Objective To investigate the effect of colquhounia root tablet(CRT)on hyperglucose-in-duced epithelial-mesenchymal transition(EMT)in renal tubular epithelial cells(HK-2),and to explore its possible action mechanism.Methods HK-2 was cultured in vitro,and HK-2 was divided into the following five groups:control group(CON group),hyperosmolar group(MA group),high glucose group(HG group),high sugar+CRT group(HG+CRT group),high sugar+phosphatidylinositol 3 kinase inhibitor group(HG+LY29400 group),high sugar+CRT+phosphatidylinositol 3 kinase inhibitor group(HG+CRT+LY29400).The real time immunofluorescence quantitative PCR(qPCR)was used to detect the mRNA ex-pression levels of E-cadherin,α-smooth muscle actin(α-SMA)and phosphatase and tensin homolog(PTEN)in each group.Western-blot was used to detect the protein expression levels of PTEN,phosphatidylinositol 3 kinase(PI3K),protein kinase B(Akt),phosphorylated protein kinase B(p-Akt),E-cadherin and α-SMA in each group.Results Compared with the CON group,the protein and mRNA expression levels of α-SMA,p-Akt protein expression level and p-Akt/Akt ratio in the HG group were increased,the protein and mRNA ex-pression levels of E-cadherin and PTEN were decreased,and the differences were statistically significant(P＜0.05).Compared with the HG group,the α-SMA protein and mRNA expression levels in the HG+CRT group were decreased,while the E-cadherin protein and mRNA expression levels were increased,and the differences were statistically significant(P＜0.05).Compared with the HG+CRT group,there was no significant differ-ence in the E cadherin,α SMA,PTEN,P13K and Akt protein expression levels and p-Akt/Akt ratio in the HG+CRT+LY29400 group had no significant differences(P＞0.05).while the expression level of p-Akt protein was increased,and the difference was statistically significant(P＜0.05).Conclusion In vitro,CRT could re-verse hyperglucose-induced renal tubular epithelial cell EMT via the PTEN/PI3K/Akt signaling pathway.

Objective:To establish and validate a gallstones classification method based on deep learning.Methods:A total of 618 gallstones samples were collected from East Hospital Affiliated to Tongji University, and 1 023 high-definition cross-sectional gallstones profile images were captured to construct a cross-sectional gallstones profile image dataset. Based on the traditional eight-category gallstones classification method, a lightweight network model, MobileNet V3, was trained using deep learning and transfer learning methods. The classification performance of MobileNet was evaluated using a confusion matrix with metrics such as accuracy rate, precision rate, F1 score, and recall rate. The MobileNet V3 was improved and further validated using accuracy and loss values.Results:The accuracy rate (94.17%), precision rate (94.03%), F1 score (92.96%) and recall rate (92.99%) of the improved MobileNet V3 model were better than other networks. The improved MobileNet V3 model achieved the highest accuracy rate (94.17%) in gallstones profile classification and was validated by the test set. The confusion matrix showed a weighted average of accuracy rate (92.0%), precision rate (92.6%), and F1 score (92.2%) for each category of gallstones.Conclusions:Based on deep learning, a high-accuracy gallstones classification method is proposed, which provides a new idea for the intelligent identification of gallstones.

Objective To evaluate the accuracy of three-dimensional(3D)reconstruction of the gallbladder volume based on computed tomography(CT)images and study the biomechanical changes in gallbladder motility to explore the relationship between gallbladder dynamics and gallstone formation.Methods A method for calculating gallbladder volume based on CT 3D reconstruction of The gallbladder model was proposed and compared with the ellipsoid method.A finite element model of the gallbladder was constructed for fluid dynamics analysis to simulate changes in gallbladder motor function under different angles of convergence between the cystic and common bile ducts and in the presence of gallstones.Results The mean errors of the specific gallbladder model volume and ellipsoid volume of the 50 patients were 7.26％and 25.35％,respectively.During the refilling period,the maximum pressure,deformation,and flow velocity of the pear-shaped gallbladder were significantly higher than those of the gourd-shaped gallbladder.The angle between the gallbladder and common bile duct had little effect on the bile flow pattern,and the maximum bile flow rate was reached at an angle of 120°.The bile flow velocity of the gallbladder with calculus was lower than that of the gallbladder without calculus,and there was a vortex near the calculus.Conclusions Calculating gallbladder volume based on CT 3D reconstruction is more accurate than the ellipsoid method.Compared with a pear-shaped gallbladder,a gourd-shaped gallbladder has lower gallbladder wall contraction,bile flow rate,and poor motor function.The bile flow rate in the gallbladder is slow,which is more likely to lead to the enlargement of gallstones or the formation of new gallstones.

Objective:To investigate the clinical characteristics, differential diagnosis, treatments and prognosis of facial nerve hemangioma and schwannoma at genicular ganglion, so as to provide reference for clinical diagnosis and treatments of facial nerve tumor at genicular ganglion.Methods:Clinical data of 13 patients with facial nerve tumors at genicular ganglion confirmed by postoperative pathology in the Ninth People′s Hospital affiliated to Shanghai Jiaotong University School of Medicine from March 2018 to April 2020 were retrospectively analyzed, including seven cases of hemangioma and six cases of schwannoma. There were eight males and five females. Their ages ranged from 20 to 65, with an average age of 40. The course of disease ranged from 3 to 118 months, with an average of 52 months. All the patients underwent preoperative HRCT of the temporal bone and facial nerve dynamic contrast-enhanced(DCE) MRI examinations. All the patients had detailed surgical procedures and at least one-year postoperative follow-up.Results:On HRCT of the temporal bone, (4/7) hemangioma at geniculate ganglion showed characteristic honeycomb appearance, while 6/6 schwannoma and 3/7 hemangiomas showed expansive bone changes. On DCE-MRI, geniculate ganglion hemangioma (7/7) showed characteristic "point-to-surface" enhancement, and schwannoma (6/6) showed characteristic "face-to-surface" enhancement. For five hemangioma-patients with HB-Ⅱ-Ⅳ before surgery, the facial nerve anatomy was completely preserved through transcanal endoscopic approach(TEA), and the facial nerve function improved one year after surgery (two cases of HB-I, two cases of HB-Ⅱ, and one case of HB-Ⅲ). For two patients, with preoperative facial nerve function HB-Ⅴ-Ⅵ, since their tumors was inseparable from the nerves, they were performed with facial nerve anastomosis during the surgery, and the facial nerve function was improved to HB-Ⅳ level one year after surgery. For six patients with meningioma whose facial nerve function was greater than or equal to HB-Ⅲ, based on the preoperative hearing level, the involved segments, and duration of facial paralysis, three of them were conducted surgeries through middle cranial fossa approach, one by translabyrinthine approach, and one via mastoid approach. Two patients among them with complete facial paralysis over three years preoperatively were not performed facial nerve anastomosis after total resections of the tumors, and there was no improvement in facial nerve function one year after surgery. Three patients underwent facial nerve anastomosis after total tumor resections, and their facial nerve function was HB-Ⅲ in one patient, HB-Ⅳ in two patients one year after surgery. One patient (preoperative HB-Ⅲ) had a normal hearing level preoperatively, and the tumor involved the labyrinth segment. To protect the hearing, partial tumor was resected through the middle cranial fossa approach, and facial nerve function improved to HB-Ⅱ one year after surgery.Conclusions:Temporal bone HRCT combined with DCE-MRI are useful for the differential diagnosis of hemangioma and schwannoma at geniculate ganglion and provide references for preoperative clinical decision makings. It is extremely necessary to select the appropriate surgical approach based on the patient′s hearing and involved segments. For geniculate ganglion hemangioma, early surgery can improve the possibilities of anatomical integrity of facial nerve, thereby improving facial nerve function postoperatively.TEA is a kind of surgical method worth consideration, with the characteristics of minimally invasive, favorable postoperative features, and so on. For schwannoma, one-stage functional reconstruction of the facial nerve is recommended during the resection of the tumors because of the inevitable damage to the anatomical integrity of the facial nerve.

Pulmonary fluid refers to a thin and continuous liquid layer mainly consisting of airway mucus and lining liquid on the inner surface of alveoli, which is essential for maintaining a healthy lung. The clinical significance of rheological properties of pulmonary fluid in airway stability, pulmonary barrier and clearance functions, ventilator induced lung injury and surfactant replacement therapy in infant respiratory distress syndrome was introduced in this paper. Furthermore, a variety of classical methods for measuring surface tension and liquid viscosity, such as Langmuir-Wilhelmy balance, captive bubble method, glass capillary viscometer and rotational viscometer, and emerging techniques (e.g. particle tracking microrheometer and axisymmetric drop shape analysis) were reviewed, and their advantages and drawbacks were also compared, in order to provide an important reference for the assisted diagnosis and treatment of lung diseases in clinical practice.

Objective To evaluate the imaging findings of thoracic Castleman's disease (CD)to improve the diagnostic accuracy. Methods The imaging findings of 14 cases of thoracic CD confirmed by pathology were analyzed retrospectively.Plain and dynamic contrast-enhanced CT scans were performed in all patients before surgery.Results Among the 14 cases,10 cases were hyaline vascular type (HVT)and other 4 cases were plasma cell type (PCT).HVT-CD showed well-define,homogeneous soft-tissue lesion with different sizes of lymph nodes around the lesions in 2 cases,mottled calcification in 2 cases and coarse calcification in 1 case.Dynamic enhanced CT showed HVT-CD had obvious enhancement in arterial phase,and sustained enhancement in venous phase and delayed phase.PCT-CD all showed enlarged lymph nodes in the mediastinum and bilateral axillary,associated with interstitial pneumonia,pulmonary nodules,ground glass opacity and pleural effusion,with marked and sustained enhancement 1 case.Conclusion Thoracic HVT-CD presents equal density on CT plain scan,and obvious and durative enhanement on multiphase contrast-enhanced CT,which can be accompanied by lymphnodes around the lesions and intratumoral calcification.With the above imaging findings,we should consider the possibility of HVT-CD.CT features of PCT-CD are non-specific,a comprehensive evaluation of the clinical data should be combined,but the obviously enhanced PCT-CD can be diagnosed.

It has been over 200 years since the acoustic neuroma(AN) was firstly reported.From simply describing its symptoms to the decline of surgical mortality,the protection of facial and acoustic nerve function,as well as the improvement of the patients' quality of life.Physicians made efforts on evolving the diagnostic techniques and treatment strategies,and a better understanding of AN's development.The current major managements of AN are microsurgery,stereotactic radiosurgery,and follow-up.We reviewed the AN's history and prospected its future managements.

According to the clinical requirements of cardiopulmonary bypass surgery, this paper established a simulation system for cardiac surgery which consists of venous reservoir, variable balance chamber, blood suction bag, ventricle suction bag, resistance valves, pressure gauges and tubings. Using the proposed system, perfusionists can mimic the implementation of pre-established surgery strategy, predict various abnormal conditions in the operation, and accordingly take the urgent actions so as to improve the success rate of surgery and to ensure the safety of patients.
Cardiac Surgical Procedures ; instrumentation ; Cardiopulmonary Bypass ; instrumentation ; Catheters, Indwelling ; Heart ; Humans ; Suction

According to the clinical requirements of cardiopulmonary bypass surgery, this paper established a simulation system for cardiac surgery which consists of venous reservoir, variable balance chamber, blood suction bag, ventricle suction bag, resistance valves, pressure gauges and tubings. Using the proposed system, perfusionists can mimic the implementation of pre-established surgery strategy, predict various abnormal conditions in the operation, and accordingly take the urgent actions so as to improve the success rate of surgery and to ensure the safety of patients.

Using extracorporeal circulation for cardiopulmonary bypass is the first step for the successful cardiac surgery, and the blood pump is the key component in extracorporeal circulation devices, the control and measurement of mechanical-fluid parameters such as flow rate and pressure are very important to guarantee the successful cardiac surgery. This paper reviews several control methods of the blood pump based on the flow rate/pressure, heart rate, ventricular work and blood assist index, and also discusses the direct and indirect measurements of the flow rate and pressure. This review concludes with the main possible trends for the further development of the blood pump control and testing methods.
Equipment Design ; Extracorporeal Circulation ; instrumentation ; Heart-Assist Devices