Abstract:Motion sickness refers to a multi-system physiological syndrome caused by abnormal acceleration and motion vision scene immersion. It occurs commonly in transportation, military operations, space exploration and other fields. This article reviews recent advances in mechanism, prediction and assessment as well as control measures for motion sickness, and discusses possible research direction of motion sickness in the future. The biological basis for motion sickness sensory conflict theory has been expanded; genomic sequencing and artificial intelligence techniques have been used as novel tools for motion sickness prediction and evaluation. Acclimatization training, anti-motion sickness medication and non-drug symptom control measures used in combination is the key for motion sickness prevention and treatment.

Abstract:Objective To observe the changes of plasma gastrointestinal hormones in motion sickness sensitive and insensitive individuals before and after vertical oscillation stimulation, and to construct a susceptibility prediction model for motion sickness. Methods A total of 60 healthy male volunteers were enrolled to receive sinusoidal vertical oscillation stimulation for 45 min. The motion sickness susceptibility questionnaire (MSSQ) was filled out before the experiment. Immediately after motion, the severity of motion sickness was evaluated by Graybiel scale. The motion sickness sensitive (Graybiel score≥8 and MSSQ susceptibility index＞21, n＝15) and insensitive (Graybiel score≤2 and MSSQ susceptibility index＜5, n＝15) participants were screened. Plasma levels of glucagon-like peptide-1 (GLP-1), cholecystokinin (CCK), leptin, ghrelin, neuropeptide Y (NPY) and orexin A (OXA) were detected by enzyme-linked immunosorbent assay before and after vertical oscillation stimulation. Logistic regression model was used to analyze the predictive effect of plasma gastrointestinal hormone levels on susceptibility to motion sickness, and a combined predictive model was established. Receiver operating characteristic (ROC) curve was used to analyze predictive value of the model. Results Ghrelin and CCK levels were significantly increased in the sensitive group after stimulation compared with those before stimulation (both P＜0.01), while NPY and leptin levels were significantly decreased (both P＜0.01). Similar results were also observed when compared with the insensitive group after stimulation. Multivariate logistic regression analysis showed that plasma ghrelin, CCK and NPY were independent predictors of susceptibility to motion sickness. The established susceptibility prediction model for motion sickness was logit(P)＝－0.051×ghrelin＋0.060×NPY－0.169×CCK＋33.397. ROC curve analysis showed that area under curve (AUC) value of the prediction model was 0.988, the sensitivity and specificity were 100.0% and 93.3%, respectively, and the prediction effect was better than ghrelin, CCK and NPY alone (AUC＝0.792, 0.880, 0.838). Conclusion The changes of peripheral gastrointestinal appetite regulating hormone levels may be related to the susceptibility to motion sickness. The combined use of these indicators can predict the susceptibility to motion sickness.

Abstract:Objective To explore the improving effects of motion sickness acclimatization training methods, namely sinusoidal vertical oscillation stimulation and sinusoidal vertical oscillation stimulation combined with visual virtual reality (VR) swell stimulation, on cognitive performance of individuals with extremely severe motion sickness. Methods A total of 90 individuals with extremely severe motion sickness screened by the Graybiel score during 6 h navigation were randomly divided into vertical group, vertical＋VR group, and control group (n＝30). The abilities of vigilance, memory, rapid calculation, information processing and visual manipulation were evaluated before and after the acclimatization training using a self-developed cognitive performance evaluation software. Results On the 1st day of training, the numbers of missed targets of the vertical group and vertical＋VR group were increased in the vigilance test; the reaction time was prolonged in the short-term memory, rapid calculation, information processing and visual manipulation tasks; and the efficiency of rapid calculation was reduced. After acclimatization training, the numbers of missed targets were reduced to the baseline level in the vertical and vertical＋VR groups, and the reaction time in the short-term memory, rapid calculation, information processing and visual manipulation tasks and the efficiency of rapid calculation were improved. Conclusion Motion sickness caused by vertical oscillation stimulation or vertical oscillation combined with visual VR swell stimulation can decrease vigilance, short-term memory, rapid calculation, information processing and visual manipulation abilities. Motion sickness acclimatization training can significantly improve the above cognitive abilities.

Abstract:Objective To study the acclimatization time and effects for preventing motion sickness under sinusoidal vertical oscillation stimulation, visual virtual reality (VR) swell stimulation, and their combined stimulation. Methods Totally 120 individuals with extremely severe motion sickness during 6 h navigation were randomly divided into 4 groups (n＝30): vertical group, VR group, vertical＋VR group, and control group. The severity of symptoms during the training period was assessed daily by Graybiel scale, and the number of drops from flexible treadmill in the VR group was recorded. The Graybiel score of 0 for 3 d and/or the number of drops for 0 were considered as complete acclimatization. The training effect was validated by navigation under more severe sea conditions. Results The Graybiel scores of the vertical group and vertical＋VR group, as well as the number of drops of the VR group were decreased with the increase of training days, and reached the acclimatization level on the 3^rd, 5^th, and 2^nd training day, respectively. The longest acclimatization time in the vertical, vertical＋VR, and VR groups was 8, 8, and 5 d, with an average acclimatization time of 3.6, 3.9, and 2.7 d, respectively; the acclimatization rates within 5 d were 93.33% (28/30), 76.67% (23/30), and 100.00% (30/30), respectively; the proportions of individuals with effective acclimatization training in the verification voyage were 86.67% (26/30), 96.67% (29/30), and 66.67% (20/30), respectively; and the training efficiency was 85.19%, 96.30%, and 62.97%, respectively. Conclusion Three training methods all have effects on motion sickness acclimatization, and the acclimatization period is 5-8 d. The acclimatization effects of the vertical oscillation and vertical oscillation＋VR training are better than the VR training.

Abstract:Objective To observe the effect of the supine-posture ripple wood training in preventing motion sickness caused by linear acceleration. Methods Totally 61 motion sickness sensitive males were screened by a vertical oscillation simulator and divided into mildly sensitive group (Graybiel score 1-15, n＝28) and severely sensitive group (Graybiel score ≥ 16, n＝33). The participants in the 2 groups received 5-d ripple wood training, 30 min/d. The movement frequency of the ripper wood was maintained at 0.25-0.35 Hz, with an acceleration of 0.15-0.25 g. Graybiel score during the training period was recorded. The static balance function test was conducted before and after training on the 1^st and 5^th day. Results During the training period, the Graybiel scores and motion sickness incidence in the severely sensitive group were decreased with the increase of training days, and all participants achieved complete acclimatization on the 4^th day. The Graybiel scores of the mildly sensitive group were low during the whole period, and the complete acclimatization period was 2 d. There was no significant difference in the sway area of the severely sensitive group in static balance function test before and after training (P＞0.05). The mean velocity of the severely sensitive group in static balance function test was significantly increased after training versus before training on the 1^st day (P＜0.01), and there was no significant difference before and after training on the 5^th day (P＞0.05). There were no significant differences in the sway area or mean velocity of the mildly sensitive group during the whole training period (all P＞0.05). The validation experiment showed that the motion sickness incidence and the symptom severity were significantly decreased in both groups; the motion sickness incidence of the mildly sensitive group decreased from 100.00% (28/28) to 35.71% (10/28); the incidence of severe symptoms in the severely sensitive group decreased from 100.00% (33/33) to 6.06% (2/33) and the vomiting incidence decreased from 96.97% (32/33) to 6.06% (2/33). Conclusion The supine-posture ripple wood training has great effect in preventing motion sickness, with widespread use and simple operation.

Abstract:Objective To observe the distribution characteristics of motion sickness susceptibility and compare the efficacy of modified motion sickness susceptibility questionnaire (MSSQ), motion sickness history questionnaire and Graybiel scale in evaluating motion sickness. Methods The susceptibility to motion sickness and historical symptoms were investigated using MSSQ and motion sickness history questionnaire among 1 661 males in navy units A, B, and C. A total of 389 people from the unit C were selected for simulating vertical oscillation stimulation, and the severity of motion sickness was evaluated by Graybiel scale during the stimulation process. The evaluation efficacy of MSSQ, motion sickness history questionnaire and Graybiel scale for motion sickness was analyzed by receiver operating characteristic (ROC) curves. Results The overall distribution of motion sickness susceptibility assessed by MSSQ and motion sickness history questionnaire in this population was right skewed. The distribution characteristics in the units A, B, and C were consistent with the overall distribution, and there was no significant difference among the 3 units. A positive correlation was observed between the MSSQ and the motion sickness history questionnaire in the units A, B, and C (r_s＝0.565, 0.565, 0.554), and both of them were comparable in assessing the incidence of motion sickness and severe motion sickness. However, the incidence of motion sickness assessed by Graybiel scale was significantly lower than that assessed by MSSQ and motion sickness history questionnaire (both P＜0.05), and the incidence of severe motion sickness was significantly higher than that assessed by MSSQ and motion sickness history questionnaire (both P＜0.05). ROC curve analysis showed that MSSQ had good predictive value for motion sickness susceptibility and severe motion sickness (area under curve ［AUC］ ＝0.736, 0.750), while the Graybiel scale had poor predictive ability (AUC＝0.559, 0.557). Conclusion The right skewed distribution of susceptibility to motion sickness is preliminarily determined. During the acclimatization training for motion sickness, the susceptible individuals can be screened by MSSQ and then subjected to vertical oscillation stimulation to improve the training efficiency.

Abstract:Objective To investigate whether prophylactic anticoagulation therapy can reduce the risk of postoperative complications in patients with primary liver cancer (PLC) after hepatectomy, and to explore the influencing factors of postoperative complications. Methods The clinical data of 495 patients undergoing hepatectomy for PLC in The Third Affiliated Hospital of Naval Medical University (Second Military Medical University) from Feb. 2019 to May 2021 were collected. The patients were divided into anticoagulation group (n＝287, receiving prophylactic low-molecular-weight heparin after surgery) and conventional treatment group (n＝208). The postoperative complications were compared between the 2 groups, and the influencing factors were analyzed using logistic regression model. Results The postoperative overall complication incidence of the 495 patients after hepatectomy was 30.7% (152/495), ranking as infection (9.1%, 45/495), acute respiratory distress syndrome (ARDS; 6.5%, 32/495), bleeding (6.3%, 31/495), post-hepatectomy liver failure (PHLF; 6.1%, 30/495), and venous thromboembolism (VTE; 2.8%, 14/495). The incidence rates of postoperative VTE, ARDS, and PHLF were significantly lower in the anticoagulation group than those in the conventional treatment group (1.4% ［4/287］ vs 4.8% ［10/208］, 3.8% ［11/287］ vs 10.1% ［21/208］, and 3.8% ［11/287］ vs 9.1% ［19/208］; all P＜0.05), but there was no significant difference in the incidence of postoperative bleeding between the 2 groups (P＞0.05). Multivariate logistic regression analysis showed that age, portal hypertension, and tumor number were independent risk factors for postoperative VTE; portal hypertension, intraoperative blood loss, intraoperative blood transfusion, and preoperative procalcitonin (PCT) were independent risk factors for PHLF; ascites and preoperative bilirubin were independent risk factors for ARDS; and postoperative prophylactic anticoagulation was an independent protective factor for VTE and ARDS (all P＜0.05). Conclusion Prophylactic anticoagulation can reduce the risks of VTE, PHLF, and ARDS in PLC patients after hepatectomy, without increasing the risk of postoperative bleeding. Age, portal hypertension, number of tumors, intraoperative blood loss, intraoperative blood transfusion, ascites, preoperative PCT, and preoperative bilirubin are risk factors for postoperative complications of PLC patients after hepatectomy.

Abstract:Objective To explore the correlations between triglyceride glucose index (TyG) and its derivatives TyG-body mass index (BMI) and TyG-alanine transaminase (ALT) with the risk of lean metabolic associated fatty liver disease (MAFLD). Methods A total of 207 patients diagnosed with lean MAFLD and 100 lean healthy controls who received annual health examination in Health Management Center of our hospital from Jul. to Dec. 2023 were enrolled. Plasma lipids, blood glucose, liver function, TyG, TyG-BMI and TyG-ALT were compared between the 2 groups. The influencing factors of lean MAFLD were analyzed by univariate and multivariate logistic regression models. All subjects were divided into 4 subgroups (Q1-Q4) according to the quartile of TyG and its derivatives, and the prevalence of lean MAFLD in each subgroup was observed. The receiver operating characteristic (ROC) curves of TyG, TyG-BMI and TyG-ALT for lean MAFLD were plotted to evaluate the prediction efficiency. Results Of the 8 764 health examination cases included, 2 350 (26.8%) had MAFLD, of which 207 were lean MAFLD (8.8%, 207/2 350). Compared with the lean healthy controls, the patients in the lean MAFLD group were older, with more male and high BMI, and their fasting blood glucose, total cholesterol, triglyceride, low density lipoprotein-cholesterol, ALT, aspartate transaminase, γ-glutamyl transpeptidase, alkaline phosphatase, total bilirubin, TyG, TyG-BMI and TyG-ALT were significantly increased, while high density lipoprotein-cholesterol was significantly decreased (all P＜0.01). Logistic regression analysis showed that age, male, and elevated ALT level were independent risk factors for lean MAFLD. The prevalence of lean MAFLD in the Q4 subgroup of TyG was significantly higher than that in the Q1 and Q2 subgroups (34.3% ［71/207］ vs 10.6% ［22/207］ and 24.2% ［50/207］, both P＜0.05). The prevalence rates of lean MAFLD in the Q4 subgroup of TyG-BMI and the Q4 subgroup of TyG-ALT were significantly higher than those in the corresponding Q1, Q2, and Q3 subgroups (35.3% ［73/207］ vs 8.2% ［17/207］, 24.6% ［51/207］, and 31.9% ［66/207］; 33.8% ［70/207］ vs 14.0% ［29/207］, 23.2% ［48/207］, and 29.0% ［60/207］; all P＜0.05). The area under curve (AUC) of TyG-BMI in predicting lean MAFLD was 0.869 0 (95% confidence interval ［CI］ 0.825 5-0.912 6, P＜0.001), which was higher than that of TyG (AUC＝0.818 8 ［95% CI 0.768 0-0.869 6, P＜0.001］) and TyG-ALT (AUC＝0.772 5 ［95% CI 0.718 7-0.826 2, P＜0.001］). Conclusion TyG, TyG-BMI, and TyG-ALT are associated with lean MAFLD, and have predictive value for lean MAFLD. TyG and its derivatives are easy to calculate and cheap, and can be used for preliminary clinical assessment of lean MAFLD.

Abstract:Objective To explore a method to improve the accuracy and generalization ability of medical diagnostic neural network models under conditions of small data volumes, and to address the issue of poor neural network model performance in computer-aided diagnosis of nail diseases due to limited training data. Methods A dual-model strategy integrating instance segmentation with fine-grained feature classification was proposed. The neural network model based on dual-model strategy was trained using the dataset of Image-Based Intelligent Diagnosis of Nail Disease Model task of the first National Digital Health Innovation Application Competition & Health and Medical Big Data Theme Competition. This dataset covered 8 types of nail diseases, including nail matrix nevi, paronychia, nail psoriasis, onychomycosis, subungual hemorrhage, melanonychia, periungual warts, and nail melanoma, with class imbalance present. The diagnostic performance of the dual-model strategy was evaluated and compared with single-model strategies (image classification models ［ResNet50 and Swin Transformer］ and target detection model based on faster region-based convolutional neural network ［Faster R-CNN］) under the same hardware and software training conditions. Results The dataset included 1 048 samples, including 210 cases of nail matrix nevi, 186 cases of paronychia, 69 cases of nail psoriasis, 203 cases of onychomycosis, 149 cases of subungual hemorrhage, 71 cases of melanonychia, 93 cases of periungual warts, and 67 cases of nail melanoma, with 90% used for training various models and 10% for evaluation. The micro F1 score was 0.324 in the image classification model based on ResNet50, 0.381 in the image classification model based on Swin Transformer, 0.572 in the target detection model based on Faster R-CNN, and 0.714 in the dual-model strategy model Mask R-CNN＋Swin Transformer. The accuracy rates for diagnosing different nail diseases in the dual-model strategy were: nail matrix nevi 80.95% (17/21), paronychia 89.47% (17/19), nail psoriasis 100.00% (7/7), onychomycosis 70.00% (14/20), subungual hemorrhage 73.33% (11/15), melanonychia 14.29% (1/7), periungual warts 55.56% (5/9), and nail melanoma 42.86% (3/7). The micro F1 score for evaluating the dual-model strategy on a test set of 1 000 cases was 0.844. Conclusion The dual-model strategy can effectively combine models with different functions to well accomplish the task of intelligent diagnosis of nail diseases under small data volume training conditions.

Abstract:Objective To systematically evaluate the efficacy and safety of hydromorphone or morphine for cancer pain using intrathecal drug infusion system (IDDS). Methods Chinese and English literature databases, including CNKI, Wanfang, VIP, CBM, PubMed, Cochrane Library, and Ovid, were searched from inception to Aug. 31, 2023 to collect randomized controlled trials (RCTs) about intrathecal infusion of morphine or hydromorphone in treatment of cancer pain. Two reviewers independently screened literature and extracted data according to the inclusion and exclusion criteria, and evaluated the quality of RCTs using a Cochrane bias risk assessment tool. Then, meta-analysis was performed using RevMan 5.4.1 software. Results A total of 6 RCTs, involving 544 patients, were enrolled. Among them, there were 282 cases in the hydromorphone group and 262 cases in the morphine group. The meta-analysis results showed that there were no significant differences in pain score or number of breakthrough pain episodes between the 2 groups after treatment (all P＞0.05). Compared with the morphine group, the incidence rates of nausea and vomiting, constipation, and somnolence were significantly decreased in the hydromorphone group (P≤0.05), and the quality of life was significantly higher (P＜0.05). Conclusion The efficacy of hydromorphone administered by IDDS for cancer pain is comparable to morphine; hydromorphone has advantages in reducing adverse reactions and improving quality of life of patients.

Abstract:Objective To prepare indocyanine green (ICG)-loaded platelet membrane biomimetic liposome (ICG-PLP) for tumor photothermal therapy, and to preliminarily evaluate its in vitro characteristics. Methods ICG-PLP was prepared by an ultrasound method, and its particle size and zeta potential were determined using a laser particle size analyzer. The encapsulation efficiency of ICG-PLP was detected by ultraviolet spectrophotometry. The photothermal properties of ICG-PLP were investigated under 808 nm near-infrared ray irradiation (2 W/cm²), and the retention of platelet membrane proteins was observed by sodium dodecylsulfate-polyacrylamide gel electrophoresis. The uptake of ICG-PLP by mouse macrophage RAW264.7, human non-small cell lung cancer cell A549, mouse melanoma cell B16-F10, and mouse breast cancer cell 4T1 was observed by a laser confocal microscope. Furthermore, the phototoxicity of ICG-PLP was detected by methyl thiazolyl tetrazolium assay, and the safety of ICG-PLP was preliminarily evaluated according to hemolysis rate and cytocompatibility. Besides, the in vivo retention time of ICG, ICG-loaded liposome and ICG-PLP in healthy SD rats was observed after tail vein injection. Results ICG-PLP was successfully prepared and its encapsulation efficiency, particle size, zeta potential, and the polydispersity index were (97.68±0.01)%, (109.77±0.76) nm, (－21.23±0.84) mV, and 0.22±0.01, respectively. ICG-PLP well retained the proteins on platelet membrane and showed good photothermal properties. Platelet membrane enhanced the uptake of biomimetic nanoparticles by tumor cells A549, B16-F10, and 4T1, and reduced the phagocytosis of biomimetic nanoparticles by macrophages. ICG-PLP exhibited a favorable photothermal therapy effect and could kill tumor cells. Additionally, ICG-PLP displayed a good safety. After intravenous administration, ICG-PLP prolonged the in vivo retention time of ICG in healthy SD rats. Conclusion ICG-PLP has been successfully constructed. It has a great potential in targeted drug delivery and tumor photothermal therapy.

Abstract:Objective To explore the association of epidermal growth factor receptor (EGFR) mutant non-small cell lung cancer (NSCLC) with tyrosine kinase inhibitor (TKI)-related rash based on network pharmacology and to predict the potential traditional Chinese medicine. Methods Gene chip data of EGFR mutant NSCLC cell lines and normal fibroblasts before and after treatment with erlotinib, a TKI, were collected from Gene Expression Omnibus database. Differentially expressed genes were screened using limma package of R 4.3.2 software. Cross-over target genes were screened using venn package. The differentially expressed genes and cross-over target genes were analyzed using ClusterProfiler package. CoreMine Medical database was used to predict traditional Chinese medicine of the cross-over target genes, and the nature, flavour, and channel tropism were analyzed. The results were verified by molecular docking method. Results A total of 126 cross-over target genes were screened. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses indicated that the differentially expressed genes and cross-over target genes were enriched in chromosome, spindle and other regions, and were involved in biological processes such as mitosis and DNA replication. These genes were also associated with signaling pathways including DNA replication, lysosomes, and cell cycle. Gene set enrichment analysis results showed that chemokine pathway and nucleotide-binding oligomerization domain-like receptor signaling pathway were activated in the NSCLC cells, and mammalian target of rapamycin signaling pathway and amino acid metabolic pathway were disturbed in the fibroblasts after treatment with erlotinib. CoreMine Medical database predicted that 354 kinds of traditional Chinese medicines were mainly classified as cold, warm and flat, bitter, pungent and sweet, belonging to stomach, lung and liver meridians. Taking Scutellaria baicalensis as an example, molecular docking analysis of experimentally validated target genes and their active components revealed strong binding interactions between the target genes and active components. Conclusion EGFR mutant NSCLC and TKI-related rash have homology in pathogenesis, both involving DNA replication and cell cycle, which provides traditional Chinese medicine medication instruction for patients with EGFR mutant NSCLC and TKI-related rash.

Abstract:Objective To explore the correlations between self-esteem, social support and mental health status of patients with deep burns at special sites at different stages of the disease course. Methods A total of 36 inpatients who were admitted to Department of Burn Surgery of The First Affiliated Hospital of Naval Medical University (Second Military Medical University) between Jan. 2020 and Sep. 2023 were enrolled. The patients were assessed with self-rating anxiety scale (SAS), self-rating depression scale (SDS), post-traumatic stress disorder (PTSD) checklist-civilian version (PCL-C), Rosenberg self-esteem scale (RSES), and perceived social support scale (PSSS) within 7 d of burns (early stage of disease), at wound closure (early rehabilitation stage), and 3 months after wound closure (late rehabilitation stage). The data were collected and invalid data were excluded for statistical analysis. Results A total of 36 patients effectively completed all the scales. There were anxiety, depression and PTSD in patients with deep burns at special sites at different stages of the disease course, and the number of burn patients with anxiety, depression and PTSD showed a downward trend with the course of disease. The RSES score at the early rehabilitation stage was positively correlated with SAS score (r_s＝0.412, P＝0.013), SDS score (r_s＝0.347, P＝0.038) and PCL-C score (r_s＝0.447, P＝0.006) at the early stage of disease, but not with SAS, SDS, or PCL-C scores at the early and late rehabilitation stages (all P＞0.05). There were no correlations between PSSS score at the early rehabilitation stage and SAS, SDS, or PCL-C scores at the early stage of disease or SAS or PCL-C scores at the early stage of rehabilitation (all P＞0.05), but there were negative correlations between PSSS score at the early rehabilitation stage and SDS score at the early stage of rehabilitation (r＝－0.430, P＝0.009) and SAS score (r＝－0.467, P＝0.004), SDS score (r＝－0.483, P＝0.003), and PCL-C score (r_s＝－0.351, P＝0.036) at the late stage of rehabilitation. Conclusion Anxiety, depression, and PTSD are observed in patients with deep burns in special areas at different stages of the disease. A high level of self-esteem is associated with an increased risk of mental problems at early stage of burns. Conversely, a high level of social support is associated with a reduced likelihood of mental problems at late stage of rehabilitation.

Abstract:The brain has been considered to be completely isolated from the peripheral lymphatic system due to lack of conventional lymphatic structures. However, with the discoveries of perivascular spaces, glymphatic system and meningeal lymphatic vessels, the brain has been recognized to have its own unique lymphatic drainage pathway connected with peripheral lymphatic system. Traumatic brain injury, as one of diseases influencing the treatment outcomes of neurosurgery, has not been reasonably explained for its long term neurodegenerative symptoms such as memory decline and cognitive dysfunction after injury. With the deepening of research, it has been found that the perivascular spaces, glymphatic system, and meningeal lymphatic vessels are all damaged to a certain extent after traumatic brain injury, leading to a decline in the function of intracranial lymphatic system and a large accumulation of metabolites in brain tissue, thereby affecting neurological function and resulting in neurodegenerative symptoms.

Abstract:Low-intensity pulsed ultrasound (LIPUS) is a low-cost, non-invasive and safe treatment method mainly used for musculoskeletal diseases, especially for fractures and nonunion. This article reviews the therapeutic effects of LIPUS on various musculoskeletal and nervous system diseases and analyzes its mechanism and potential targets. It is found that besides fracture and nonunion, LIPUS also has clinical application prospect in treating osteoporosis, muscle injury, and motor nervous system diseases.

Abstract:Objective To understand the epidemic status of biological stings on an island and the knowledge about environmental emergencies of personnel stationed on the island. Methods With convenience sampling, we investigated 270 personnel using a self-designed anonymous questionnaire based on clinical treatment situation and on-the-spot investigation of the island. Results A total of 270 questionnaires were distributed, and 254 valid questionnaires were returned, with an effective rate of 94.07%. A total of 164 (64.57%) personnel had a history of stings, with median times of 2 (0, 5). The main clinical symptoms were local swelling and pain (142 cases, 86.59%) and pruritus (110 cases, 67.07%). The personnel scored 14 (11, 17) for the first aid knowledge about island environmental emergencies (the full score was 26). The vast majority of personnel (227 cases, 89.37%) believed that it was necessary to learn the knowledge about island environmental emergencies, and the majority of personnel (186 cases, 73.23%) hoped to learn through centralized teaching. Conclusion The environmental emergencies represented by biological stings are becoming increasingly serious, so it is necessary to carry out multiple prevention and environmental control measures, and to carry out regular and long-term training for personnel stationed on islands.

Abstract:Objective To compare the detection rates of X-ray, ultrasound, computed tomography (CT) and cone beam CT (CBCT) for submandibular gland calculi in different positions, and to explore the auxiliary value of 3-dimensional visualization technology in diagnosis and treatment of submandibular gland calculi. Methods The X-ray, ultrasound, CT and CBCT examination data of 113 patients with submandibular gland calculi at General Hospital of Ningxia Medical University from Nov. 2014 to Mar. 2021 were retrospectively analyzed. The detection rates and overall detection rates of the 4 imaging methods for calculi in different positions were compared. Mimics 19.0 software and CBCT data were used for 3D reconstruction imaging, visually displaying the location, size, morphology, and number of calculi from a visual perspective. Results There was no significant difference in the total detection rate of submandibular gland calculi between CBCT and CT (98.2% ［111/113］ vs 95.6% ［108/113］, P＞0.05), but both were significantly higher than that of X-ray (65.5%, 74/113) and ultrasound (73.5%, 83/113). The detection rates of ultrasound for calculi in the anterior and middle ducts were the lowest (63.6% ［21/33］ and 72.2% ［26/36］, respectively), which were significantly different from those of CBCT (97.0% ［32/33］ and 100.0% ［36/36］, respectively) and CT (93.9% ［31/33］ and 97.2% ［35/36］, respectively) (all P＜0.05). The detection rate of X-ray for calculi in the posterior duct was significantly lower than that of ultrasound, CBCT, and CT (40.9% ［18/44］ vs 81.8% ［36/44］, 97.7% ［43/44］, and 95.5% ［42/44］, all P＜0.01). After CBCT data were imported into Mimics 19.0 software, submandibular gland calculi with different sizes, shapes, or numbers were successfully visualized and reconstructed. The reconstructed image was clear, and anatomical position relationship between the calculi and the mandible was visualized. Conclusion CBCT has good application value in the diagnosis of submandibular gland calculi and can replace traditional CT for the diagnosis of sialolithiasis. Clinically, CBCT examination can be directly performed for accurate diagnosis of calculi in the posterior duct which are not detected by double coincidence diagnosis but are indicated by ultrasound. For calculi in the anterior and middle ducts, X-ray and CBCT are preferred. Visualization technology helps clinical patient education and the development of personalized preoperative treatment plans.

Abstract:Objective To explore the flow chart and key points of etiological differential diagnosis of character “卜” sign in fetal three-vessel and trachea (3VT) view. Methods A retrospective study was performed on ultrasound images of 37 fetuses, who had “卜” sign in 3VT view during fetal heart ultrasound scanning in The Affiliated Suzhou Hospital of Nanjing Medical University from Aug. 2020 to Oct. 2023. The types of diseases with “卜” sign and the flow chart and key points of differential diagnosis were summarized. All cases were diagnosed by 2 experienced senior prenatal ultrasound doctors independently. Results The incidence of “卜” sign was 0.14% (37/27 019). Among the 37 fetuses with “卜” sign on 3VT view, 13 (35.14%) cases had complete transposition of great arteries (TGA), 11 (29.73%) had double outlet of right ventricle with abnormal relationship of great arteries (DORV/AA), 7 (18.92%) had truncus arteriosus (TA, van Praagh A1, A2 and A3), and 6 (16.22%) had pulmonary atresia with ventricular septal defect (PA/VSD). During the process of differential diagnosis, the presence or absence of aorta and pulmonary arteries, the ventricle-artery connection relationship, and the blood supply to both lungs should be focused on, and the final diagnosis can be derived step by step according to the flow chart. The key points of differential diagnosis were as follows: the ventricle-artery connection was inconsistent in TGA; in DORV/AA both aorta and pulmonary artery were entirely or mostly from right ventricle without normal spiral relationship; in TA only a common artery trunk was detected, and main pulmonary artery or its branches were from the artery trunk; and in PA/VSD pulmonary artery was atresia and only aorta was detected, and the blood supply to both lungs was from ductus arteriosus and/or aortopulmonary collateral arteries. Conclusion The fetal differential diseases with “卜” sign in 3VT view include TGA, DORV/AA, TA (van Praagh A1, A2 and A3), and PA/VSD. Understanding the flow chart and key points of differential diagnosis can improve the prenatal detection rate and diagnosis of related malformations.