最新刊期
卷 45 ， 期 4 ， 2024
- 摘要：Pulmonary Arterial Hypertension （PAH） is a chronic progressive cardiopulmonary disease. The main pathological changes are vasoconstriction and pulmonary artery proliferative remodeling and right ventricular hypertrophy. Further exploration of the pathogenesis of PAH can reveal that its related pathways include vascular proliferation， vascular wall remodeling， oxidative stress， inflammatory response and gene regulation. Although great progress has been made in the treatment of PAH in recent years， the mortality rate is still high， current clinical treatments have not effectively improved the prognosis， and the disease has great impact on the physical， social， work and emotional aspects of patients. This article will review the latest research on the treatment of PAH， aiming to provide new clues for the clinical treatment of PAH.关键词：pulmonary arterial hypertension;pathogenesis;molecular mechanism;vascular remodeling;medication;non-drug therapy
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发布时间：2024-07-30 - 摘要：225Ac has high linear energy transfer， suitable half-life， short particle range， and good coordination ability， making it one of the promising alpha emitters in targeted radioisotope therapy for tumors， and it has significant research value. This article briefly introduces the physical and chemical properties of 225Ac， as well as common chelating agents （prostate-specific membrane antigen， octreotide， nano-carriers， etc.）. It reviews the applications of targeted drugs labeled with 225Ac in tumors， based on peptides or small molecules as targeting agents， monoclonal antibodies or proteins as targeting molecules， and nano-carriers. It also analyzes the value of its application in therapy， summarizes the methods of labeling with 225Ac and the selection of suitable chelating agents， improvements in targeting specificity， and toxicity side effects. Furthermore， it looks forward to the localization of 225Ac production to meet future clinical needs， in order to provide reference for the subsequent development of 225Ac-labeled drugs.关键词：Actinium-225;α-emitting radionuclide;tumor;targeted α-therapy;polypeptide;antibody;nanocarrier
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发布时间：2024-07-30 - 摘要：Scientific research laboratory is the base of scientific research and talent training in the university. During the construction and development of “world-class universities and first-class disciplines”， laboratory safety management has been facing urgent challenges. Based on the laboratory management methods of Zhongshan School of Medicine of Sun Yat-sen University， we analyzed the classification and characteristics of discipline laboratories， laboratory safety access training and assessment， and summarized the actual situation and construction of safety management system for basic medical laboratories. This paper expounded on laboratory management， such as management system construction， safety management， safety inspection and supervision， safety awareness of all staff and system execution， so as to provide a feasible and creative scientific guidance and basis for university laboratory biosafety management， and establish a healthy and safe experimental environment to ensure the safety of laboratory work.关键词：basic medical laboratory;management system;laboratory safety;laboratory management;biosafety
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发布时间：2024-07-30 - 摘要：In recent years， the incidence of spinal cord injury （SCI） has shown an increasing trend， and the resulting motor impairment cause significant harm to patients themselves and public health. Although the current clinical treatments for motor disorders after SCI are diverse， mainly focusing on improving dysfunction and improving patients' daily living ability through external stimulation， there is still a lack of radical solutions. Epidural electrical stimulation （EES） as an emerging treatment technology， has been shown in a number of international clinical studies on the SCI significant potential of motor function recovery， has significant curative effect， convenient， widely applicable， adjustable advantages， the rehabilitation of movement disorders after SCI has a lot of big benefits， in the spinal cord injury rehabilitation has great prospect. However， most of the domestic research are limited to the neurogenic bladder caused by abnormal autonomic nerve function after SCI， and mostly combine traditional Chinese and western medicine rehabilitation treatment， the emerging therapy of EES， this paper aims to review the basic principle of EES， potential mechanism of action and its c linical application progress in the treatment of movement disorders after SCI， in order to provide reference for the clinical application and scientific research of EES treatment of motor disorders after SCI.关键词：spinal cord injury （SCI）;epidural electrical stimulation （EES）;motor impairment， rehabilitation;review
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发布时间：2024-07-30 - 摘要：As a key regulator of neuronal growth， development and synaptic plasticity， BDNF/ TrkB signaling pathway is widely involved in the occurrence and development of central nervous system diseases， such as ischemic stroke， Alzheimer's disease， Parkinson's disease and spinal cord injury. Studies have shown that acupuncture can regulate the activity of BDNF/TrkB signaling pathway， and has significant therapeutic potential for these diseases. Its mechanism of action is related to participating in synaptic remodeling， inhibiting neuronal apoptosis， and promoting neurogenesis or synaptic regeneration. This article reviews the role of BDNF/TrkB signaling pathway in central nervous system diseases and the regulation mechanism of acupuncture on this pathway， in order to provide new ideas for clinical treatment. Future studies should further explore the precise regulatory mechanism of acupuncture on BDNF/TrkB signaling pathway in order to develop more efficient and safe treatment strategies.关键词：acupuncture;BDNF/TrkB signaling pathway;central nervous system diseases;ischemic stroke;Alzheimer's disease;Parkinson's disease;spinal cord injury;mechanism of action
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发布时间：2024-07-30
Review
- 摘要：ObjectiveTo investigate the protective effect of Zhuangtongyin on the Middle Cerebral Artery Occlusion （MCAO） model by modulating ferroptosis through the Nrf2-SCL7A11/xCT-Gpx4 pathway and its underlying mechanism.MethodsC57BL/6J mice were randomly divided into Sham operation group （Sham）， model group （MCAO）， low-dose Zhuangtongyin group （ZTY-L）， high-dose Zhuangtongyin group（ZTY-H）， with 5 mice in each group. The MCAO group was modelled by silica gel embolization， the middle cerebral artery of mice was embolized for 1h， then the silica gel was pulled out and reperfusion was performed after 72 h； and the other operations in the Sham group were the same as those in the MCAO group except that the thread plug was not inserted. The neural function of mice was evaluated by Zea-Longa method. TTC staining was used to evaluate the volume of cerebral infarction. The level of brain injury was evaluated by HE staining and Nissl staining. Prussian blue staining and the expression of iron transport-related carrier receptors TfR1 and DMT1 on mRNA level was detected by qPCR to evaluate the iron ion deposition level in mice brain. The expression of lipid peroxidation-related gene ACSL4 on mRNA level was detected by qPCR， and the content of 4-HNE was detected by ELISA kit to evaluate the lipid peroxidation level of mice brain. The expressions of ferroptosis marker PTGS2 mRNA level was detected by qPCR. The expressions of Nrf2， SCL7A11/xCT， Gpx4 in mice brain tissue were detected by Western-blot and immunofluorescence.ResultsZhuangtongyin improved the nerve function of mice after MCAO （P＜0.05） and the cerebral infarction volume of mice （P＜0.05） and alleviate the pathological injury of cerebral cortex cells after MCAO operation. Zhuangtongyin attenuated the accumulation of trivalent iron ions in the brain tissue of mice following MCAO. Additionally， Zhuangtongyin downregulated the expression of TfR1 and DMT1 mRNA （P＜0.001）， a transporter associated with cellular iron ion uptake， in the brains of post-MCAO mice. Furthermore， Zhuangtongyin reduced levels of lipid peroxidation product 4-HNE （P＜0.001） and suppressed ACSL4 mRNA expression in brain tissue post-MCAO （P＜0.001）. Besides， Zhuangtongyin downregulated the expression of PTGS2 mRNA （P＜0.001）， in the brains of post-MCAO mice. Zhuangtongyin increased the expression of nrf2 into the nucleus （P＜0.001）， and increased the expression of xCT and Gpx4 in neurons after MCAO （P＜0.001）.ConclusionZhuangtongyin can enhance the nerve function and reduce cerebral infarction volume in MCAO/R mice， alleviate the pathological damage of cerebral cortex cells， and modulate the expression of key signaling molecules in the Nrf2-SCL7A11/xCT-Gpx4 pathway. Therefore， it is suggested that the mechanism by which Zhuangtongyin improves MCAO/R injury in mice may involve regulating ferroptosis through the Nrf2-SCL7A11/xCT-GPX4 pathway.关键词：ischemic stroke;ferroptosis;Zhuangtongyin;Nrf2-SCL7A11/xCT-Gpx4 pathway;mechanisms of action
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发布时间：2024-07-30 - 摘要：ObjectiveTo investigate the effect and mechanism of Shuxuetong and its main component hirudin on the apoptosis of cerebellar granule neurons （CGNs） in Sprague-Dawley（SD） rats.MethodsCGNs incubated in vitro for 7 days were divided into survival control group or 25 K group （cultured in medium containing 25 mmol/L KCL） and apoptosis group or 5 K group （cultured in medium containing 5 mmol/L KCL）. CGNs were separately treated with proportionally diluted and different concentrations of Shuxuetong （1/50， 1/40， 1/30， 1/20 and 1/10） and the corresponding different concentrations of hirudin （2， 2.5， 3.34， 5 and 10 U / mL）. Hoechst staining was performed to analyze the apoptosis. Western blot was used to detect the expression levels of Cleaved Caspase-3， Bim and VEGF.ResultsHoechst staining showed that 5 K group had a higher apoptosis rate than 25 K group. In 25 K group， there was no significant change in the apoptosis rate between neurons treated with different concentrations of Shuxuetong and hirudin， but significant changes was found in 5 K group and the higher the concentration， the lower the apoptosis rate. Western blot results revealed that， compared with control neurons in 5 K group， Shuxuetong injection and hirudin treatments resulted in a decrease of Cleaved Caspase-3 and Bim expression， but an increase of VEGF protein.ConclusionsShuxuetong and its main component hirudin inhibits the apoptosis of CGNs through suppressing proapoptotic BH3-only protein Bim.关键词：Cerebellar granule neurons;apoptosis;shuxuetong;hirudin;Bim;VEGF
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发布时间：2024-07-30 - 摘要：ObjectiveTo identify the relationship between tumor tissue interleukins （ILs） and non-small cell lung cancer （NSCLC） patients with poor response to immune checkpoint blockade （ICB） therapy， and to investigate the differential expression of ILs in tumor of NSCLC patients as well as its effect on ICB response and prognosis.MethodsA total of 61 patients diagnosed with NSCLC and treated with ICB were retrospectively collected from the data of a previous study. We obtained transcriptome sequencing data from tumor tissues and survival data of the patients before ICB treatment. Using bioinformatics methods， we screened for ILs that significantly affected the efficacy and prognosis of ICB treatment. We evaluated the efficacy of ICB treatment using progressive-free survival （PFS） and assessed the prognosis using overall survival （OS）. The Kaplan-Meier survival curve and ROC curve were used to analyze the predictive effect and efficacy of ILs on the efficacy and prognosis of ICB in NSCLC patients.ResultsThe results of the univariate Cox regression analysis in our study showed that nine ILs were found to be associated with OS of NSCLC patients treated with ICB at a significance level of P < 0.1. Further multivariate analysis revealed that high expression of IL-11， IL-17D， and IL-36A was significantly associated with poor prognosis in these patients （P < 0.05）. The results from the Kaplan-Meier survival curve analysis revealed a significant negative correlation between the high expression of IL-17D and both PFS and OS in NSCLC patients. Specifically， patients with IL-17D high expression had a median PFS of 3.1 months compared with 6.5 months in low expression patients ［95% confidence interval （CI） （1.178， 3.655）， P = 0.009］. Similarly， the median OS was 9.8 months in the high expression group versus 21.8 months in the low expression group ［95%CI （1.116， 4.392）， P = 0.018］. ROC curve showed that the prediction performance was favorable ［AUCPFS = 0.702，95%CI （0.562， 0.842）， P = 0.027； AUCOS = 0.684， 95%CI （0.550， 0.818）， P = 0.014］. Although IL-11 and IL-36A alone were not significant predictors of PFS and OS in NSCLC patients， the median PFS and OS were notably shortened to 2.2 months （P = 0.003） and 3.0 months （P < 0.001）， respectively， when high expression of IL-11 and IL-36A was combined with high expression of IL-17D. The ROC curve analysis demonstrated an improvement in prediction efficiency for both PFS and OS in NSCLC patients ［AUCPFS = 0.748， 95%CI （0.615， 0.880）， P = 0.007； AUCOS = 0.703， 95%CI （0.573， 0.833）， P = 0.007］.ConclusionThe results suggest that high expression of IL-11， IL-17D， and IL-36A is associated with a higher risk of disease progression which correlates to poor PFS and OS in NSCLC patients.关键词：IL-11;IL-17D;IL-36A;non-small cell lung cancer;immune checkpoint blockade therapy
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发布时间：2024-07-30 - 摘要：ObjectiveDepression is a common mental illness with a profound impact on physical health. Depression has been associated with a higher risk of bacterial infection； however， whether this relationship is causal and how depression affects infection remains unclear. Therefore， we aimed to investigate the effects of depressive phenotype in infected mice by constructing a chronic unpredictable mild stress （CUMS） model.MethodsMice were induced with CUMS for 4 weeks. The depressive phenotype was evaluated using behavioral tests. Subsequently， the mice were intraperitoneally injected with Klebsiella pneumoniae to establish bacterial infection. Serum and abdominal tissues were collected 48 h after infection. Hematoxylin-eosin （HE） staining was used to observe the pathological changes in the tissues， and enzyme-linked immunosorbent assay （ELISA） was used to measure the levels of inflammatory factors. In addition， the fecal samples collected before infection were analyzed for 16S rDNA gene of gut microbiota， and the expression levels of NF-κB/NLRP3 signaling pathway in colon tissues of uninfected mice were detected.ResultsBehavioral tests showed that compared with the control mice， CUMS mice had significantly lower body weight （P<0.000 1， t=5.426）， lower sucrose preference rate （P<0.001， t=4.937）， increased swimming stationary time （P<0.001， t=16.37）， and decreased time spent in the central area of the open field （P<0.01， t=3.575）. Survival analysis showed that compared with the control mice， the survival rate of CUMS mice significantly decreased after infection （P<0.05）. Additionally， histochemical staining showed that tissue damage in the liver （P<0.05， t=4.025）， kidney （P<0.05， t=2.828）， and mesentery （P<0.01， t=5.367） significantly increased. Furthermore， ELISA results showed that the levels of the inflammatory cytokines IL-6 （P<0.01， t=3.365）， IL-1β （P<0.01， t=4.061）， TNF-α （P<0.01， t=4.460） and LPS （P<0.000 1， t=27.24） were elevated. The difference was statistically significant. According to 16S rDNA sequencing， CUMS-induced changes in the intestinal bacterial community structure of mice， making them significantly different from the control mice. Compared with the control mice， the expression levels of NF-κB （P<0.01， t=6.825） and NLRP3 （P<0.001， t=9.561） were upregulated in CUMS mice.ConclusionThe CUMS model was successfully constructed and CUMS mice developed more severe bacterial infection. Gut microbiota was dysregulated and the expression of NF-κB/NLRP3 signaling pathway was up-regulated in CUMS mice， which was related to the susceptibility to bacterial infection.关键词：Depression;Chronic unpredictable mild stress;Infections;Gut microbiota;Inflammation
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发布时间：2024-07-30 - 摘要：ObjectiveTo explore the expression of transcription factor KLF16 in nonalcoholic fatty liver disease （NAFLD） and its effect on lipid metabolism.MethodsAn animal model of NAFLD was constructed in mice induced by a high-fat diet. The mice were divided into normal diet group （ND） and high fat diet group （HFD）. NAFLD cell model was constructed by primary mouse liver cells induced by oleic acid. The cells were divided into control group （Control group） and oleic acid induction group （OA group）. Real-time fluorescence quantitative PCR （RT-qPCR） and Western blot were used to detect KLF16 expression in NAFLD animal and cell models. In vitro and in vivo models of KLF16 knockdown were constructed by injection of adeno-associated virus （AAV） into mouse tail veins and transient transfection of cell siRNA. Hematoxylin-eosin staining （HE） and other methods were used to detect changes in lipid deposition in NAFLD models before and after KLF16 knockout. RT-qPCR was used to detect the expression of key genes of lipid metabolism in both cellular and animal NAFLD models before and after KLF16 knockdown. Western blot assay was used to detect the expression of endoplasmic reticulum stress protein in NAFLD model before and after KLF16 knockdown.ResultsThe expression level of KLF16 was up-regulated in HFD group and OA group， and lipid deposition was increased in OA group after KLF16 was depressed. There was no change in TC level in hepatocytes between groups （P>0.05）， and TG level was increased in different degrees （P<0.05， P<0.001）. At the same time， the change of KLF16 expression also caused the change of ER stress protein expression in OA group.ConclusionThe transcription factor KLF16 may alleviate lipid deposition in nonalcoholic fatty liver disease by endoplasmic reticulum stress.关键词：Krüppel-like factor 16;endoplasmic reticulum stress;nonalcoholic fatty liver disease;lipid metabolism;adeno-associated virus;gene knockdown
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发布时间：2024-07-30 - 摘要：ObjectiveTo analyze the trends in the disease burden of esophageal cancer attributed to smoking in China from 1990 to 2019.MethodsUsing the Joinpoint 4.9.1.0 software， based on the Global Burden of Disease Study 2019 data， we examined the mortality， Disability-Adjusted Life Years （DALY） data， and death rates of esophageal cancer attributed to smoking in China from 1990 to 2019， along with national population data. The trends in disease burden was described and the age-period-cohort model was employed to analyze the effects of age， period， and cohort on the trends in disease burden due to smoking.ResultsJoinpoint analysis indicated that the age-standardized mortality rate （ASMR） and DALY rate attributable to smoking showed an average annual percent change （AAPC） of -1.42% and -1.72%， respectively. For females， the AAPC values for ASMR and DALY rate were -3.26% and -3.70%， respectively， while for males， these were -1.28% and -1.54%， respectively. The disease burden by age attributable to smoking showed a general declining trend across all age groups in mortality and DALY rates. The disease burden from smoking， measured by age， displayed a consistent downward trend in both mortality and DALY rates across all age groups. The 40-44 age group saw the sharpest decline， with Annual Average Percent Changes （AAPC） of -3.05% for mortality and -3.04% for DALY rates. This was closely followed by the 45-49 age group， which experienced AAPC values of -2.73% and -2.72%， respectively. Analysis using the age-period-cohort model showed that the impact of age on mortality and DALY rates due to smoking initially increases with age before subsequently decreasing. The period effect revealed a general increase in the mortality rate from smoking in China， except for a dip between 2005 and 2010； otherwise， the trend was upward over time. The DALY rate demonstrated variability across different periods. The cohort effect indicated a decrease in both mortality and DALY rates due to smoking as successive birth cohorts progressed.ConclusionsOur study reveals that the disease burden of esophageal cancer attributed to smoking factors exhibits gender differences and shows an overall declining trend over time. Efforts should be intensified to enhance health education for men， particularly focusing on smoking cessation education for smokers aged 35-39， in order to improve the overall level of primary prevention of esophageal cancer.关键词：esophageal cancer;smoking;disease burden;Joinpoint model;age-period-cohort model
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发布时间：2024-07-30 - 摘要：ObjectiveTo investigate the impact of varying concentrations of baicalein on the proliferation and biological responses of MC3T3-E1 cells， as well as the antibacterial efficacy of baicalein against prevalent oral bacteria， and to elucidate the underlying mechanisms.MethodsMC3T3-E1 cells were exposed to different concentrations of baicalein （0， 6， 12， 18， and 24 μmol/L） and cell viability was determined by using the CCK-8 assay. Alkaline phosphatase （ALP） activity of MC3T3-E1 cells following osteogenic induction was assessed. RT-PCR was used to examine the expression of RunX2， BMP2， and Osterix. After 24 hours of treatment， the antibacterial potential of baicalein against Escherichia coli， Staphylococcus Aureus and Streptococcus Sanguis was evaluated by using the K-B paper disk method.ResultsBaicalein exhibited a modest reduction in proliferation of MC3T3-E1 cells but without affecting their sustained proliferation. Baicalein at a concentration of 18 μmol/L enhanced ALP activity of MC3T3-E1 cells， upregulated BMP2 and Osterix expression， downregulated RunX2 expression， significantly inhibited the proliferation of Staphylococcus Aureus and Streptococcus Sanguis （P < 0.05）.ConclusionsBaicalein at an optimal concentration （18 μmol/L） demonstrated a promotional effect on the osteogenic differentiation of MC3T3-E1 cells and effectively suppressed the proliferation of common oral bacteria， including Staphylococcus Aureus and Streptococcus Sanguis.关键词：preosteoblasts;baicalein;osteogenesis;bacteriostasis;differentiation;proliferation
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发布时间：2024-07-30
Preclinic Research
- 摘要：ObjectiveTo evaluate the changes in cardiac structure and ventricular function in patients with Anderson-Fabry Disease （AFD） by two-dimensional speckle tracking echocardiography （2D-STE） and to explore the characteristics of their early cardiac involvement.MethodsAll 45 patients diagnosed with AFD in this observational study underwent routine ultrasonic cardiogram （UCG） examination and 2D-STE. The patients were divided into 2 groups based on UCG measurements： with left ventricular hypertrophy （interventricular septum or posterior left ventricular wall thickness ≥12 mm） and without left ventricular hypertrophy. TomTec software was used to analyze the echocardiographic images， then the baseline data， UCG routine parameters and myocardial strain of the two groups were compared.ResultsThe study included 27 males （60.0%） and 18 females （40.0%）， with an average age of （32.33±16.11）， 17 cases （37.78%） with left ventricular hypertrophy and 28 cases （62.22%） without left ventricular hypertrophy. All patients had normal left ventricular ejection fraction （LVEF） （> 50%）. Compared with those without left ventricular hypertrophy， patients with left ventricular hypertrophy had significantly more target organ involvement， significantly higher E/A and average E/E' ratios （P < 0.05）. No statistical difference was found in global and segmental longitudinal strain （LS）， circumferential strain （CS） and radial strain （RS） of the endocardium and myocardium between the two groups （all P > 0.05）. There were lower absolute values of global and segmental LS and CS in the myocardium than in the endocardium （all P < 0.05）， and higher absolute values of LS and RS in the mid segment than in the basal and apical segments （all P < 0.05）.ConclusionsThere is no significant association between early systolic dysfunction and left ventricular wall thickness. 2D-STE strain can be used to detect AFD in the early stage. Ventricular wall myocardium exhibits more serious involvement than endocardium and mid segment was less involved than the apical and basal segments.关键词：Anderson-Fabry Disease （AFD）;left ventricular hypertrophy;two-dimensional speckle tracking echocardiography （2D-STE）;strain;left ventricular dysfunction
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发布时间：2024-07-30 - 摘要：ObjectiveTo explore echocardiographic features in idiopathic ventricular fibrillation （IVF） patients by multiparametric echocardiographic assessment， in order to evaluate the feasibility of identifying patients at high risk of ventricular arrhythmia using echocardiography.MethodsPatients diagnosed with IVF for the first time in Sun Yat-sen Memorial Hospital from January 2019 to December 2023 were included. Age- and sex-matched healthy individuals were included as control. Multiparametric echocardiographic assessment was performed， involving conventional parameters， myocardial mechanical movement parameters， electro-mechanical parameters， and myocardial energetic parameters. Continuous variables were compared using independent samples t-test or Mann-Whitney U test. The receiver operating characteristic （ROC） curves were performed for echocardiographic parameters to assess their diagnostic value for IVF. The intraclass correlation coefficient （ICC） was used to assess the inter-observer and intra-observer variability.ResultsNine patients with IVF and thirty healthy individuals were included in this study. In total， 702 left ventricular segments and 117 right ventricular free wall segments were analyzed for myocardial function. Left ventricular global longitudinal strain （LV-GLS） was lower in IVF group than in the control group ［（18.8±2.7） % vs. （21.2±1.9） %，P=0.004］. Left ventricular mechanical dispersion （LV-MD） was higher in IVF group than in the control group ［（44±13） ms vs. （36±9） ms，P=0.022］. Global work index （GWI） was lower in IVF group than in the control group ［（1991±365） mmHg% vs. （2319±408） mmHg%，P=0.037］. Based on the results of the ROC curve test， LV-GLS， LV-MD and GWI had the better diagnostic performance， with the area under the curve （AUC） of 0.748， 0.737 and 0.722， the cutoff value of 19.5%， 39.5ms and 2049mmHg%， respectively. The combination of three indices had the largest AUC value of 0.800. All echocardiographic parameters had excellent intra-observer repeatability and inter-observer reproducibility. The ICC for all parameters was higher than 0.75.ConclusionOur results show variable degrees of left ventricular dysfunction are observed in IVF patients by multiparametric echocardiographic assessment. Decreased LV-GLS， increased LV-MD and decreased GWI are considered high-risk echocardiographic features for malignant arrhythmia.关键词：idiopathic ventricular fibrillation;echocardiography;speckle tracking imaging;myocardial work;mechanical dispersion
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发布时间：2024-07-30 - 摘要：ObjectiveTo investigate the difference of ultrasound characteristics between pure mucinous carcinoma （PMC） and fibroadenoma （FA） of the breast.MethodsUltrasound data of 50 continuous patients with breast PMC from January 2012 to January 2021 and 100 continuous patients with breast FA from June 2018 to January 2019 in Sun Yat-sen Memorial Hospital of Sun Yat-sen University were retrospectively reviewed. The ultrasound characteristics of the two groups were evaluated according to the 2013 BI-RADS Ultrasound Atlas， and the differences in age， maximum diameter and ultrasound characteristics between the two groups were compared.ResultsThe median age of PMC patients was 47 years and that of FA patients was 33 years. The age of PMC patients was higher than that of the FA group， and the difference between the two groups of patients was statistically significant （P<0.001）. The median maximum diameter of PMC patients was 2.4 cm， which was greater than that of the FA group （1.8 cm）， and the difference was statistically significant （P=0.001）. Of the PMC， 70% （35/50） were irregular， 82% （41/50） were parallel to the skin， 92% （46/50） had no circumscribed margin， 72% （36/50） were hypoechoic， and 68% （34/50） had enhanced posterior echo. Of the FA， 69% （69/100） were oval or round， 98% （98/100） were parallel to the skin， 54% （54/100） had circumscribed margin， 98% （98/100） were hypoechoic， and 75% （75/100） had no posterior features. The differences in the above ultrasound characteristics between the PMC and FA groups were statistically significant （P<0.001， P=0.001， P<0.001， P<0.001， P<0.001）. There was no significant difference between calcifications and blood flow.ConclusionsCompared with the FA group， patients with PMC are older and the diameter of the lesions are larger. On ultrasound， the morphology and margin of most breast PMC still show the growth characteristics of invasive cancer. Meanwhile， the posterior echo of PMC is enhanced， which is a unique manifestation.关键词：breast;mucinous carcinoma;pure mucinous carcinoma;fibroadenoma;ultrasound
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发布时间：2024-07-30 - 摘要：ObjectiveTo explore the predictive value of multimodal clinical and ultrasonographic data in first- and second-trimester for small for gestational age （SGA）， so as to build and internally validate SGA prediction models based on multiple machine learning algorithms.MethodsThis retrospective study enrolled 1，307 pregnant women with singleton pregnancies， diagnosed SGA according to INTERGROWTH-21st fetal growth criteria， and collected multimodal clinical data including general clinical information， biochemical test data， and prenatal ultrasound screening data. Extreme gradient boosting （XGBoost） algorithm was used to calculate the importance of variables. Seven machine learning algorithms were used to construct and internally verify the prediction models. The area under the receiver operating characteristic curve （AUC） was used as the main indicator to measure the prediction performance and used to compare predictive performance between models with the sensitivity at a 10% false positive rate.ResultsThe optimal prediction model built based on general clinical information and biochemical test data had an AUC of 0.70， 95%CI （0.609， 0.791） and a sensitivity of 0.38， 95%CI （0.236， 0.519）. The optimal prediction model based on prenatal ultrasound screening data was better than the former， with an AUC of 0.77， 95%CI （0.687， 0.858） and a sensitivity of 0.62， 95%CI （0.457， 0.743）. The two data sets were combined to form the multimodal clinical dataset， and the performance of the best prediction model was further improved with an AUC of 0.91， 95%CI （0.851， 0.972） and a sensitivity of 0.88， 95%CI （0.745， 0.947）， and the model calibration showed good goodness of fit.ConclusionBy using machine learning algorithms to fully explore the predictive value of different types of clinical data for SGA in first- and second-trimester， this study proves the absolute advantages of multimodal clinical data for SGA screening， and provides an accurate and effective reference for personalized management of pregnant women.关键词：Small for gestational age;prediction model;machine learning;first-trimester;second-trimester
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发布时间：2024-07-30 - 摘要：ObjectiveTo explore the clinical characteristics of neurobrucellosis in Kashi， Xinjiang Uygur Autonomous Region， thus improve the diagnosis and treatment.MethodsA retrospective analysis was conducted on the clinical data of 18 cases of neurobrucellosis who were admitted to the First People's Hospital of Kashi Prefecture between December 2019 and January 2024.ResultsThe study included 9 males and 9 females， with a median age of 36 years （range： 17-54.5）. A clear epidemiological history was found in all the 18 brucllosis patients， 12 of whom presented with meningoencephalitis， 5 meningitis， and 1 encephalitis. Two comorbided with spinal meningitis， 2 osteoarthritis and 1 epididymitis. Most frequently reported clinical symptoms were headache， fever and fatigue. The prevalence rates of brucellosis by rose bengal plate agglutination test （RBPT） and serum agglutination test （SAT） were 11/12 and 8/9， respectively. Two of 10 patients had positive blood cultures， four of 16 had positive cerebrospinal fluid （CSF） cultures and five of five were detected to be positive by next-generation sequencing （NGS） for pathogens in CSF. CSF showed exudative changes and elevated number of leukocytes， with predominance of single nucleated cells. All patients were treated with the combined use of two to four from the drugs like doxycycline， rifampicin， ceftriaxone， cefixime， minocycline， levofloxacin and sulfanilamide. Most patients had a favorable prognosis.ConclusionsNeurobrucellosis should be considered in all patients with central nervous system manifestations from endemic areas. If there are exudative changes in CSF， differential diagnoses can be made by serological testing， blood culture， CSF culture and NGS. NGS could significantly increase the accuracy for neurobrucellosis diagnosis.关键词：Neurobrucellosis;Brucellosis;Encephalitis;Meningitis;Meningoencephalitis
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发布时间：2024-07-30 - 摘要：ObjectiveThis study aimed to improve the existing semen processing methods in the field of reproductive male medicine， particularly focusing on the 300 ×g 20 min treatment condition in the double-layer density gradient method， to enhance fertilization outcome.MethodsSemen specimens from 1 623 patients undergoing assisted reproductive techniques at the Reproductive Medicine Center of the Sixth Affiliated Hospital of Sun Yat-sen University from July and September 2020 and March and May 2022 were collected for preliminary experiments. Four different double-layer density gradient methods （200 ×g 10 min， 200 ×g 20 min， 300 ×g 10 min， and 300 ×g 20 min） were compared for sperm DNA fragmentation rates and recovery rates after processing. Subsequently， the optimal method was selected as the new approach and compared with the current method in use （300 ×g 20 min double-layer gradient method） to assess any statistical differences in fertilization rates. Further optimization to a single-layer density gradient method was performed based on the new method and compared with the double-layer density gradient method to determine any statistical differences. Experimental conditions were strictly controlled for temperature， centrifugation speed， and duration， with the quantity and processing conditions of each sample recorded.ResultsAmong the four double-layer density gradient methods， the sperm DNA fragmentation rate was lower with the 300 ×g 10 min treatment compared to 300 ×g 20 min while ensuring sufficient sperm recovery rates. Consequently， the 300 ×g 10 min method was selected as the new approach for experimentation. Results indicated that the total fertilization rate and 2 pronuclei （2PN） fertilization rate with the new 300 ×g 10 min method were higher than with the 300 ×g 20 min method， the difference was statistically significant （P < 0.05）. Although the cleavage rate with 300 ×g 10 min was slightly higher than 300 ×g 20 min， the difference was not statistically significant （P > 0.05）. The total fertilization rate and 2PN fertilization rate were slightly higher with the single-layer density gradient method compared to the double-layer density gradient method， but the difference was not statistically significant （P > 0.05）. The cleavage rate with the single-layer density gradient method was higher than the double-layer density gradient method， and the blastocyst formation rate is lower than that of the double-layer density gradient method， and the differences are statistically significant （P < 0.05）.ConclusionThe 300 ×g 10 min double-layer density gradient method successfully improved total fertilization rates， 2PN fertilization rates， and cleavage rates compared to the existing 300 ×g 20 min method， while reducing the time required for semen optimization processing. Although the single-layer density gradient method improves the cleavage rate， and saves reagent costs and operation time， its blastocyst formation rate has decreased. These findings provide valuable guidance and insights for semen processing methods in the field of reproductive andrology.关键词：sperm DNA fragmentation index;double-layer density gradient centrifugation;single-layer density gradient centrifugation;fertilization rate;cleavage rate
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发布时间：2024-07-30 - 摘要：ObjectiveTo understand the current status of human immunodeficiency virus （HIV）， Treponema pallidum （TP）， hepatitis C virus （HCV） and hepatitis B virus （HBV） infections among patients undergoing screening tests in a specialized cancer hospital in South China， and to analyze the completion of further testing for confirmation， so as to provide a reference for management of common infectious diseases and prevention of nosocomial infections.MethodsWe analyzed the positive rates of HIV antigen/antibody combination assay （HIV-comb）， TP antibody （anti-TP）， HCV antibody （anti-HCV） and hepatitis B surface antigen （HBsAg） among the outpatients and inpatients who underwent the screening tests in 2022. Then we examined the percentage of those patients with seropositivity for further confirmation.ResultsIn patients who underwent the screening tests， the positive rate， percentage of patients for further confirmation test and overall prevalence for HIV-comb were were 0.07%， 100% and 0.06%， respectively； for Anti-PT 1.99%， 100% and 0.51%， respectively. Positive rate of anti-HCV was 0.90% and 26.61% of patients completed further HCV RNA quantitative assay， in 26.44% of whom， HCV RNA levels were above the detection limit. Positive rate of HBsAg was 21.06% and 54.40% of patients completed further HBV DNA quantitative assay， in 51.60% of whom， HBV DNA levels were above the detection limit. As for the nucleic acid testing among the suspected hepatitis patients， we found smaller coverage in outpatients than in inpatients and larger coverage in liver cancer patients than in other patients.ConclusionsCompared with general population， patients in this specialized cancer hospital had similar infection levels of HIV and syphilis， and 100% of them completed further confirmation testing. Hepatitis C and hepatitis B infections were at a relatively high level， but which could not accurately reflect the level of virus replication due to insufficient coverage of nucleic acid testing. Specialized cancer hospitals should prompt medical staff to attach more importance to screening and further confirmation of common infectious diseases among tumor patients. While offering anti-cancer treatment， hospitals should also actively refer the confirmed cases with infectious diseases to designated or general hospitals for a better outcome and quality of medical services.关键词：specialized cancer hospital;patients;infectious diseases;infection status;screening;diagnosis
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发布时间：2024-07-30
Clinical Research
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