Application progress of machine learning in orthopedic diagnosis and treatment / 国际生物医学工程杂志

In recent years, artificial intelligence-related technologies have been deeply combined with many medical fields, and the intersection of medicine and engineering has become a hot topic. There are problems with heavy data and difficulty making decisions in orthopedic disease diagnosis and treatment. Machine learning is an important method of artificial intelligence. Since it can automatically analyze and predict medical big data, it is widely used in the field of orthopedics. It also assists physicians in completing disease diagnosis and treatment efficiently. In this review paper, the application and progress of machine learning in preoperative, intraoperative, and postoperative diagnosis and treatment in orthopedics are reviewed, providing new ways for exploring more rational diagnosis and treatment strategies.

Application of artificial intelligence technology in fighting against COVID-19 / 中华全科医师杂志

Artificial Intelligence (AI) is an interdisciplinary subject developed on the basis of computer technology, cybernetics, mathematics, philosophy and brain science. The purpose of AI is to study new ways to extend the intelligence of human brain in various fields. In recent years, the rapid development of AI technology has brought innovation to medical science and health care. During the pandemic of coronavirus disease 2019 (COVID-19) AI has been widely used in epidemiological investigation and outbreak prediction, clinical diagnosis and treatment, hospital management, research and development of new drugs and vaccines. The application of AI has reduced the clinical workload and the consumption of medical resources, greatly assisted the battle against COVID-19.This article introduces the progresses on the applications of AI technology to provide information for its further application in the fighting against COVID-19.

Application and research progress of artificial intelligence technology in trauma care / 中华创伤杂志

Multiple injuries caused by trauma have high rates of disability and mortality and are difficult to treat, which have a negative impact on the patients, their families and the society. At present, the medical model of trauma treatment is still inadequate, and the treatment of trauma patients faces great challenges. Artificial intelligence (AI) is an intelligent technology based on machine learning, reinforcement learning and deep learning algorithm, and it has been applied to the treatment of patients with trauma. Its efficient and accurate computer vision, planning and decision-making, and big data statistical analysis not only improve the safety and efficiency in the treatment of trauma, but also reduce the workload of clinicians, which makes up for the deficiency of the traditional model of trauma care. After screening the recent studies of AI in trauma care, the authors review its application in emergency triage, diagnosis, treatment and prevention of war trauma, in order to introduce the latest research progress of AI in trauma care and provide references for future developments.

Application and prospect of Mixed Reality in trauma orthopaedics / 中华创伤骨科杂志

Mixed Reality (MR) is a new digital holographic imaging technology after Virtual Reality (VR) and Augmented Reality (AR). The recent rapid advances in medical MR have brought a new mode of clinical diagnosis and treatment for medical workers. In dealing with complex and changeable situations of injury in trauma orthopaedics, MR provides a new means of diagnosis and treatment for clinicians because it breaks the boundary between a digital world and a real world to present a new individualized and three-dimensional visualization. This paper intends to discuss the application value and prospect of MR in traumatic orthopaedics.

Modified Smith-Petersen approach and internal fixation for Pipkin types I and II femoral head fractures / 中华创伤杂志

Objective:To investigate the efficacy of internal fixation of Pipkin types I and II femoral head fractures through the modified Smith-Petersen (S-P) approach.Methods:A retrospective case control study was conducted to analyze the clinical data of 33 patients with Pipkin types I and II femoral head fractures admitted to Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology from June 2015 to September 2019. There were 22 males and 11 females, aged 20-40 years (mean, 29.5 years). There were 15 patients with Pipkin type I fractures and 18 with Pipkin type II fractures. A total of 22 patients were treated using the modified S-P approach via the sartorius and tensor fascia lata space (modified S-P group) and 11 patients were treated using the modified K-L approach via the posterior superior iliac spine and gluteus maximus (modified K-L group). The operation duration, intraoperative blood loss, postoperative drainage volume, length of hospital stay, numeric rating scales (NRS) for pain assessment at postoperative 15 days, bone healing time, Harris hip joint score at postoperative one month, and complication rate were compared between the two groups.Results:All patients were followed up for 1-24 months (mean, 6.5 months). The operation duration, blood loss, drainage rate and length of hospital stay in modified S-P group were better than those in modified K-L group [(71.7±7.3)minutes vs. (112.1±6.7)minutes, (55.9±6.2)ml vs. (99.4±8.7)ml, (91.2±5.9)ml vs. (121.3±7.0)ml, (6.0±1.5)days vs. (10.5±1.6)days] ( P<0.01). There were no significant differences between two groups in terms of NRS, bone healing time and Harris score ( P>0.05). The incidence of complications was similar between the two groups, including femoral head ischemia necrosis, traumatic arthritis, and heterogenous ossification ( P>0.05). Conclusion:For Pipkin types I and II femoral head fractures, the modified modified S-P approach is superior to modified K-L approach in aspects of operative time, intraoperative blood loss, postoperative drainage and length of hospital stay.

Multi-site analysis of acute effects of air pollutants combination exposure on mortality in Jiangsu Province, China / 中华预防医学杂志

Objective@#To explore the acute effect of fine particulate matters (PM2.5), O3, NO2 on daily non-accidental mortality, cardiovascular disease mortality and respiratory mortality data in thirteen cities of Jiangsu province.@*Methods@#Daily average concentrations of non-accidental mortality, cardiovascular disease mortality, respiratory mortality data and environmental data were collected from January 1, 2015 to December 31, 2017 in thirteen cities of Jiangsu Province. Daily air quality, mortality and meteorology data were collected from the Information System of Air Pollution and Health Impact Monitoring of Chinese Center for Disease Control and Prevention. We used generalized additive model to evaluate the association between daily concentrations of air pollutants and mortality at single-city level and multi-city level, after adjusting the long-term and seasonal trend, as well as meteorological factors and the effect of "days and weeks" . A multivariate Meta-analysis with random effects was applied to estimate dose-response relationship between air pollutants and mortality.@*Results@#At multi-city level, per interquartile range increase of PM2.5, O3, NO2 was associated with an increase of 1.10% (95%CI: 0.66%, 1.54%), 0.59% (95%CI: 0.18%, 1.00%), 2.00% (95%CI: 1.29%, 2.72%) of daily non-accidental mortality respectively; 1.01% (95%CI: 0.63%, 1.38%), 0.66% (95%CI: 0.02%, 1.30%), 1.62% (95%CI: 1.00%, 2.23%) of daily cardiovascular mortality respectively; 1.09% (95%CI: 0.35%, 1.82%), 0.44% (95%CI: -0.29%, 1.16%), 2.75% (95%CI: 1.42%, 4.08%) of daily respiratory mortality respectively. The air pollutants effect varied across different cities. The strongest effect of PM2.5 was current day (excess risk (ER)=1.10%, 95%CI: 0.66%, 1.54%)), the strongest effect of O3 was 2-day lag (ER=1.82%, 95%CI: 0.69%, 2.97%) and the strongest effect of NO2 was 1-day lag (ER=2.09%, 95%CI: 1.34%, 2.83%) of daily non-accidental mortality respectively.@*Conclusion@#The increases of PM2.5 and NO2 concentration could result in the increases of daily non-accidental mortality, cardiovascular disease mortality and respiratory mortality. O3 could result in the increases of daily non-accidental mortality and cardiovascular disease mortality. The acute effects for non-accidental mortality from high to low were NO2, PM2.5 and O3, and the strongest effect of PM2.5 was current day. O3 and NO2 had lagged effects.

Study on the molecular mechanism of miR-200b-3p regulates the proliferation,invasion,migration and apoptosis of pancreatic cancer cells by down-regulating VEGFA / 国际肿瘤学杂志

Objective To explore the molecular mechanism of miR-200b-3p regulates the prolifera-tion,invasion,migration and apoptosis of pancreatic cancer cells by targeting vascular endothelial growth factor A (VEGFA). Methods The expression of miR-200b-3p in pancreatic cancer tissues and cell lines was detec-ted by quantitative real-time fluorescence PCR (qRT-PCR). Pancreatic cancer PANC-1 cells were divided into NC group,miR-200b-3p mimic group,si-VEGFA group and si-VEGFA + miR-200b-3p inhibitor group. The proliferation,migration and invasion of PANC-1 cells were measured by CCK-8 and Transwell assay. The apop-tosis of PANC-1 cells was detected by Annexin V-FITC/ PI double staining flow cytometry assay. The targeted relationship of miR-200b-3p and VEGFA was estimated by dual luciferase reporter gene assay and Western blotting. Results The expression of miR-200b-3p in pancreatic cancer tissues and cell lines was decreased. After miR-200b-3p was overexpressed in PANC-1 cells for 48 h,the cell viabilities of PANC-1 cells in NC group and miR-200b-3p mimic group were 1. 250 ± 0. 028 and 0. 983 ± 0. 044,the numbers of migrated cells were 402. 700 ± 21. 530 and 158. 000 ± 17. 620,the numbers of invaded cells were 478. 300 ± 31. 050 and 170. 000 ± 32. 470,and the cell apoptosis rates were (5. 280 ± 0. 352)％ and (7. 430 ± 0. 393)％ . The cell viability,migration and invasion of PANC-1 cells in miR-200b-3p mimic group were significantly decreased than those in NC group (t = 5. 060,P = 0. 007;t = 8. 796,P = 0. 001;t = 6. 863,P = 0. 002). The cell apop-tosis rate in miR-200b-3p mimic group was significantly higher than that in NC group (t = 4. 076,P = 0. 015). The fluorescence intensity in VEGFA-WT group was 1. 000 ± 0. 027,which was significantly higher than that in VEGFA-WT + miR-200b-3p mimic group (0. 632 ± 0. 048;t = 6. 637,P = 0. 003). The fluorescence intensi-ties in VEGFA-MUT group and VEGFA-MUT + miR-200b-3p mimic group were 1. 000 ± 0. 049 and 0. 868 ± 0. 047,with no statistically significant difference (t = 1. 944,P = 0. 124). After miR-200b-3p was overex-pressed in PANC-1 cells for 48 h,the expressions of VEGFA in NC group and miR-200b-3p mimic group were 1. 000 ± 0. 058 and 0. 762 ± 0. 020,respectively. The expression level in miR-200b-3p mimic group was lower than that in NC group (t = 3. 908,P = 0. 017). After transfection of PANC-1 cells with si-VEGFA or si-VEGFA + miR-200b-3p inhibitor for 48 h,the cell viabilities of PANC-1 cells in NC group,si-VEGFA group and si-VEGFA + miR-200b-3p inhibitor group were 1. 300 ± 0. 058,0. 943 ± 0. 047 and 1. 143 ± 0. 023,the numbers of migrated cells were 446. 000 ± 17. 350,206. 300 ± 19. 360 and 428. 300 ± 30. 330,and the numbers of invaded cells were 510. 300 ± 24. 550,175. 700 ± 24. 290 and 473. 700 ± 35. 530,with statisti-cally significant differences (F = 15. 830,P = 0. 004,F = 33. 530,P = 0. 001,F = 38. 860,P < 0. 001). The cell viability,migration and invasion of PANC-1 cells in si-VEGFA group were significantly decreased than those in NC group (P = 0. 003,P < 0. 001,P < 0. 001). There was no significant difference between si-VEGFA + miR-200b-3p inhibitor group and NC group (P = 0. 107,P = 0. 854,P = 0. 671). The cell apop-tosis rates in NC group,si-VEGFA group and si-VEGFA + miR-200b-3p inhibitor group were (3. 810 ± 0. 577)％,(7. 373 ± 0. 482)％ and (3. 650 ± 0. 514)％,with a statistically significant difference (F =16. 020,P = 0. 004). The cell apoptosis rate in si-VEGFA group was significantly higher than that in NC group (P = 0. 007),but there was no significantly difference between si-VEGFA + miR-200b-3p inhibitor group and NC group (P = 0. 975). Conclusion miR-200b-3p suppresses the proliferation,invasion and migration and promotes the apoptosis of pancreatic cells by down-regulating VEGFA.

Study on the molecular mechanism of miR-200b-3p regulates the proliferation, invasion, migration and apoptosis of pancreatic cancer cells by down-regulating VEGFA / 国际肿瘤学杂志

Objective@#To explore the molecular mechanism of miR-200b-3p regulates the proliferation, invasion, migration and apoptosis of pancreatic cancer cells by targeting vascular endothelial growth factor A (VEGFA).@*Methods@#The expression of miR-200b-3p in pancreatic cancer tissues and cell lines was detected by quantitative real-time fluorescence PCR (qRT-PCR). Pancreatic cancer PANC-1 cells were divided into NC group, miR-200b-3p mimic group, si-VEGFA group and si-VEGFA+ miR-200b-3p inhibitor group. The proliferation, migration and invasion of PANC-1 cells were measured by CCK-8 and Transwell assay. The apoptosis of PANC-1 cells was detected by Annexin V-FITC/PI double staining flow cytometry assay. The targeted relationship of miR-200b-3p and VEGFA was estimated by dual luciferase reporter gene assay and Western blotting.@*Results@#The expression of miR-200b-3p in pancreatic cancer tissues and cell lines was decreased. After miR-200b-3p was overexpressed in PANC-1 cells for 48 h, the cell viabilities of PANC-1 cells in NC group and miR-200b-3p mimic group were 1.250±0.028 and 0.983±0.044, the numbers of migrated cells were 402.700±21.530 and 158.000±17.620, the numbers of invaded cells were 478.300±31.050 and 170.000±32.470, and the cell apoptosis rates were (5.280±0.352)% and (7.430±0.393)%. The cell viability, migration and invasion of PANC-1 cells in miR-200b-3p mimic group were significantly decreased than those in NC group (t=5.060, P=0.007; t=8.796, P=0.001; t=6.863, P=0.002). The cell apoptosis rate in miR-200b-3p mimic group was significantly higher than that in NC group (t=4.076, P=0.015). The fluorescence intensity in VEGFA-WT group was 1.000±0.027, which was significantly higher than that in VEGFA-WT+ miR-200b-3p mimic group (0.632±0.048; t=6.637, P=0.003). The fluorescence intensities in VEGFA-MUT group and VEGFA-MUT + miR-200b-3p mimic group were 1.000±0.049 and 0.868±0.047, with no statistically significant difference (t=1.944, P=0.124). After miR-200b-3p was overexpressed in PANC-1 cells for 48 h, the expressions of VEGFA in NC group and miR-200b-3p mimic group were 1.000±0.058 and 0.762±0.020, respectively. The expression level in miR-200b-3p mimic group was lower than that in NC group (t=3.908, P=0.017). After transfection of PANC-1 cells with si-VEGFA or si-VEGFA + miR-200b-3p inhibitor for 48 h, the cell viabilities of PANC-1 cells in NC group, si-VEGFA group and si-VEGFA + miR-200b-3p inhibitor group were 1.300±0.058, 0.943±0.047 and 1.143±0.023, the numbers of migrated cells were 446.000±17.350, 206.300±19.360 and 428.300±30.330, and the numbers of invaded cells were 510.300±24.550, 175.700±24.290 and 473.700±35.530, with statistically significant differences (F=15.830, P=0.004, F=33.530, P=0.001, F=38.860, P<0.001). The cell viability, migration and invasion of PANC-1 cells in si-VEGFA group were significantly decreased than those in NC group (P=0.003, P<0.001, P<0.001). There was no significant difference between si-VEGFA + miR-200b-3p inhibitor group and NC group (P=0.107, P=0.854, P=0.671). The cell apoptosis rates in NC group, si-VEGFA group and si-VEGFA+ miR-200b-3p inhibitor group were (3.810±0.577)%, (7.373±0.482)% and (3.650±0.514)%, with a statistically significant difference (F=16.020, P=0.004). The cell apoptosis rate in si-VEGFA group was significantly higher than that in NC group (P=0.007), but there was no significantly difference between si-VEGFA + miR-200b-3p inhibitor group and NC group (P=0.975).@*Conclusion@#miR-200b-3p suppresses the proliferation, invasion and migration and promotes the apoptosis of pancreatic cells by down-regulating VEGFA.

Value of serum and biliary carcinoembryonic antigen, carbohydrate antigen 19-9, and carbohydrate antigen 24-2 in diagnosis of benign and malignant biliary obstructive diseases / 临床肝胆病杂志

Objective To investigate the value of serum and biliary carcinoembryonic antigen (CEA),carbohydrate antigen 19-9 (CA19 -9),and carbohydrate antigen 24-2 (CA24-2) in the diagnosis of benign and malignant biliary obstructive diseases.Methods A total of 40 patients with benign biliary obstructive diseases and 40 with malignant ones,who were diagnosed and treated in The Central Hospital of Enshi Autonomous Prefecture from June 2015 to December 2016,were enrolled.Serum samples collected on admission and bile samples collected during surgery were used to measure the levels of tumor markers CEA,CA19-9,and CA24-2.The t-test was used for comparison between two groups,and a receiver operating characteristic (ROC) curve analysis was performed for each tumor marker in the diagnosis of benign and malignant biliary obstructive diseases.Results Compared with the benign group,the malignant group had significantly higher serum levels of CA19-9 and CA24-2 (t =5.899 and 3.223,both P ＜ 0.05) and biliary levels of CEA,CA19-9,and CA24-2 (t =3.304,7.615,and 7.279,all P ＜0.05).In the patients with malignant biliary obstructive diseases,the levels of CEA,CA19-9,and CA24-2 in the bile were significantly higher than those in serum (t =3.297,4.975,and 3.993,all P ＜ 0.05).Biliary CA24-2 had the highest Youden index (0.75) and area under the ROC curve (AUC) (0.946);biliary CA19-9 had a Youden index of 0.74 and an AUC of 0.937,and serum CA19-9 had a Youden index of 0.68 and an AUC of 0.898.These three indices had a relatively high diagnostic value.Combined measurement of biliary CA24-2,serum CA19-9,and biliary CA19-9 had a sensitivity of 94.75％,a negative predictive value of 93.50％,and a Youden index of 0.82 in the diagnosis of malignant biliary obstructive diseases.Conclusion Biliary tumor markers have a great value in the diagnosis of malignant biliary obstructive diseases,and the combined measurement of biliary CA24-2,serum CA19-9,and biliary CA19-9 has the highest value in the differential diagnosis of benign and malignant biliary obstructive diseases.

Clinical significance of the expression of D-amino acid oxidase gene in hepatocellular carcinoma tissues / 国际检验医学杂志

Objective To study the clinical significance of the expression of D-amino acid oxidase(DAO) in hepatocellular carcinoma(HCC) tissues.Methods The gene expression profiles and related clinical data of 214 HCC cases were collected.Univariate and multivariate analyses were conducted to investigate the association between DAO expression levels,clinical traits,the prognosis.Results Univariate analysis indicated that there were a lower level of blood alpha fetoprotein(AFP,P=0.001),a smaller number of nodules(P=0.042),a better TNM stage(P=0.014),a lower metastasis risk(P=0.001) and a better prognosis(P=0.011)in the samples with high DAO expression.Multivariate analysis also indicated a lower AFP level(OR:0.162,95%CI:0.078-0.336) and metastasis risk(OR:0.140,95%CI:0.069-0.284) in the samples with high DAO expression,as well as a better prognosis(OR:0.833,95%CI:0.700-0.992).Conclusion DAO expression was associated with blood AFP levels,metastasis risk and prognosis in HCC,and its high expression was a protective factor for HCC.

Chemical constituents of the stem bark of Bombax ceiba L / 中国药科大学学报

@#Thirteen compounds were isolated from the stem bark of Bombax ceiba L. by silica gel, and Sephadex LH-20 column chromatography. Their structures were identified by spectroscopic analysis as: lupeol(1), lupeone(2), betulinic acid(3), zeorin(4), oleanolic acid(5), 3-oxooleanolic acid(6), cleomiscosin A(7), (±)-lyoniresinol(8), desmosterol(9), stigma-3, 6-dione(10), (+)-lasiodiploidin(11), aurantiamide acetate(12), and(2S, 3S, 4R, 10E)-2-［(2R)-2-hydroxytetracosanoylamino］-10-octadecene-1, 3, 4-triol(13). Among them, compounds 3, 4, 6, 7-13 were isolated from this plant for the first time.

Analysis of the clinical effect of biliary-enteric anastomosis and biliary stent to palliative treatment of malignant obstructive jaundice / 中国医师进修杂志

Objective To analyze the clinical effect of biliary-enteric anastomosis and biliary stent to palliative treatment of malignant obstructive jaundice.Methods A total of 40 patients with inoperable malignant obstructive jaundice were enrolled in this study,and 20 patients were performed biliary stent placement (stent group),simultaneously 20 patients were performed biliary-enteric anastomosis (operation group).The fatality rate after operation,the level of total bilirubin before treatment and after treatment for 4,7,14 d,the rate of hyperpyrexia,nausea and vomiting,postoperative recurrence of jaundice were compared between two groups.Results There were no dead in two groups.The level of total bilirubin was decreased after treatment,and there was no significant in two groups before treatment and after treatment for 4,7,14 d (P ＞ 0.05).The rate of hyperpyrexia in operation group was significantly lower than that in stent group (0 vs.4/20) (P ＜ 0.05).Conclusion For palliative treatment of malignant obstructive jaundice,the biliary-enteric anastomosis should be performed first if there is no significant contraindication.