OBJECTIVES: To construct a nomogram for predicting the efficacy of immune checkpoint inhibitors (ICIs) in advanced non-small cell lung cancer (aNSCLC) by integrating chest CT radiomics signature that reflects the tumor microenvironment (TME) and clinical parameters of the patients. METHODS: Transcriptomic and CT imaging data from TCGA, GEO and TCIA databases were integrated for weighted gene co-expression network analysis (WGCNA) of the GEO cohort to identify the immunotherapy-related genes (IRGs) associated with ICIs response. A prognostic model was built using these IRGs in the TCGA cohort to assess immune microenvironment features across different risk groups. Radiomics features were extracted from TCIA lung_3 cohort using PyRadiomics, and 94 features showing strong association with IRGs (|r|>0.4) were selected. A retrospective cohort consisting of 210 aNSCLC patients receiving first-line ICIs at Guangdong Provincial People's Hospital was analyzed and divided into training (n=147) and validation (n=63) groups. Least absolute shrinkage and selection operator was used for radiomic features selection, and logistic regression was applied to construct a combined clinical-radiomic model and nomogram for predicting ICIs therapy response. The performance of the model was evaluated using ROC curve, calibration curve, and decision curve analysis. RESULTS: WGCNA identified 84 IRGs enriched in immune activation pathways. The combined model outperformed individual models in both the training (AUC=0.725, 95% CI: 0.644-0.807) and validation cohorts (AUC=0.706, 95% CI: 0.577-0.836). Calibration curve and decision curve analyses confirmed the clinical efficacy of the nomogram for predicting ICIs therapy response in aNSCLC patients. CONCLUSIONS The genomic-radiomic-clinical multidimensional predictive framework established in this study provides an interpretable biomarker combination and clinical decision-making tool for evaluating ICIs efficacy in aNSCLC, potentially facilitating personalized immunotherapy decision-making.
Humans ; Carcinoma, Non-Small-Cell Lung/therapy* ; Tumor Microenvironment ; Lung Neoplasms/therapy* ; Immunotherapy ; Tomography, X-Ray Computed ; Nomograms ; Retrospective Studies ; Immune Checkpoint Inhibitors/therapeutic use* ; Prognosis ; Male ; Female ; Radiomics

Objective:To explore the epidemiological characteristics, imaging findings, pulmonary function changes, dust exposure situations, and treatment outcomes of accelerated silicosis through an analysis of existing literature.Methods:In December 2024, relevant literature from January 1, 1965 to December 15, 2024 was retrieved through the China National Knowledge Infrastructure (CNKI), Wanfang Database, VIP Database, EMbase, and PubMed databases. Keywords included "rapidly progressive silicosis" "accelerated silicosis" "subacute silicosis""artificial stone" and related terms. By incorporating, analyzing, and retrieving data from literatures, a comprehensive review of the epidemiology, clinical features, treatment options, and prognosis of fast forward silicosis was conducted.Results:A total of 72 literatures were included, including 23 cohort studies, 28 case reports, 3 case-control studies, and 18 cross-sectional studies. The average age of all 1794 patients was 33.67 years, with an average dust exposure duration of 5.58 years. The primary occupations associated with accelerated silicosis were stone processing, mining, and artificial quartz stone manufacturing. Imaging findings predominantly included small nodules, ground-glass opacities, and massive fibrosis. Antifibrotic treatment at the early stage of the disease could clearly delay disease progression. However, dust concentrations in workplaces were significantly above safety limits, with inadequate protective measures.Conclusion:Accelerated silicosis is characterized by its rapid onset, swift progression, and unfavorable prognosis. However, it has not garnered adequate attention in the present context. Reliable standard and guidelines are urgently needed to guide clinical diagnosis and treatment.

Objective:To investigate the antimicrobial activity of the antiparasitic drug tiliquinol to Enterococcus faecalis. Methods:From 2023 to 2024, the standard Enterococcus faecalis strain ATCC 29212 and 6 clinical isolates in the Laboratory Department of the Affiliated Changsha Hospital of Xiangya School of Medicine were selected as the subject of this investigation. The sensibility of tiliquinol against E. faecalis was assessed using broth microdilution method, time-killing curves, and kirby-bauer test; the drug resistance induction ability of tiliquinol was detected by continuous induction of resistance and one-step resistance test. The antimicrobial ability of tiliquinol was determined by the biofilm combined laser confocal microscopy. Skin subcutaneous abscess model of E. faecalis infection was established to evaluate the in vivo antibacterial activity of tiliquinol. Paired t-tests and analysis of variance were used for comparisons between two groups and among multiple groups respectively. Results:The minimum inhibitory concentration (MIC) and minimum bactericidal concentration of tiliquinol against E. faecalis ATCC 29212 were both 2 mg/L. Kirby-bauer test showed obvious antimicrobial activity of tiliquinol against E. faecalis. The time-killing curves showed that the subinhibitory concentration of tiliquinol could effectively inhibit bacterial proliferation. Fifteen-day continuous treatment with tiliquinol showed no drug resistance mutation; tiliquinol treatment at 8×MIC for four hours caused reduced count of viable bacteria from (12.01±1.14) lg CFU/ml to (7.72±0.94) lg CFU/ml in ATCC 29212 stain ( t=3.64; P<0.05), while tiliquinol at 2×MIC significantly inhibited the formation of ATCC 29212 biofilm, which reduced from (1.73±0.27) to (0.18±0.14) ( t=8.77, P<0.05); tiliquinol at 4×MIC also significantly cleared the formed biofilm, which reduced from (0.52±0.03) to (0.40±0.06) ( t=3.07, P<0.05). Utilizing the skin subcutaneous abscess model revealed significant antibacterial effects of tiliquinol treatment, specifically, and compared with the control group, the viable bacterial loads in the 30 mg/kg tiliquinol treatment group decreased by more than 1 lg CFU/ml ( t=4.099, P<0.05). Conclusion:Tiliquinol exhibits substantial antibacterial efficacy against E. faecalis both in vitro and in vivo.

Objective:To investigate the antimicrobial activity of the antiparasitic drug tiliquinol to Enterococcus faecalis. Methods:From 2023 to 2024, the standard Enterococcus faecalis strain ATCC 29212 and 6 clinical isolates in the Laboratory Department of the Affiliated Changsha Hospital of Xiangya School of Medicine were selected as the subject of this investigation. The sensibility of tiliquinol against E. faecalis was assessed using broth microdilution method, time-killing curves, and kirby-bauer test; the drug resistance induction ability of tiliquinol was detected by continuous induction of resistance and one-step resistance test. The antimicrobial ability of tiliquinol was determined by the biofilm combined laser confocal microscopy. Skin subcutaneous abscess model of E. faecalis infection was established to evaluate the in vivo antibacterial activity of tiliquinol. Paired t-tests and analysis of variance were used for comparisons between two groups and among multiple groups respectively. Results:The minimum inhibitory concentration (MIC) and minimum bactericidal concentration of tiliquinol against E. faecalis ATCC 29212 were both 2 mg/L. Kirby-bauer test showed obvious antimicrobial activity of tiliquinol against E. faecalis. The time-killing curves showed that the subinhibitory concentration of tiliquinol could effectively inhibit bacterial proliferation. Fifteen-day continuous treatment with tiliquinol showed no drug resistance mutation; tiliquinol treatment at 8×MIC for four hours caused reduced count of viable bacteria from (12.01±1.14) lg CFU/ml to (7.72±0.94) lg CFU/ml in ATCC 29212 stain ( t=3.64; P<0.05), while tiliquinol at 2×MIC significantly inhibited the formation of ATCC 29212 biofilm, which reduced from (1.73±0.27) to (0.18±0.14) ( t=8.77, P<0.05); tiliquinol at 4×MIC also significantly cleared the formed biofilm, which reduced from (0.52±0.03) to (0.40±0.06) ( t=3.07, P<0.05). Utilizing the skin subcutaneous abscess model revealed significant antibacterial effects of tiliquinol treatment, specifically, and compared with the control group, the viable bacterial loads in the 30 mg/kg tiliquinol treatment group decreased by more than 1 lg CFU/ml ( t=4.099, P<0.05). Conclusion:Tiliquinol exhibits substantial antibacterial efficacy against E. faecalis both in vitro and in vivo.

Objective:To explore the epidemiological characteristics, imaging findings, pulmonary function changes, dust exposure situations, and treatment outcomes of accelerated silicosis through an analysis of existing literature.Methods:In December 2024, relevant literature from January 1, 1965 to December 15, 2024 was retrieved through the China National Knowledge Infrastructure (CNKI), Wanfang Database, VIP Database, EMbase, and PubMed databases. Keywords included "rapidly progressive silicosis" "accelerated silicosis" "subacute silicosis""artificial stone" and related terms. By incorporating, analyzing, and retrieving data from literatures, a comprehensive review of the epidemiology, clinical features, treatment options, and prognosis of fast forward silicosis was conducted.Results:A total of 72 literatures were included, including 23 cohort studies, 28 case reports, 3 case-control studies, and 18 cross-sectional studies. The average age of all 1794 patients was 33.67 years, with an average dust exposure duration of 5.58 years. The primary occupations associated with accelerated silicosis were stone processing, mining, and artificial quartz stone manufacturing. Imaging findings predominantly included small nodules, ground-glass opacities, and massive fibrosis. Antifibrotic treatment at the early stage of the disease could clearly delay disease progression. However, dust concentrations in workplaces were significantly above safety limits, with inadequate protective measures.Conclusion:Accelerated silicosis is characterized by its rapid onset, swift progression, and unfavorable prognosis. However, it has not garnered adequate attention in the present context. Reliable standard and guidelines are urgently needed to guide clinical diagnosis and treatment.

Objective:To investigate personal exposures to nitrogen oxides(NOX)and nitrogen di-oxide(NO2)and the influence of baseline personal characteristics,living environment and daily activity patterns of the participants on the exposures among adults over 35 in Tianjin and Shanghai.Methods:In this panel study,91 healthy nonsmoking adults aged over 35 from Tianjin and Shanghai participated in our study.The study was conducted in summer and winter.The participants were followed for three times with an interval of at least two weeks.Only participants in Shanghai were followed once in winter because of the COVID-19 pandemic.Twenty-seven participants completed follow-up visits in both seasons.We measured their 24 h personal exposures to NOX and NO2and collected their baseline and time-activity in-formation through questionnaire/diary.The linear mixed model was used to analyze the associations be-tween potential influencing factors and personal NOX and NO2 exposure levels.Results:There were 349 follow-up visits with valid 24 h personal NO2 and NOX exposure measurements in the two cities.The ave-rage 24 h personal exposures to NO2 and NOX(volume fraction)in Tianjin participants were 18.0 x 10-9 and 26.2 × 10-9 in summer,and 31.0 x 10-9 and 54.9 x 10-9in winter,respectively;and the average 24 h personal exposures to NO2 and NOX in Shanghai participants were 38.7 x 10-9and 100.0x10-9in summer,and 45.5 x10-9 and 139.2 x 10-9 in winter,respectively.The results of univariate regression analysis showed that their personal NOX exposure levels were significantly associated with city,season,gender,average daily cooking times,and ambient NO2 concentrations measured at fixed-site monitoring stations.In addition to the above factors,the personal NOX exposure levels were also significantly associ-ated with educational level and the personal NO2 exposure levels were also significantly associated with passive smoking,average daily home time,cooking energy type,residential distance from main traffic road,and use of kitchen ventilators.Multivariate regression analysis showed that the personal exposure levels of NO2 and NOX were significantly lower in Tianjin than that in Shanghai,were significantly lower in summer than that in winter,and were significantly and positively associated with ambient NO2 concen-trations measured at fixed-site monitoring stations.In addition,personal NOX exposure levels were signifi-cantly lower in females than in males,and personal NO2 exposure levels were significantly positively asso-ciated with average daily cooking times and significantly inversely associated with average daily home time.For every interquartile range(IQR)increase(12.7 × 10-9)in ambient NO2,the personal NO2 exposure levels increased by 27.5％(95％CI:17.0％-38.9％),and personal NOX exposure levels in-creased by 16.1％(95％CI:7.1％-25.8％).Conclusion:Season,city and ambient NO2 concentra-tions are significant influencing factors of personal exposure levels of NO2and NOX At the same time,the personal exposures levels of NO2 are also affected by lifestyle factors.Our study provides scientific evi-dence for making precise air pollution control decisions and reducing the exposure levels of NOX in the population.

Objective:To investigate the influence of combining therapy of massage on sacro-2 to sacro-4 spinal cord reflexion area and anal dilatation therapy on constipation after cerebral apoplexy and promote the rehabilitation of defecation function in patients with constipation after stroke.Methods:Aandomized controlled study method was chosen, 80 patients with constipation after cerebral apoplexy treated in Guangzhou Traditional Chinese Medicine Hospital from August 2018 to July 2019 were selected as research subjects by convenience sampling. The enrolled patients were divided into 2 groups, 40 to the observation group and 40 to the control group by random number table method. On the basis of routine constipation related nursing measures, the control group was given anal dilatation therapy, while the observation group′s treatment was given massage on sacro-2 to sacro-4 spinal cord reflexion area combined with anal dilatation therapy. Before intervention and after intervention, the changes of therapeutic effect of constipation effect, constipation symptoms scores and the degree of neurological deficit were all compared between the two groups.Results:There were 22 males and 18 females in the observation group; age ranged from 40 to 75 (63.33 ± 8.49) years old; in the control group, there were 23 males and 17 females, aged 41-74 (63.03 ± 7.60) years old. Before intervention, there was no statistically significant difference in constipation symptom scores and neurological deficits between the two groups (both P>0.05). After intervention, the score of constipation symptoms was (3.80 ± 2.05) points and the score of the degree of neurological deficit was (7.58 ± 2.69) points in the observation group, both lower than (5.18 ± 3.52) points and (8.90 ± 2.73) points in the control group with statistically significant differences between the two groups ( t values were respectively -2.13 and -2.19, both P<0.05). The total efficacy of the observation group was 97.50% (39/40), which was significantly higher than 87.50% (35/40) of the control group with statistically significant differences between the two groups ( χ2 = - 2.11, P<0.05). Conclusions:Nursing intervention of massage on sacro-2 to sacro-4 spinal cord reflexion area combined with anus dilatation therapy on constipation after cerebral apoplexy can effectively reduce the symptoms of constipation and lowered the degree of neurological deficit, which is beneficial to the functional rehabilitation of patients with cerebral apoplexy.

Due to traditional professional divisions, the practice of endoscopy by gastro-intestinal surgeons in China remains controversial. However, with the evolution of treatment philo-sophies, medical technology, and equipment advancements, a trend of integration between tradi-tional surgery and endoscopy is emerging. Gastrointestinal surgeons performing endoscopy can maxi-mize patient benefits, and they naturally possess advantages in conducting endoscopic procedures. It is recommended to further establish entry thresholds for surgeons to perform endoscopy, provide standardized endoscopic training for surgeons, and coordinate efforts at the administrative depart-ment. With the support of artificial intelligence, more patients can receive minimally invasive, indivi-dualized, and precise treatments.

Inhibiting the death receptor 3(DR3)signaling pathway in group 3 innate lymphoid cells(ILC3s)pre-sents a promising approach for promoting mucosal repair in individuals with ulcerative colitis(UC).Paeoniflorin,a prominent component of Paeonia lactiflora Pall.,has demonstrated the ability to restore barrier function in UC mice,but the precise mechanism remains unclear.In this study,we aimed to delve into whether paeoniflorin may promote intestinal mucosal repair in chronic colitis by inhibiting DR3 signaling in ILC3s.C57BL/6 mice were subjected to random allocation into 7 distinct groups,namely the control group,the 2％dextran sodium sulfate(DSS)group,the paeoniflorin groups(25,50,and 100 mg/kg),the anti-tumor necrosis factor-like ligand 1A(anti-TL1A)antibody group,and the IgG group.We detected the expression of DR3 signaling pathway proteins and the proportion of ILC3s in the mouse colon using Western blot and flow cytometry,respectively.Meanwhile,DR3-overexpressing MNK-3 cells and 2％ DSS-induced Rag1-/-mice were used for verification.The results showed that paeoniflorin alleviated DSS-induced chronic colitis and repaired the intestinal mucosal barrier.Simultaneously,paeoniflorin inhibited the DR3 signaling pathway in ILC3s and regulated the content of cytokines(interleukin-17A,granulocyte-macrophage colony stimulating factor,and interleukin-22).Alternatively,paeoniflorin directly inhibited the DR3 signaling pathway in ILC3s to repair mucosal damage indepen-dently of the adaptive immune system.We additionally confirmed that paeoniflorin-conditioned me-dium(CM)restored the expression of tight junctions in Caco-2 cells via coculture.In conclusion,paeoniflorin ameliorates chronic colitis by enhancing the intestinal barrier in an ILC3-dependent manner,and its mechanism is associated with the inhibition of the DR3 signaling pathway.