Objective: To evaluate the diagnostic performance of magnetic resonance spectroscopy (MRS) in discriminating fumarate hydratase-deficient (FH-d) uterine leiomyomas (ULs) from FH-preserved ULs. Materials and Methods: This study consisted of three stages, with independent cohorts recruited for each stage: 1) sample-size estimation was retrospectively performed on UL specimens (diameter ≥3 cm; age, 20–40 years) from our database with immunohistochemistry (IHC) for 2-succinocysteine (2-SC) as the reference, without genetic testing, 2) MRS sequence optimization in confirmed FH germline mutation participants with ultrasound-detected ULs (diameter ≥3 cm), without IHC analysis, and 3) prospective diagnostic test accuracy was evaluated in consecutive participants with ultrasound-detected ULs (diameter ≥3 cm;age, 20–40 years), using IHC for 2-SC for determining the FH status and subsequent genetic testing in those with positive 2-SC results to identify whether FH mutations were germline or somatic in origin. The choline and fumarate peaks in MRS were classified as positive, negative, or technical failure (TF). TFs were analyzed separately and excluded from the primary diagnostic accuracy calculations. T1-, T2-, and diffusion-weighted images were interpreted as hyperintense or hypointense. The enhancement rate and apparent diffusion coefficient were also acquired. Diagnostic performance was compared between MRS and various magnetic resonance imaging (MRI) features. Results: The optimal MRS parameters for the fumarate peak were echo time (TE) = 140 ms and an average of 256. Among the 360 prospective participants, 37 were confirmed to have FH-dULs. MRS showed positive fumarate peaks in 35 of 37 FH-dULs.After excluding six TFs, the positive fumarate peak on MRS showed 94.6% (35/37) sensitivity, 99.7% (316/317) specificity, and 99.2% (351/354) accuracy, all of which were significantly superior to those of other MRI features (P ≤ 0.002). Conclusion A positive fumarate peak on MRS may be a useful imaging biomarker for diagnosing FH-dULs.

Natural killer cells(NK)are important innate immune cells that do not require prior antigen exposure and can directly recognize and attack virus-infected cells and tumor cells.The activation and effector functions of NK cells are regulated by a balance of signals delivered through their surface activating receptors and inhibitory re-ceptors,which bind to ligands on target cells to achieve cytotoxicity via"induced self"and"missing self"recogni-tion models.The killing mechanisms of NK cells primarily include release of cytotoxic granules such as perforin and granzymes to induce target cell lysis,death receptor-mediated apoptosis,secretion of various cytokines,chemokines and growth factors to coordinate with other immune cells in killing tumor cells,thereby generating secondary im-mune responses and antibody-dependent cellular cytotoxicity(ADCC).

Objective:To investigate the current application of blood purification in the treatment of acute poisoning within Jiangsu Province and to evaluate the impact of extracorporeal blood purification on the clinical outcomes of critically poisoned patients.Methods:This multicenter, cross-sectional real-world observational study followed patients presenting with poisoning to the emergency departments of nine hospitals in Jiangsu Province between June 2015 and May 2019. Data were collected on demographic characteristics, vital signs within the first hour of emergency presentation, treatment modalities, length of hospital stay, and survival outcomes. Clinical data from patients who underwent extracorporeal blood purification were compared with those who did not, using the Wilcoxon rank-sum test and Chi-square test.Results:A total of 4 178 poisoning cases were included between June 2015 and May 2019. Among them, 21.7% (908/4 178) received blood purification therapy, while 78.3% (3 270/4 178) did not. Hemoperfusion (90.4%) was the most frequently employed method, followed by continuous renal replacement therapy (CRRT) (4.4%). In combined blood purification modalities, 4.8% underwent hemoperfusion combined with CRRT, 0.1% received hemoperfusion with plasma exchange, and another 0.1% underwent hemoperfusion combined with both CRRT and plasma exchange. Among patients who underwent blood purification, pesticide poisoning was the most prevalent (76.3%), with the most common toxic agents being paraquat (23.7%), dichlorvos (8.7%), methamidophos (5.2%), omethoate (4.0%), and glyphosate (3.7%). Compared to the non-blood purification group, patients in the blood purification group were more likely to present within the first hour with a low Glasgow Coma Scale (GCS) score (3-8) (22.6% vs. 9.7%, P <0.05), low mean arterial pressure (8.0% vs. 3.2%, P <0.05), longer hospital stays [5(3,9) days vs. 2(1,4) days, P <0.05] and a higher in-hospital mortality rate (21.1% vs. 5.3%, P <0.05). Follow-up via telephone 28 days after discharge revealed a survival rate of 78.9%, with a mortality rate of 21.1% in the blood purification group. Conclusions:Hemoperfusion is the most commonly utilized blood purification technique for treating poisoning in Jiangsu Province, with pesticides being the primary toxic agents treated. Although the mortality rate is higher in the blood purification group, the intervention may still contribute to improved patient outcomes.

Creutzfeldt-Jakob disease(CJD)is a rapidly progressive and fatal neurodegenerative disorder caused by prions,with certain infectivity and iatrogenic transmission risks.With the rapid progress and application of new dia-gnostic biomarkers and detection methods,as well as the construction and improvement of surveillance and reporting systems,the detection of CJD in patients domestically and internationally has shown an increasing trend year by year.Due to its long incubation period and heterogeneity of early symptoms,early identification and diagnosis of the disease is difficult,increasing the risk of transmission within medical institutions.Currently,there is a lack of con-sensus on the infection prevention and control of CJD.In order to timely identify and diagnose CJD as well as effec-tively block its transmission in medical institutions,this consensus summarizes 15 clinical concerns and formulates 24 specific recommendations based on the latest domestic and international research findings and clinical evidence,as well as combines with clinical practice,aiming to standardize healthcare-associated infection prevention and control measures for CJD and reduce its transmission risk in medical institutions.

Creutzfeldt-Jakob disease(CJD)is a rapidly progressive and fatal neurodegenerative disorder caused by prions,with certain infectivity and iatrogenic transmission risks.With the rapid progress and application of new dia-gnostic biomarkers and detection methods,as well as the construction and improvement of surveillance and reporting systems,the detection of CJD in patients domestically and internationally has shown an increasing trend year by year.Due to its long incubation period and heterogeneity of early symptoms,early identification and diagnosis of the disease is difficult,increasing the risk of transmission within medical institutions.Currently,there is a lack of con-sensus on the infection prevention and control of CJD.In order to timely identify and diagnose CJD as well as effec-tively block its transmission in medical institutions,this consensus summarizes 15 clinical concerns and formulates 24 specific recommendations based on the latest domestic and international research findings and clinical evidence,as well as combines with clinical practice,aiming to standardize healthcare-associated infection prevention and control measures for CJD and reduce its transmission risk in medical institutions.

AIM: To observe the effect of RBC preservation solution with sodium pyruvate on the morphology, structure and function of RBC stored in vitro in type 2 diabetes rats. METHODS: Thirty SPF male SD rats, were randomly divided into 3 groups (n=10): non-T2DM conventional RBC preservation solution (group A), T2DM conventional RBC preservation solution (group B) and T2DM sodium pyruvate RBC preservation solution (group C). The leukoreduced RBC from the tail vein and stored for 0 d (T0), 7 d (T1), 14 d (T2), 21 d (T3) and 28 d (T4) to detect the morphology, structure and the contents of 2, 3-DPG, reactive oxygen species (ROS), malondialdehyde (MDA) and lactic acid (LA) of RBC in group A, B and C. The RBC stored for 14 days in vitro were labeled with PKH26, and its survival rate were tested in vivo at 1, 4, 10 and 16 hours after intravenous infusion. RESULTS: At T0, the RBC morphology of group A was intact, which was better than that of group B and group C. With the extension of storage time, the morphology of RBC in each group gradually transformed into a spindle-spherical shape. Compared with group A, the incidence of acanthocytes in group B and group C was higher, and the incidence of acanthocytes in group C was lower than that in group B. Compared with group A, the content of 2, 3-DPG in group B and group C decreased, while ROS and MDA increased at different time points (P<0.05). The content of 2,3-DPG in group C was higher than that in group B (P<0.05), and the contents of ROS and MDA were lower than those in group B (P<0.05). LA content in group B was higher than that in group A and group C (P<0.05). At T2-T4, the LA content in group C was lower than that in group A (P<0.05). The survival rate of RBC in group A was higher than that in group B and C, and the survival rate of RBC in group B was lower than that in group C (P<0.05). CONCLUSION: Sodium pyruvate added RBC preservation solution has a certain protective effect on RBC stored in vitro in type 2 diabetic rats, and its mechanism may be related to its antioxidant effect.

Male ; Humans ; Liquid Chromatography-Mass Spectrometry ; Chromatography, Liquid ; Tandem Mass Spectrometry ; Varicocele/diagnosis* ; Biomarkers

Objective:To evaluate the effect of novel erythrocyte preservation solution on the quality of erythrocytes in stored blood of type 2 diabetes mellitus (T2DM) rats.Methods:Forty SPF male Sprague-Dawley rats, aged 8 weeks, weighing 180-220 g, were used in this study. Ten rats randomly selected served as conventional erythrocyte preservation solution group (group A). T2DM model was prepared in the remaining 30 rats. Twenty T2DM rats were divided into 2 groups ( n=10 each) using a random number table method: T2DM conventional erythrocyte preservation solution control group (group C) and T2DM novel erythrocyte preservation solution observation group (group Y). Erythrocyte preservation solution was prepared to simulate the preoperative autologous blood donation process, and blood was collected from the tail vein to isolate the red blood cells, and then the corresponding preservation solution was added. Immediately after blood collection (T 0) and at 7, 14 and 21 days of preservation (T 1-3), the morphological structure of erythrocytes was observed with a light microscope, and the concentrations of 2, 3-diphosphoglycerate (2, 3-DPG) and reactive oxygen species (ROS) were also determined by enzyme-linked immunosorbent assay at T 0-T 3 and 28 days of preservation (T 4). PKH26 was used to label the erythrocytes stored in vitro for 28 days, and then the erythrocytes were transfused back into rats. The survival rate of erythrocytes was detected by flow cytometry at 1, 7, 13 and 18 h after retransfusion. Results:The erythrocyte damage was aggravated at different time points of preservation in group C when compared with group A. Compared with group C, the damage to erythrocytes was significantly alleviated at different time points of preservation in group Y. Compared with group A, the concentration of 2, 3-DPG in erythrocytes was significantly decreased at T 0 and T 2-T 4, the concentration of ROS was increased at T 0-T 4, and the survival rate of erythrocytes was decreased at 1, 7 and 18 h after retransfusion in group C ( P<0.05). Compared with group C, the concentration of 2, 3-DPG in erythrocytes was significantly increased at T 0-T 4, the content of ROS was decreased at T 1, T 3 and T 4, and the survival rate of erythrocytes was increased at 1, 7 and 18 h after retransfusion in group Y ( P<0.05). Conclusions:The novel erythrocyte preservation solution can improve the quality of stored erythrocytes and increase the survival rate of erythrocytes in vivo after retransfusion in T2DM rats.

Objective:To provide theoretical basis for strength and endurance training of waist and abdominal muscles and prevention of waist injuries in fighter pilots by exploring the muscle strength and work characteristics of the waist and abdominal flexor and extensor muscles in fighter pilots.Methods:Sixty male fighter pilots who were qualified for flight in aeromedical assessment, aged 24-46 years old, were randomly selected and divided into 24-30, 31-40, 41-46 years group. The Isomed2000 isokinetic dynamometer system was applied to measure the muscle strength and work performance of the abdominal and lumbar flexors and extensors of the fighter pilots with the angular velocities of 60°/s and 180°/s. The flexion and extension muscle peak torque, relative peak torque, flexion-extension ratio, and endurance ratio were compared among different age groups of pilots.Results:At the same angular velocity, the peak torque and relative peak torque of the lumbar and abdominal extensor muscles in fighter pilots were greater than those of the flexor muscles, with statistically significant differences ( t=7.01-9.13, all P<0.001). The peak torque and relative peak torque of the lumbar and abdominal flexor and extensor muscles significantly decreased with increasing test angular velocity ( t=13.63-17.25, all P<0.001). Under the angular velocity of 60°/s, there were no significant differences in the peak torque and relative peak torque of the flexor muscles among different age groups (both P>0.05); there were significant differences in the peak torque and relative peak torque of extensor muscles ( F=5.31, 6.61, P=0.008, 0.003) and 41-46 years groups were lower than the other 2 groups ( P=0.019, 0.003, 0.002, 0.004). Under an angular velocity of 180°/s, there were significant differences in the peak torque and relative peak torque of the waist and abdominal flexor and extensor muscles among different age groups ( F=3.82, 3.47, 3.83, 5.49, P=0.028, 0.043, 0.027, 0.008); the relative peak torque of the abdominal and lumbar flexor and extensor muscles in the 24-30 years group was higher than that in the 41-46 years group ( P=0.032, 0.006). The peak torque and the relative peak torque of the abdominal and lumbar flexor muscles in 31-40 years group were higher than those in 41-46 years group ( P=0.008, 0.013). The low qualification rate of peak torque ratio indicated the imbalance between flexor and extensor muscles and the poor endurance of abdominal and lumbar flexor and extensor muscles than that of flexor muscles. There was no statistically significant difference in the endurance ratio of the abdominal and lumbar flexor and extensor muscles among different age groups ( P>0.05). Conclusions:The balance between flexor and extensor muscles of waist and abdominal muscles should be paid more in fighter pilot′s fitness training. For the pilots older than 40 the training targeted to slow the muscles decline is necessary.

Objective:To provide theoretical basis for strength and endurance training of waist and abdominal muscles and prevention of waist injuries in fighter pilots by exploring the muscle strength and work characteristics of the waist and abdominal flexor and extensor muscles in fighter pilots.Methods:Sixty male fighter pilots who were qualified for flight in aeromedical assessment, aged 24-46 years old, were randomly selected and divided into 24-30, 31-40, 41-46 years group. The Isomed2000 isokinetic dynamometer system was applied to measure the muscle strength and work performance of the abdominal and lumbar flexors and extensors of the fighter pilots with the angular velocities of 60°/s and 180°/s. The flexion and extension muscle peak torque, relative peak torque, flexion-extension ratio, and endurance ratio were compared among different age groups of pilots.Results:At the same angular velocity, the peak torque and relative peak torque of the lumbar and abdominal extensor muscles in fighter pilots were greater than those of the flexor muscles, with statistically significant differences ( t=7.01-9.13, all P<0.001). The peak torque and relative peak torque of the lumbar and abdominal flexor and extensor muscles significantly decreased with increasing test angular velocity ( t=13.63-17.25, all P<0.001). Under the angular velocity of 60°/s, there were no significant differences in the peak torque and relative peak torque of the flexor muscles among different age groups (both P>0.05); there were significant differences in the peak torque and relative peak torque of extensor muscles ( F=5.31, 6.61, P=0.008, 0.003) and 41-46 years groups were lower than the other 2 groups ( P=0.019, 0.003, 0.002, 0.004). Under an angular velocity of 180°/s, there were significant differences in the peak torque and relative peak torque of the waist and abdominal flexor and extensor muscles among different age groups ( F=3.82, 3.47, 3.83, 5.49, P=0.028, 0.043, 0.027, 0.008); the relative peak torque of the abdominal and lumbar flexor and extensor muscles in the 24-30 years group was higher than that in the 41-46 years group ( P=0.032, 0.006). The peak torque and the relative peak torque of the abdominal and lumbar flexor muscles in 31-40 years group were higher than those in 41-46 years group ( P=0.008, 0.013). The low qualification rate of peak torque ratio indicated the imbalance between flexor and extensor muscles and the poor endurance of abdominal and lumbar flexor and extensor muscles than that of flexor muscles. There was no statistically significant difference in the endurance ratio of the abdominal and lumbar flexor and extensor muscles among different age groups ( P>0.05). Conclusions:The balance between flexor and extensor muscles of waist and abdominal muscles should be paid more in fighter pilot′s fitness training. For the pilots older than 40 the training targeted to slow the muscles decline is necessary.