after trauma were selected from a forensic science institute during recent six years. Traumatic conditions, medical malpractices and contribute degree of malpractice were estimated and analyzed. RESULTS: The reasons of trauma included accidents and intentional injury. Among these cases, there were 10 involved in malpractice, of which 7 cases played secondary role. CONCLUSION Diagnosis, symptom observation and emergency therapy are the important keys for determining the responsibility in death cases of medical tangles after trauma.
Adult ; Aged ; Cause of Death ; Female ; Forensic Medicine ; Fractures, Bone/pathology* ; Humans ; Male ; Malpractice ; Medical Errors/prevention & control* ; Middle Aged ; Retrospective Studies ; Wounds and Injuries/pathology* ; Young Adult

Objective To probe the technical processes of the suboccipital retrosigmoidal craniotomy with replacement of bone flap and deep muscles incision and suture and its clinical application. Methods The data of 40 patients undergoing suboccipital craniotomy to the cerehello-pontine angle lesions, deep muscles incision and suture in our hospital from May, 2003 to May, 2005 were analyzed retrospectively. Results All the procedures of craniotomy including removal of the bone flap, deep muscles incision and suture were accomplished safely with an average operation time of 40-60 min. Two patients appeared post-operative subcutaneous hydrops without CSF leakage and the majority can move their head freely sixth day after the operation. Conclusion Suboccipital retrosigmoidal craniotomy with replacement of bone flap, and deep muscles incision and suture, being a safe and feasible method, may decrease the happening of postoperative CSF leakage and encephalocele, and accelerate the recover of head movement.

OBJECTIVETo explore the clinical effect of talar neck fractures treated by open reduction and internal fixation with screws.

METHODSAmong 28 cases in the study, 20 cases were males and 8 cases were female. The age ranged from 22 to 72 years with an average of 38 years. Based on the Hawkins classification,there were 6 cases of type I,18 of type I and 4 of type II. They were treated by open reduction and internal fixation with screws.

RESULTSTwenty-eight cases were followed up for 1 to 7 years(mean 2.8 years). The evaluation of the results by Hawkins functional rating scale revealed excellent in 14 cases,good in 9 cases, fair in 3 cases and poor in 2 cases. The excellent and good rate were 83.2%. Osteonecrosis occurred in 5 cases with 3 of type II and 2 of type III fractures. Two of 3 cases with talar displacement were found with osteonecrosis or painful arthritis. The subtalar arthritis occurred in 6 cases, 3 of which were associated with ankle arthritis. Two cases underwent arthrodesis because of painful arthritis of the subtalar joint or osteonecrosis of the talar body. Wound infection and anteromedial skin necrosis of the ankle were not found.

CONCLUSIONTreatment of talar neck fractures could obtain satisfactory clinical results through open reduction and internal fixation with screws. Protection of the residual blood supply, anatomically reduction and stable fixation are essential for successful treatment of talar neck fractures.

Adult ; Aged ; Bone Screws ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; diagnostic imaging ; surgery ; Humans ; Male ; Middle Aged ; Radiography ; Talus ; injuries ; surgery

OBJECTIVETo investigate the methylation frequencies of multiple tumor suppressor genes (TSGs) in hepatocellular carcinoma (HCC) and the clinical implication of aberrant DNA methylation in molecular carcinogenesis of HCC.

METHODSSixty samples of HCC and the paired adjacent liver tissue, 16 samples from post-hepatitis cirrhotic livers, 5 from livers with chronic hepatitis and 5 from normal livers were collected. Eight TSGs frequently silenced by hypermethylation of their promoters in various types of digestive tumors were selected, including APC, RASSF1A, p16, GSTP1, MGMT, DAPK, SOCS-1 and RIZ1. The status of promoter methylation in these 8 genes was investigated using methylation-specific polymerase chain reaction. The clinicopathological data of HCC were also analyzed in order to evaluate the clinical implication of aberrant methylation in HCC.

RESULTSMethylation of the 8 TSGs was quite frequent in HCC, with a methylation rate of 95.0% in RASSF1A, 90.0% in APC, 73.3% in GSTP1, 65.0% in p16, 61.6% in RIZ1 and 60.0% in MGMT. Methylation of the 6 genes was more frequent in HCC than that in adjacent tissues (P < 0.05). The methylation rate of MGMT, GSTP1 and RIZ1 in the adjacent tissues was 41.6%, 40.0% and 25.0%, respectively, significantly higher than that in cirrhotic liver (P < 0.05). p16 methylation was more frequently observed in HCC in elderly patients. The frequency of MGMT methylation was tended to be higher in giant HCC than that in the other types of HCC. Patients with MGMT methylation in the tumor were found to have a shorter disease free survival.

CONCLUSIONDifferent frequency of methylation in hepatocellular carcinomas, adjacent liver tissues and cirrhotic livers implies that epigenetic alteration in the hepatocellular carcinogenesis may be a gradually progressive process. Methylation status of MGMT, GSTP1 and RIZ1 may be promising in risk assessment of hepatocellular carcinoma and in early diagnosis. Furthermore, MGMT methylation might be also used as a potential prognostic biomarker for hepatocellular carcinoma patients.

Adult ; Aged ; Base Sequence ; Carcinoma, Hepatocellular ; genetics ; metabolism ; DNA Methylation ; DNA Modification Methylases ; genetics ; metabolism ; DNA Repair Enzymes ; genetics ; metabolism ; DNA, Neoplasm ; genetics ; DNA-Binding Proteins ; genetics ; metabolism ; Disease-Free Survival ; Female ; Follow-Up Studies ; Gene Expression Regulation, Neoplastic ; Genes, Tumor Suppressor ; Glutathione S-Transferase pi ; genetics ; metabolism ; Hepatitis B, Chronic ; genetics ; metabolism ; Histone-Lysine N-Methyltransferase ; Humans ; Liver ; metabolism ; Liver Cirrhosis ; genetics ; metabolism ; Liver Neoplasms ; genetics ; metabolism ; Male ; Middle Aged ; Molecular Sequence Data ; Neoplasm Recurrence, Local ; Nuclear Proteins ; genetics ; metabolism ; Transcription Factors ; genetics ; metabolism ; Tumor Suppressor Proteins ; genetics ; metabolism ; Young Adult

Objective To observe dynamically the response of the retinal ganglion cells (RGCs) following chronic optic nerve compression in cats. Methods Thirty adult cats were randomly divided into 6 groups (n=5): normal control group, sham operation group, 1-week compression group, 2-week compression group, 4-week compression group and 8-week compression group. The chronic optic nerve injury was produced by an inflatable balloon implanted under the optic chiasm. RGCs of all animals were labeled with Dil by retrograde tracing 2 weeks before operation. After each group animals were killed by perfusion, the retina were harvested to observe the pathological changes using the light microscope and electron microscope and the number of RGCs was counted under fluorescence microscope. Results There were three cell layers in normal HE stained retinas of cats with clear limits, named ganglion cell layer, bipolar cell layer and photoreceptor cell layer in sequence from vitreous body to selera. By 4 weeks after optic nerve compression, there were no obvious pathological changes in the retinas, however, at 8 weeks the nuclei of the RGCs became markedly thin, with the larger almost disappearing, and the total thickness of the retinas reduced with the glial cells proliferating. Under electron microscopy, the RGCs of the normal eats had large ovate nuclei with homogeneous karyoplasms. The cytoplasm occupied only small space of the cells, but contained a great of cellular organelle. At 4 and 8 weeks after compression, it was found in the retinal ganglion cells that the components of cytoplasm reduced, the endoplasmic reticulum expanded, the mitochondria was swollen, the vacuole occurred under the plasma membrane, the membrane of nuclei was shrunk and the chromatin was marginated and condensed. The density of the DiI labeled RGCs in the normal group animals ranged from 406 to 527 cells/mm2, with an average of (465±38) cells/mm2 and higher density in the central area than in the peripheral one. The number of the RC, Cs was unchanged by 4 weeks after optic nerve compression, but 8 weeks later, the number declined significantly to (293±32) cells/mm2 by about 37%. Conclusion The RGCs present delayed and secondary degeneration following chronic optic nerve compression, which gives an opportunity to protect the RGCs.