Objective To construct a predictive model for cerebral small vessel disease (CSVD) MRI burden based on β2-microglobulin (β2-MG) and lipoprotein(a) [Lp(a)], analyze its predictive value, and validate the model. Methods A total of 138 CSVD patients admitted to Anhui No.2 Provincial People’s Hospital from February 2023 to August 2024 were enrolled. Patients were divided into a low-burden group (n=63) and a moderate/severe burden group (n=75) according to the CSVD MRI burden scoring criteria. The related clinical data were compared between the two groups. Binary logistic regression analysis was used to identify independent factors for CSVD moderate/severe MRI burden. A nomogram predictive model was constructed based on these factors and its performance was evaluated. Results The proportions of male patients, as well as those with a history of diabetes or hypertension, were significantly higher in the moderate/severe burden group than those in the low burden group. Additionally, the age of patients in the moderate/severe burden group was significantly older, and the levels of β2-MG, Lp(a), and homocysteine (Hcy) were higher than those in the low burden group (P＜0.01). Binary logistic regression analysis revealed that hypertension, diabetes, β2-MG, and Lp(a) were independent factors for CSVD moderate/severe MRI burden (P＜0.05). The nomogram predictive model based on these four factors had a cut-off value of 0.467 0, with an area under curve (AUC) of 0.838 7 (95%CI 0.760 8-0.916 6) in the training set (n＝97) and 0.854 1 (95%CI 0.742 1-0.966 1) in the internal validation set (n＝41) . The calibration curve demonstrated good agreement between predicted and observed values. Decision curve analysis (DCA) indicated that the nomogram model had good clinical utility. Conclusions The nomogram model based on β2-MG and Lp(a) has high predictive performance in assessing the risk of CSVD moderate/severe MRI burden, with good discrimination and calibration.

Objective To investigate the corr-elation between MRI burden and inflammatory factors and depression in elderly patients with cerebral small vessel disease(CSVD).Methods The clinical data of 150 patients with CSVD confirmed by brain MRI(CSVD group)and 40 patients with normal brain MRI(control group)were collected.The Hamilton depression rating scale 17-item(HAMD-17)was used to evaluate the degree of depression of the patients.The differences in CSVD burden,inflammatory markers and risk factors between the depressed group and the non-depressed group were compared,and the predictive value of the three and their combined predictions on depression were analyzed.The difference and correlation of HAMD-17 item scale scores between control group and CSVD group were compared.Results There were statistically significant differences in women,stress level,and high-sensitivity C-reactive protein(hs-CRP)level between the depressed group and the non-depressed group(all P＜0.05).Logistic regression analysis showed that CSVD burden degree,female,and hs-CRP were independent risk factors for depression(all P＜0.05).The ROC curve showed that the cut-off value of CSVD burden for depression was moderate,the sensitivity was 73％,the specificity was 47％,and the area under the curve(AUC)was 0.648(95％CI:0.558-0.738,P=0.002);the cut-off value of hs-CRP for depression was 3.73 mg/L,the sensitivity was 60％,the specificity was 73％,and the AUC area was 0.657(95％CI:0.566-0.748,P=0.001);the sensitivity of gender to depression was 68％,the specificity was 52％,and the AUC area was 0.597(95％CI:0.505-0.690,P=0.045).The combined sensitivity and specificity of the three were 70％and 73％,and the AUC area was 0.738(95％CI:0.656-0.820,P＜0.001).Compared with that in the control group,the HAMD-17 score of patients in the mild,moderate and severe burden groups were significantly increased(H=21.854,P＜0.001).Spearman correlation analysis showed that CSVD burden was positively correlated with HAMD-17 score(r=0.330,P＜0.001).Conclusions CSVD burden,female and elevated hs-CRP are independent risk factors for depression in elderly patients with CSVD.The degree of CSVD burden is positively correlated with depression score,and the accuracy of the combined prediction model is high,which has certain predictive value for senile depression.

Objective To investigate the corr-elation between MRI burden and inflammatory factors and depression in elderly patients with cerebral small vessel disease(CSVD).Methods The clinical data of 150 patients with CSVD confirmed by brain MRI(CSVD group)and 40 patients with normal brain MRI(control group)were collected.The Hamilton depression rating scale 17-item(HAMD-17)was used to evaluate the degree of depression of the patients.The differences in CSVD burden,inflammatory markers and risk factors between the depressed group and the non-depressed group were compared,and the predictive value of the three and their combined predictions on depression were analyzed.The difference and correlation of HAMD-17 item scale scores between control group and CSVD group were compared.Results There were statistically significant differences in women,stress level,and high-sensitivity C-reactive protein(hs-CRP)level between the depressed group and the non-depressed group(all P＜0.05).Logistic regression analysis showed that CSVD burden degree,female,and hs-CRP were independent risk factors for depression(all P＜0.05).The ROC curve showed that the cut-off value of CSVD burden for depression was moderate,the sensitivity was 73％,the specificity was 47％,and the area under the curve(AUC)was 0.648(95％CI:0.558-0.738,P=0.002);the cut-off value of hs-CRP for depression was 3.73 mg/L,the sensitivity was 60％,the specificity was 73％,and the AUC area was 0.657(95％CI:0.566-0.748,P=0.001);the sensitivity of gender to depression was 68％,the specificity was 52％,and the AUC area was 0.597(95％CI:0.505-0.690,P=0.045).The combined sensitivity and specificity of the three were 70％and 73％,and the AUC area was 0.738(95％CI:0.656-0.820,P＜0.001).Compared with that in the control group,the HAMD-17 score of patients in the mild,moderate and severe burden groups were significantly increased(H=21.854,P＜0.001).Spearman correlation analysis showed that CSVD burden was positively correlated with HAMD-17 score(r=0.330,P＜0.001).Conclusions CSVD burden,female and elevated hs-CRP are independent risk factors for depression in elderly patients with CSVD.The degree of CSVD burden is positively correlated with depression score,and the accuracy of the combined prediction model is high,which has certain predictive value for senile depression.

Objective:To explore the expression of family with sequence similarity 83 member A (FAM83A) in colorectal cancer, and the effect of FAM83A knockdown on the proliferation of colorectal cancer cells and the related mechanism.Methods:The expression of FAM83A in the tissues of 102 patients with colorectal cancer and its adjacent tissues was detected by immunohistochemistry. HCT116 cells were divided into experimental group and control group. The experimental group cells were transfected with FAM83A-siRNA plasmid, and the control group cells were transfected with MOCK-siRNA plasmid. The mRNA content of FAM83A in each group was detected by fluorescence quantitative PCR. The expressions of FAM83A, P13K, p-AKT and p-mTOR in each group were detected by Western blot. CCK8 assay and clonogenesis assay were used to detect cell proliferation.Results:The positive rate of FAM83A in colorectal cancer patients was 88.23% (90 cases /102 cases), and the expression rate of FAM83A in paracancer tissues was 10.78% (11 cases /102 cases). The expression rate of Fam83a in colorectal cancer tissues was significantly higher than that in paracancer tissues, with statistical significance ( P<0.001). After siRNA transfection, the mRNA expression levels of FAM83A in HCT116 cells of the experimental group and control group were 1.23±0.20 and 0.43±0.12, respectively, and the protein expression levels of FAM83A were 1.19±0.11 and 0.23±0.08, respectively. The expression levels of P13K were 1.21±0.17 and 0.28±0.09, the expression levels of p-AKT were 1.35±0.23 and 0.57±0.18, and the expression levels of p-mTOR were 1.48±0.20 and 1.05±0.14. The expression of P13K, p-Akt and p-mTOR was down-regulated (all P<0.05). The absorbance of HCT116 cells in the experimental group and the control group was 1.09±0.22 and 2.21±0.27, respectively. The cloning rate of HCT116 cells in the experimental group and the control group was 21.6%±2.4% and 62.7%±4.1%, respectively. The proliferation ability of HCT116 cells in the experimental group decreased significantly ( P<0.05) . Conclusions:The expression of FAM83A is significantly increased in colorectal cancer tissues, which may be related to the malignant degree of colorectal cancer. FAM83A affects the proliferation of colorectal cancer cells through the P13K/AKT/mTOR signaling pathway.

AIM:To determine the link between infliximab,adalimumab,vedolizumab,ustekinumab and risk of lymphoma in order to provide reference for the safety of clinical application.METHODS:Dis-proportionality analysis and Bayesian analysis were used in data mining to screen the suspected lym-phoma after the use of four biological agents based on the FAERS data from October 2012 to June 2023.The fatality and hospitalization rates of this four biological agents associated lymphoma were also investigated.RESULTS:Totally 705 cases of four biological agents associated lymphoma were collected.Four biological agents associated lymphoma appeared to influent more young pa-tients and middle-aged patients than elderly pa-tients(25.11％vs.22.41％vs.12.2％).There were slightly more male than females(42.84％vs.35.60％).Infliximab has the highest reporting odds ratio[ROR3.40,95％CI=(3.03,3.82)],proportional ratio[PRR3.38,95％CI=(3.01,3.79)],information component(IC1.14,IC-2SD=1.02)and empirical Bayes geometric mean(EBGM2.21,EBGM05=2.01).Significant difference in the fatality rate and hospi-talization rate among four biological agents were not found.CONCLUSION:Infliximab showed a strongest lymphoma association than the other three biological agents.Lymphoma risk should be vigilant when using infliximab.

BACKGROUND: Current replacement procedures for stenosis or occluded arteries using prosthetic grafts have serious limitations in clinical applications, particularly, endothelialization of the luminal surface is a long-standing unresolved problem.METHOD: We produced a cell-based hybrid vascular graft using a bioink engulfing adipose-derived mesenchymal stromal cells (ADSCs) and a 3D bioprinting process lining the ADSCs on the luminal surface of GORE-Tex grafts. The hybrid graft was implanted as an interposition conduit to replace a 3-cm-long segment of the infrarenal abdominal aorta in Rhesus monkeys. RESULTS: Complete endothelium layer and smooth muscle layer were fully developed within 21 days post-implantation, along with normalized collagen deposition and crosslinking in the regenerated vasculature in all monkeys. The regenerated blood vessels showed normal functionality for the longest observation of more than 1650 days. The same procedure was also conducted in miniature pigs for the interposition replacement of a 10-cm-long right iliac artery and showed the same long-term effective and safe outcome. CONCLUSION This cell-based vascular graft is ready to undergo clinical trials for human patients.

Objective To analyze the correlation between anxiety symptoms and abnormal brain function in patients with chronic obstructive pulmonary disease (COPD) under long-term chronic hypoxia. Methods Twenty-one patients with COPD complicated with anxiety were prospectively selected as COPD group, and 26 healthy individuals matched for gender and age were selected as control group. Both groups underwent high-resolution 3D-T1-weighted imaging (3D-T1WI), T2-fluid-attenuated inversion recovery (T2-FLAIR), and blood oxygen level dependent (BOLD) sequence examination. DPARSF and SPM8 software were used to analyze the amplitude of low-frequency fluctuations (ALFF) in the brain of the two groups. Results In the COPD group, the ALFF value in the left parahippocampal gyrus-cingulate gyrus increased, and the ALFF value in the right superior frontal gyrus decreased (P < 0.05). Pearson correlation analysis found that there was a negative correlation between the ALFF value in the right superior frontal gyrus and the anxiety score (r=-0.485, P=0.03). Conclusion Chronic hypoxic patients with COPD have brain functional impairment in the right superior frontal gyrus, and the degree of impairment is positively correlated with anxiety symptoms. There may also be compensatory enhancement of brain function activity in the parahippocampal gyrus-cingulate gyrus.

Objective:To explore the effect of the training model based on the National Telemedicine Center in the technical training of children's implantable venous access port.Methods:Using the convenience sampling, 42 nurses who participated in the technical training of children's implantable venous access port in the First Affiliated Hospital of Zhengzhou University from May 2019 to December 2019 were selected as the study group. A total of 36 nurses who participated in the technical training of children's implantable venous access port in the First Affiliated Hospital of Zhengzhou University from December 2018 to March 2019 were retrospectively selected as the control group. The control group received the traditional training, and the study group implemented the training model based on the National Telemedicine Center. The theoretical assessment, operational assessment and training satisfaction were compared between the two groups before and after training.Results:After training, the theoretical assessment, operational assessment and training satisfaction scores of the study group were higher than those of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The training model based on the National Telemedicine Center in the technical training of children's implantable venous access port can enhance the professional knowledge and practical skills of nurses and improve the training satisfaction.

BACKGROUND: Low dose computed tomography (LDCT) for lung cancer screening is widely employed in China as a result of increasing cancer screening awareness. Although some pulmonary lesions detected by LDCT are cancerous, most of the pulmonary nodules are benign. It is important to make effective preoperative differentiation of pulmonary lesions and to obviate the need for surgery in some patients with benign disease. METHODS: From January 1, 2017 to December 31, 2018, patients in our institution with surgical pathology confirmed benign pulmonary lesions in which malignancy could not be excluded in preoperative assessment were enrolled in this study. Retrospective analysis of clinical data was conducted. RESULTS: 297 cases were collected in this study. Prevalence of benign disease in patients underwent resection for focal pulmonary lesions is 9.8% in our institution. In 197 patients (66.3%), pulmonary lesions were detected by LDCT screening. A total of 323 assessable pulmonary lesions were detected by chest CT. The average diameter of pulmonary lesions was (17.9±12.1) mm, and 91.0% of which were greater than or equal to 8 mm. Solid nodules accounted for 65.6% of these lesions. Imaging characteristics suggesting malignancy were common, including spicule sign (71/323, 22.0%), lobulation (94/323, 29.1%), pleural indentation (81/323, 25.1%), vascular convergence sign (130/323, 40.2%) and vacuole sign (23/323, 7.1%). 292 patients (98.3%) underwent video-assisted thoracoscopic surgery (VATS). Pulmonary wedge resection was performed in 232 cases (78.1%), segmental resection in 13 cases (4.4%) and lobotomy in 51 cases (17.2%). Surgical complications occurred in 4 patients (1.3%). The most frequent findings on surgical pathology analysis were: infectious lesions in 98 cases (33.0%), inflammatory nodules in 96 cases (32.3%), and hamartoma in 64 cases (21.5%). CONCLUSIONS Solid nodules accounted for most of these benign pulmonary lesions in which malignancy could not be excluded preoperatively, and imaging characteristics suggesting malignancy were common. VATS is an important biopsy method to identify etiology and pathology for lesions. The most frequent benign pulmonary diseases that are suspected to be malignant and underwent surgical resection are: infectious lesions, inflammatory nodules and hamartoma.

COVID-19 is caused by the 2019 novel coronavirus, which is characterized by hidden onset, long incubation period, and high contagion. The study found that the COVID-19 not only attacks the respiratory system, but also affects other systems such as the heart, kidney, and digestive tract, and could be combined with multiple system diseases such as acute cerebrovascular disease. If doctors, especially non-infective or respiratory doctors, do not pay great attention to the patient when they are receiving patients, and take good care of them, they may easily cause their own infection. This article summarizes the case of a concealed onset COVID-19 patient with cerebral infarction, which caused a medical staff infection after intravenous thrombolytic therapy, explores its clinical characteristics, treatment process and analyzes its prevention and control links to help the epidemic situation. In the prevention and control, the first-time doctor should pay attention to identification, reduce missed diagnosis, and scientific investigation to reduce occupational infection.