Smart Hip Ultrasound Technology in Screening for Infant Developmental Dysplasia of the Hip / 中山大学学报(医学科学版)

ObjectiveTo develop a deep learning system for early ultrasound screening of developmental dysplasia of the hip （DDH）， a new smart-hip ultrasound technique （S-hip）， and to validate its clinical application. MethodsWe selected 11，100 annotated and reviewed coronal ultrasound images of infant hips between November 2021 and August 2022， 8，100 of which were used for the training set and 3，000 for the test set， to build a S-hip deep learning system. To verify the consistency between the automated measurement by S-hip and the manual measurements by sonographers， 174 standard coronal ultrasound images of 87 infants' bilateral hips were acquired， then α angle， β angle and femoral head coverage （FHC） were measured by S-hip， an ultrasound expert and a resident. The measurement data and the time required for the measurements were recorded and statistically analyzed. Another 100 standard coronal ultrasound images of the hips were randomly selected and measured twice respectively by the ultrasound expert and resident to assess the intra-sonographer repeatability. ResultsThe intraclass correlation coefficient （ICC） （95% CI） values of α angle， β angle and FHC results measured by S-hip and ultrasound expert were 0.799 （0.738， 0.847）， 0.798 （0.737， 0.846） and 0.934 （0.954， 0.975）， respectively. Those values measured by the ultrasound expert and resident were 0.725 （0.645， 0.789）， 0.674 （0.583， 0.748） and 0.931 （0.908， 0.949）， respectively. The mean absolute errors （MAE） of α angle， β angle and FHC results between measurements by S-hip and ultrasound expert were 2.69 °， 4.43 ° and 2.47%， respectively. The time required for measurements by S-hip， ultrasound expert and resident was （1.59±0.36） s， （18.76±2.23） s and （19.45±2.76） s， respectively. The automated measurement by S-hip cost much shorter time than the manual measurements by sonographers and the difference was statistically significant （P<0.001）. The ICC （95% CI） values of α angle， β angle and FHC results between two measurements by the ultrasound expert were 0.943 （0.916， 0.961）， 0.959 （0.940， 0.972）， and 0.981 （0.971， 0.987）， respectively. Those values by the ultrasound resident were 0.884 （0.833， 0.921）， 0.921 （0.884， 0.946）， and 0.962 （0.944， 0.974）. ConclusionThe S-hip based on a deep learning system is a highly reliable automated technique to accurately measure α angle， β angle and FHC. Compared with ultrasound residents， S-hip allows for a more simplified and significantly quicker measurement， which may enhance the widespread use of hip ultrasound screening in infants.

Application of Chlorophyte ChlB Gene and Cyanophyte NIES Gene in the Detection of Drowning-Related Plankton / 法医学杂志

Objective To construct a polymerase chain reaction-capillary electrophoresis （PCR-CE） detection method using ChlB gene and NIES gene, investigate the method's specificity and sensitivity, and to evaluate its application value in drowning diagnosis. Methods The specific primers ChlB and NIES were designed for the conserved sequence of chlorophyte ChlB gene and cyanophyte NIES gene in GenBank to construct PCR-CE detection method; 50 species of standard DNA samples were amplified; the sensitivity was determined by gradient concentration detection of positive standard samples; 25 actual cadaver lung tissue samples （drowned： 20, natural death： 5） were detected, and the simultaneous detection results of microwave digestion-vacuum filtration-automated scanning electron microscopy （MD-VF-Auto SEM） were simultaneously compared. Results The minimum DNA detection concentration of primers ChlB and NIES was 0.161 ng and 0.109 ng, respectively, which could specifically amplify chlorophyte （Chlorella pyrenoidosa） and cyanophyte ［Microcystis aeruginosa （producing and not producing toxin）］ widespread in water. The product fragments were 156 bp and 182 bp, respectively. The results of non-drowning tissues were negative. Conclusion This method has high sensitivity and specificity. It can be applied to the detection of plankton related to drowning and combined with MD-VF-Auto SEM method, can increase the detection range of plankton related to drowning and improve the evidence power of drowning diagnosis.

Genetic Polymorphism and Forensic Application of 47 Autosomal InDel Loci in 5 Chinese Ethnic Groups / 法医学杂志

Objective To investigate the population genetic data of 47 autosomal insertion/deletion （InDel） polymorphism genetic markers involved in AGCU InDel 50 kit in Guangdong Han, Guangxi Zhuang, Guangxi Yao, Guangxi Jing, and Guangxi Mulam, and to evaluate their application in forensic DNA identification. Methods Multiplex amplification of the 768 unrelated individuals from the 5 ethnic groups mentioned above was performed with the AGCU InDel 50 kit. Genotyping was carried out by 3500xL gene analyzer, population genetic parameters were gathered and polymorphism analysis was performed. Results No linkage disequilibrium was found among 47 autosomal InDel loci in the 5 ethnic groups. The distribution of genotype frequency of 47 autosomal InDel loci confirmed to the Hardy-Weinberg equilibrium in Guangdong Han and Guangxi Zhuang. Except for rs139934789, the other 46 loci confirmed to the Hardy-Weinberg equilibrium in Guangxi Yao, Guangxi Jing, and Guangxi Mulam. The results of genetic variation analysis among the populations showed that 1.12% of genetic variation was caused by ethnic group differences. The cumulative discrimination power of 47 autosomal InDel loci for the 5 ethnic groups were all above 0.999 999 999 999 999. The cumulative probability of exclusion for each ethnic group was less than 0.999 9. The two Y-InDels were identified in all male individuals and were absent in all female individuals. Conclusion Except for rs139934789, the other 46 InDel loci have a relatively good genetic polymorphism in the 5 Chinese ethnic groups, and can be used for forensic individual identification and as effective supplements for paternity testing.

Preliminary study on correlation between carotid viscoelasticity and blood flow shear rate / 上海交通大学学报（医学版）

Objective • To examine the carotid viscoelasticity by using ultrasonic shear wave dispersion (USWD) technique, and to preliminarily analyze its correlation with blood flow shear rate. Methods • Forty-five patients of General Surgery Department of Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine from December 2018 to January 2019 were recruited, and divided into the elder group (≥ 50 years old) and the younger group (<50 years old) according to the median age. The carotid viscoelasticity of the patients was examined by USWD technique and the indexes were obtained, including carotid shear wave elasticity (SWER), shear wave dispersion (SWDR), blood flow maximum shear rate (SRmax) and mean shear rate (SRmean). The correlations between SWER, SWDR and blood flow shear rate were analyzed by Pearson correlation, respectively. Results • ① Compared with the younger group, the carotid artery SWER, SWDR, SRmax and SRmean of the patients in the elder group were lower (all P<0.05). ② The SWER and SWDR of carotid artery of all patients were positively correlated with SRmax and SRmean, respectively (all P<0.05). Conclusion • Carotid arterial viscoelastic index based on USWD technique is closely related to the blood flow shear rate, which is expected to provide a new perspective for the study of carotid arterial diseases.

Research Progress on Determination of Drowning Site / 法医学杂志

The bodies found in water are one of the most common types in forensic practice. The dis-covery site of the body is often not the drowning site. However, the determination of drowning site is vital for the identification of victim. Inorganic particles and planktons, such as granular impurities, diatoms and bacteria, are valuable markers for the diagnosis of drowning. By comparing the granular impurities and planktons in tissues and suspicious drowning mediums, the drowning site can be concluded based on their similarity of types and distribution, which has practical applied value. In this paper, the research progress on determination of drowning site is summarized to provide reference for the peers.

A new inflammation marker of chronic obstructive pulmonary disease– adiponectin / 世界急诊医学杂志（英文）

BACKGROUND: This study was undertaken to measure the concentration of adiponectin (APN) in serum and induced sputum in patients with chronic obstructive pulmonary disease (COPD during acute exacerbation (AECOPD) and at stable stage and to determine the role of APN as a marker of inflammation in the pathogenesis of COPD. METHODS: All the patients in this prospective study were enrolled from October 2008 to October 2009, including 30 male AECOPD patients from the emergency department, 30 male stable COPD patients from the department of respiratory diseases, and 30 healthy non-smoking male controls from the department of medical examination. The serum and induced sputum were collected from each patient. All of the patients had normal weight (BMI range 18.5-24.9 kg/m2). Patients with severe bronchial asthma, bronchiectasis or autoimmune disease were excluded. Cell count and classification was performed for the induced sputum. The concentrations of APN, IL-8, IL-6 and TNF-α were measured by ELISA. Pulmonary function was tested among the three groups. Comparisons between the groups were conducted by Student's t test, ANOVA analysis or nonparametric test. Correlation analysis was carried out by Pearson's product-moment correlation coefficient test or Spearman's rank-order correlation coefficient test. RESULTS: The concentrations of APN in the serum or induced sputum in AECOPD patients were significantly higher than those in stable COPD patients or healthy non-smoking controls (P<0.01). The concentration of APN in stable COPD patients was significantly higher than that in healthy non-smoking controls (P<0.01). For the AECOPD patients, APN was positively correlated with IL-8 and TNF-α in the serum and induced sputum (r=0.739, 0.734, 0.852, 0.857 respectively, P<0.05). For the stable COPD patients, APN was also positively correlated with IL-8 and TNF-α in the serum and induced sputum (r=0.751, 0.659, 0.707, 0.867 respectively, P<0.05). In addition, for the AECOPD patients, APN was positively correlated with the percentage of neutrophils in the induced sputum (r=0.439, P<0.05). CONCLUSIONS: APN is involved in the process of systematic and airway inflammation of COPD. This process is related to neutrophils in the airway, IL-8 and TNF-α. APN could be used as a new marker for inflammation of COPD.

First aid strategy for severe traumatic patients in hospital / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To study the emergency management principles of severe trauma in hospital (injury severity score larger than or equal to 16).</p><p><b>METHODS</b>We used "ATP principle" to manage severe traumatic patients. The ATP principle is composed of: 1) attending surgeons offering initial management (A); 2) teamwork commencement immediately after patients admitted to hospital (T); 3) parallel principle, ie, emergency resuscitation, evaluation and laboratory test performed simultaneously (P). Clinical effects before and after applying ATP principle were retrospectively analyzed and compared.</p><p><b>RESULTS</b>During January 1, 2002 to December 31, 2003, 338 patients were treated without applying ATP principle, in which ISS was 25.9+/-6.4, 152 cases died with the mortality being 39.2%, and the time stayed in emergency department and the time to operation room after admission were (102.8+/-16.7) min, (140.3+/-20.6) min, respectively. During January 1, 2004 to December 31, 2005, 438 patients were treated based on ATP principle, in which ISS was 28.6+/-7.8, 87 cases died with the mortality being 19.9%, and the time in emergency department and the time to operation room after admission were (69.5+/-11.5) min, (89.6+/-9.3) min, respectively. ISS showed no significant difference between the two groups (P larger than 0.05) but the mortality, the time stayed in emergency department and the time to operation room after admission were greatly reduced and showed significant difference between the two groups (P less than 0.05).</p><p><b>CONCLUSIONS</b>Applying ATP principle to treat severe traumatic patients can shorten emergency treatment time in hospital and decrease mortality.</p>

Analysis of clinical speciality of invasive fungai infection on 137 cases / 中华急诊医学杂志

Objective To analyze the clinical speciality of invasive fungal infection(IFI)and provide doctors with clinical evidence for early anti-fungal therapy.Method One hundred and thirty-seven patients with 91 male and 46 female,who suffered from invasive fungal infection in ICU from January.1,2000 to June 30, 2006,were enrolled in this study.The age ranged from 17 to 82 years old.Out of 137 patients with IFI,the percentage of albicans candida,glabirate candida,tropicalis candida and parapsilosis candida were 47.4%, 26.3%,20.4% and 3.6%,reseparately.The sputum,urine,blood and other drainages were collected to perform the fungal examination after three days of admission every three days.Results Of 137 patients,42 of them were complicated with hemorrhage,53 patients with IFI developed candida anthema in the chest,abdomen and extremity.,49 patients suffering from IFI had organ dysfunction.The chest image revealed that infiltration caused by IFI especially occurred in apex of lung in some patients.The pathogen analysis displayed that albicans candidiasis easily developed candida anthema,glabirate candidiasis frequently resulted in organ dysfunction,and tropicalis candida led to hemorrhage in some organs.Conclusions The clinical specialty,of IFI caused by candida included hemorrhage,candida anthema,organ dysfunction,and infiltration in apex of lung.

Establishment of a simple and convenient animal model of cardiac arrest for studying cerebral resuscitaion / 中华急诊医学杂志

Objective To establish an simple and convenient animal model of cardiac arrest for studying cerebral resuscitation.Method Clean male Sprague Dawley rats were randomly divided into sham group and experimental group.Cardiac arrest was induced by asphyxiation and ice-cold 0.5 mol KCl with blood flow cut off for 5 minutes.Animals were resuscitated with external cardiopulmonary resuscitation (CPR),mechanical ventilation,and epinephrine injection.Blood pressure,heart rate,successful ratio of resuscitation after 72 hours, time of cardiac arrest (T_(CA)) and return of spontaneous circulation (T_(ROSC)) were recorded.Neural deficit scores (NDS) and levels of maleic dialdehyde (MDA) in plasma were evaluated at 3,6,12,24,48,72 hours after ROSC.The damage score of cortex was measured by transmission electron microscope examination at 3 hours and 72 hours after ROSC.Results All the rats in experimental group had cardiac arrest rapidly.T_(CA) and T_(ROSC) were (137.3?10.2) seconds and (64.4?9.3) seconds,respectively,while the successful rate of resuscitation was 82.5%.The lowest NDS was at 3 hours after ROSC,while the NDS increased gradually.After CPR,the level of MDA in plasma increased significantly,slightly declined at 72 hours after ROSC,but still significantly higher than before the model.Electron microscope examination of cortex showed neuron slightly,organelle and astrocyte,but became better after 72 hours post ROSC.Conclusions The model of cardiac arrest was easy to establish,and the data provided was accurate,which is useful to study the mechanism of cerebral resuscitation.

Preventive effect and clinical significance of garlicin injection on mechanical ventilator-associated low respiratory tract deep-seated fungal infection / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To investigate the preventive effect and clinical significance of garlicin injection on ventilator-associated low respiratory tract deep-seated fungal infection (VRFI) as pneumonia.</p><p><b>METHODS</b>Retrospectively analysis on 147 patients underwent mechanical ventilation in our Intensive Care Unit (ICU) in recently 3 years was conducted. According to the garlicin injection administration was used or not, 79 patients with WVUH (West Virgina University Hospital) score > or = 25 points were selected and divided into the preventive group and the control group, and the differences in baseline conditions, incidence of VRFI and hospital outcome between the two groups were compared.</p><p><b>RESULTS</b>There was no significant difference between the two groups in baseline data as age, sex, APACHE II score, SAPS II score and WVUH score. But the incidence of VRFI in the preventive group was significantly lower than that in the control group (P<0.01). The relative risk in the latter was 2.06 (95% CI, 1.25-3.38). No significant difference was found between the two groups in hospital mortality (P>0.05).</p><p><b>CONCLUSION</b>Garlicin injection can effectively reduce the incidence of VRFI, and is inexpensive, it is an ideal prophylactic anti-fungal drug.</p>