Adenosine, a critical molecule regulating cellular function both inside and outside cells, is controlled by two human adenosine deaminases: ADA1 and ADA2. While ADA1 primarily resides in the cytoplasm, ADA2 can be transported to lysosomes within cells or secreted outside the cell. Patients with ADA2 deficiency (DADA2) often suffer from systemic vasculitis due to elevated levels of TNF-α in their blood. Monocytes from DADA2 patients exhibit excessive TNF-α secretion and differentiate into pro-inflammatory M1-type macrophages. Our findings demonstrate that ADA2 localizes to endolysosomes within macrophages, and its intracellular concentration decreases in cells secreting TNF-α. This suggests that ADA2 may function as a lysosomal adenosine deaminase, regulating TNF-α expression by the cells. Interestingly, pneumonia patients exhibit higher ADA2 concentrations in their bronchoalveolar lavage (BAL), correlating with elevated pro-inflammatory cytokine levels. Conversely, cord blood has low ADA2 levels, creating a more immunosuppressive environment. Additionally, secreted ADA2 can bind to apoptotic cells, activating immune cells by reducing extracellular adenosine levels. These findings imply that ADA2 release from monocytes during inflammation, triggered by growth factors, may be crucial for cell activation. Targeting intracellular and extracellular ADA2 activities could pave the way for novel therapies in inflammatory and autoimmune disorders.
Humans ; Adenosine Deaminase/deficiency* ; Monocytes/cytology* ; Cell Differentiation ; Intercellular Signaling Peptides and Proteins/metabolism* ; Tumor Necrosis Factor-alpha/metabolism* ; Biomarkers/metabolism* ; Macrophages/metabolism* ; Pneumonia/metabolism*

Objective To compare artificial intelligence-assisted diagnostic system and conventional manual CT image interpretation for detection of positive pulmonary nodules and differential diagnosis of benign and malignant pulmonary nodules, and to provide a reference for the application of artificial intelligence in clinical screening for lung cancer. Methods Patients who underwent chest CT scans for pulmonary nodules from March 2019 to December 2023 were enrolled. The CT images were subjected to artificial intelligence-based and conventional manual CT image interpretation. The pathological examination results of pulmonary lesions served as a gold standard for comparison of artificial intelligence-based and conventional manual CT image interpretation in detection rate of positive pulmonary nodules and differential diagnosis of benign and malignant pulmonary nodules. Results A total of 327 positive pulmonary nodules were identified in 207 patients. The detection rate of positive pulmonary nodules was significantly higher with artificial intelligence-based CT image interpretation than with conventional manual CT image interpretation (95.72% vs. 86.85%; χ²=16.16, P < 0.01). Moreover, artificial intelligence-based CT image interpretation showed significantly higher detection rates for solid (χ²=7.71, P < 0.01) and ground-glass pulmonary nodules (χ²=5.80, P < 0.05) than conventional manual CT image interpretation. The detection rates for pulmonary nodules with < 1 cm (χ²=4.97, P < 0.05), 1 to < 2 cm (χ²=7.04, P < 0.01), and 2 to < 3 cm (χ²=4.91, P < 0.05) diameters were significantly higher with artificial intelligence-based CT image interpretation than with conventional manual CT image interpretation. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for differential diagnosis of benign and malignant pulmonary nodules were 98.08%, 91.53%, 95.33%, 96.43%, and 95.71% with artificial intelligence-based CT image interpretation and 91.34%, 77.97%, 87.96%, 32.62%, and 86.50% with conventional CT image interpretation. The sensitivity (χ²=4.70, P < 0.05), specificity (χ²=4.20, P < 0.05), negative predictive value (χ²=65.28, P < 0.01), and accuracy (χ²=8.52, P < 0.01) were significantly higher with artificial intelligence-based CT image interpretation than with conventional manual CT image interpretation. However, there was no significant difference in the positive predictive value (χ²=3.80, P > 0.05). Conclusion Compared with conventional manual CT image interpretation, artificial intelligence-assisted diagnostic system for CT image interpretation can significantly increase the detection rate of positive pulmonary nodules and improve the efficiency of differential diagnosis of benign and malignant pulmonary nodules, so it deserves widespread applications in physical examination and early screening for lung cancer.

Objective To compare artificial intelligence-assisted diagnostic system and conventional manual CT image interpretation for detection of positive pulmonary nodules and differential diagnosis of benign and malignant pulmonary nodules, and to provide a reference for the application of artificial intelligence in clinical screening for lung cancer. Methods Patients who underwent chest CT scans for pulmonary nodules from March 2019 to December 2023 were enrolled. The CT images were subjected to artificial intelligence-based and conventional manual CT image interpretation. The pathological examination results of pulmonary lesions served as a gold standard for comparison of artificial intelligence-based and conventional manual CT image interpretation in detection rate of positive pulmonary nodules and differential diagnosis of benign and malignant pulmonary nodules. Results A total of 327 positive pulmonary nodules were identified in 207 patients. The detection rate of positive pulmonary nodules was significantly higher with artificial intelligence-based CT image interpretation than with conventional manual CT image interpretation (95.72% vs. 86.85%; χ²=16.16, P < 0.01). Moreover, artificial intelligence-based CT image interpretation showed significantly higher detection rates for solid (χ²=7.71, P < 0.01) and ground-glass pulmonary nodules (χ²=5.80, P < 0.05) than conventional manual CT image interpretation. The detection rates for pulmonary nodules with < 1 cm (χ²=4.97, P < 0.05), 1 to < 2 cm (χ²=7.04, P < 0.01), and 2 to < 3 cm (χ²=4.91, P < 0.05) diameters were significantly higher with artificial intelligence-based CT image interpretation than with conventional manual CT image interpretation. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for differential diagnosis of benign and malignant pulmonary nodules were 98.08%, 91.53%, 95.33%, 96.43%, and 95.71% with artificial intelligence-based CT image interpretation and 91.34%, 77.97%, 87.96%, 32.62%, and 86.50% with conventional CT image interpretation. The sensitivity (χ²=4.70, P < 0.05), specificity (χ²=4.20, P < 0.05), negative predictive value (χ²=65.28, P < 0.01), and accuracy (χ²=8.52, P < 0.01) were significantly higher with artificial intelligence-based CT image interpretation than with conventional manual CT image interpretation. However, there was no significant difference in the positive predictive value (χ²=3.80, P > 0.05). Conclusion Compared with conventional manual CT image interpretation, artificial intelligence-assisted diagnostic system for CT image interpretation can significantly increase the detection rate of positive pulmonary nodules and improve the efficiency of differential diagnosis of benign and malignant pulmonary nodules, so it deserves widespread applications in physical examination and early screening for lung cancer.

Objective To explore the feasibility of predicting expression level of Ki-67 in lung adenocarcinoma via multi-parameter of spectral CT.Methods The data of 226 patients with lung adenocarcinoma confirmed by pathology were analyzed retrospectively.The conventional and spectral CT parameters of the lesions were analyzed.According to Ki-67 expression level,all patients were divided into low expression group and high expression group.The parameters with statistical significance were identified as independent variables for multivariate logistic regression analysis to establish a logistic regression model for predicting the expression level of Ki-67.Receiver operating characteristic(ROC)curve was used to assess the diagnostic performance for each model,respectively.Results There were significant differences in the clinical factors of gender,smoking and chest pain between high and low Ki-67 expression groups.In spectral CT parameters,CT40 keV,CT100 keV,Z-effective(Zeff)and iodine concentration(IC)in the high expression group in arterial phase were significantly higher than those in the low expression group.Logistic regression analysis showed that CT100 keV was the independent risk factor for Ki-67 expression level.Both the spectral CT model and the combined model had high value in predicting the expression level of Ki-67 in lung adenocarcinoma,and the combined model had better diagnostic efficacy.Conclusion Spectral CT parameters combined with clinical factors have a certain value in predicting the expression level of Ki-67 in lung adenocarcinoma.

Objective To evaluate the efficacy of testa triticum tricum purif combined with polyethylene glycol electrolyte powder for bowel preparation before colonoscopy in patients with constipation. Methods A total of 190 patients with constipation who underwent colonoscopy were randomized into 2 groups. The study group(n=93)were given testa triticum tricum purif and polyethylene glycol electrolyte powder,whereas the control group(n=97)were given polyethylene glycol electrolyte powder only.The bowel cleanness,adenoma detection rate,and incidence of adverse events during bowel preparation were compared. Results The bowel preparation score(7.31±1.14 VS 6.06±1.22,P=0.000)and effective rate(95.70%VS 69.07%, P=0.000)in the study group was significantly higher than that in the control group. The incidence of adverse events in the study group was lower than that in the control group(5.38% VS 17.53%, P=0.009). There was no significant difference in the adenoma detection rate between the two groups (36.56% VS 26.80%, P=0.148). Conclusion Testa triticum tricum purif combined with polyethylene glycol electrolyte powder is superior to conventional method of polyethylene glycol electrolyte powder alone for colonoscopy bowel preparation in patients with constipation.

Objective To investigate the variation characteristics of peripheral platelet parameters in children with dengue fever and to assess their use and value in diagnosis,prognosis and treatment for dengue fever.Methods Platelet parameters of 69 pediatric patients with dengue fever in acute febrile phase and remission period and 103 healthy controls were compared.The difference of platelet parameters between the liver function injury group and the normal liver function group,the coagulation dysfunction group and the coagulation function normal group,the severe group and the mild group with dengue fever was compared,the causes of thrombocytopenia in children with dengue was investigated so as to better understand the situation of bone marrow producing platelets.Results P-LCR,PDW,MPV were significantly higher in patients in acute febrile phase of dengue fever,compared with the healthy subjects(P＜0.01),while PCT,PLT were significantly lower in patients in acute febrile phase of dengue fever,compared with the healthy subjects(P＜0.01).MPV was significantly lower in patients with abnormal hepatic function when compared with patients with normal hepatic function(P＜0.05),while other platelet parameters did not show significant differences(P＞0.05).PLT and PCT were significantly lower in the severe patients than those in the mild patients(P＜0.05),while other platelet parameters did not show significant differences(P＞0.05).Peripheral platelet parameters did not show significant differences between patients with or without abnormal coagulation function (P＞0.05).Conclusion Peripheral platelet parameters may play a role in the diagnosis,treatment and prognosis of dengue fever in children.

Objective To systematically evaluate the diagnosis value of thyroid autoantibodies in hashimo-to′s thyroiditis.Methods Through the systematic retrieval of the Chinese periodical full text database (CNKI),the full text database of Chinese sci-tech periodicals (VIP),the Wanfang database,the PubMed,EM-base,Scopus,Cochrane library,the database of academic dissertations at home and abroad,the database of the conference papers and so on,all formally published scientific research literature from the establishment of da-tabase to January 2017 were retrieved.The retrieval conditions included "thyroid autoantibody","thyroid per-oxidase antibody"or "TPOAb","thyroid globulin antibody" or "TGAb","thyroid microsome antibody" or "TMAb","thyrotropin receptor antibody"or "TRAb","Hashimoto""Mastitis"or "Hashimoto′s disease".The study that accorded with the standard,the data of thyroid autoantibodies,Hashimoto′s thyroiditis and other data were analyzed by Meta in order to find out the best clinical evidence.Results In the meta-analysis of 33 articles,the levels of thyroid peroxidase antibody (TPOAb),antithyroid globulin antibody (TGAb) and thy-rotropin receptor antibody (TRAb) in the patients with Hashimoto′s thyroiditis were significantly higher than those in the healthy control group.The positive rates of TPOAb,TGAb,TRAb and TMAb in the patients with Hashimoto′s thyroiditis group were higher than those in the healthy control group.The difference was statistically significant (P< 0.05).Conclusion Detection of thyroid autoantibodies TPOAb,TGAb,TRAb and TMAb has important clinical value in the diagnosis of Hashimoto′s thyroiditis.

Objective To investigate the dynamics of white blood cell count (WBC),prealbumin(PA),high sensitive C-reactive protein (hs-CRP),and vascular endothelial growth factor (VEGF) in hand-foot-and-mouth disease (HFMD) complicated with or without encephalitis and in vitro inhibitory effects of artesunate on VEGF secretion of mononuclear cells from HFMD patients.Methods Peripheral blood mononuclear cells from healthy control group,HFMD group and HFMD combined with encephalitis group were isolated by Ficoll density gradient centrifugation and treated with different concentrations of artesunate (25,50,100 mg/L).The expression of VEGF in the supernatant was examined by ELISA double antibody sandwich method.The levels of WBC,PA and hs-CRP in the three groups were also detected.Multiple samples were compared by one-way analysis of variance.Multiple comparison was performed by Dunnett T3 test.Correlation of two variables was analyzed by Spearman correlation test.Results There were significant differences in the levels of WBC,hs-CRP,PA and VEGF between the HFMD combined with or without encephalitis group and health control group (F=172.69,366.02,166.32 and 5 941.89,respectively,all P＜0.01).There were significant differences in the levels of VEGF secreted by mononuclear cells treated with three different concentrations of artesunate between the HFMD combined with or without encephalitis groups and health control group (F =194.265 and 4 750.69,respectively,both P＜0.01).Correlation analysis showed that the VEGF level secretion by mononuclear cells from HFMD patients with or without encephalitis were both negatively correlated with different concentrations of artesunate (r=-0.903 and-0.969,both P＜0.01).Conclusions Compared with HFMD without encephalitis,the secretion of VEGF by mononuclear cells,WBC and hs-CRP levels in HFMD complicated with encephalitis group all increase and PA decrease significantly.Artesunate can inhibit the secretion of VEGF by mononuclear cells of patients with hand-foot-and-mouth disease in a dosedependent manner in vitro.

Objective To observe the inhibition of piperlongumine in vitro on platelet aggregation and blood coagulation tests for children,to provide the experimental basis for clinical medication.Methods Venous blood samples from 30 children were randomly devided into 5 groups,and was centrifuge to separate platelet-rich plasma (PRP).After storing in 37 ℃ thermostat water bath for 5 minutes,the PRP which have been added DMSO as blank group,and added Aspirin (10 μmol/L)as control group,and added PL (20 μmol/L),PL(100 μmol/L),PL(200 μmol/L) as different concentrations of PL groups respectively,were induced by the addition of adenosine diphosphate (10 μmol/L),collagen(2.5 μg/mL) and the arachidonic acid(500 μg/mL).Then the platelet aggregation rate of the PRP from 5 groups could be measured by turbidimetry.Blood plasma isolated from venous blood was divided into 5 groups.In the PL groups,blood plasma were mixed up with PRP concentrations of which were 5,10,20 μmol/L.In the bland group,blood plasma were mixed up with DMSO (1％).In the control group,blood plasma were mixed up with heparin sodium(35 U/mL).After storing in 37 ℃ thermostat water bath for 5 minutes,fibrinogen(FIB),prothrombin time(PT),thrombin time(TT) and activated partial thromboplastin time of different groups were detected.Results Compared to the control group,the groups which were add PL with different concentrations (20,100,200 μmol/L) showed significant inhibition on platelet aggregation induced by AA and collagen(P<0.05).PL with concentrations of 100 μmol/L and 200 μmol/L showed significant inhibition on platelet aggregation induced by ADP(P<0.05).The PT,APTT,TT of blood plasma from children had been significantly prolonged by the intervention of PL 10 μmol/L and PL 20 μmol/L(P<0.05),however,no significant change of FIB was observed.Conclusion There are inhibitory effects of PL on platelet aggregation of blood plasma from children and anticoagulant activity in this study.

Objective To evaluate the efficacy of combined application of lactitol oral solution and polyethylene glycol electrolyte (PEG) powder compared with conventional method in bowel preparation before colonoscopy. Methods 205 patients who underwent colonoscopy were randomly divided into experimental group and control group. The experimental group (n = 102) were given lactitol and polyethylene glycol electrolyte powder, whereas the patients in control group (n = 103) were given polyethylene glycol electrolyte powder only. The visibility and adverse effects during colonoscopy were observed. Results The cleaning satisfaction rate was not statistically significant between the two groups. The proportion of cleanliness to grade 1 in experimental group was higher than that in control group. The incidence of adverse effects in experimental group was lower, and there was no effect on sleeping night. The compliance and tolerance of hospitalized patients were significantly improved. Conclusion Lactitol combined with polyethylene glycol electrolyte (peg) powder is safe, effective, with low incidence of adverse effect for bowel preparation in hospitalized patients.