Testicular histology based on testicular biopsy is an important factor for determining appropriate testicular sperm extraction surgery and predicting sperm retrieval outcomes in patients with azoospermia. Therefore, we developed a deep learning (DL) model to establish the associations between testicular grayscale ultrasound images and testicular histology. We retrospectively included two-dimensional testicular grayscale ultrasound from patients with azoospermia (353 men with 4357 images between July 2017 and December 2021 in The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China) to develop a DL model. We obtained testicular histology during conventional testicular sperm extraction. Our DL model was trained based on ultrasound images or fusion data (ultrasound images fused with the corresponding testicular volume) to distinguish spermatozoa presence in pathology (SPP) and spermatozoa absence in pathology (SAP) and to classify maturation arrest (MA) and Sertoli cell-only syndrome (SCOS) in patients with SAP. Areas under the receiver operating characteristic curve (AUCs), accuracy, sensitivity, and specificity were used to analyze model performance. DL based on images achieved an AUC of 0.922 (95% confidence interval [CI]: 0.908-0.935), a sensitivity of 80.9%, a specificity of 84.6%, and an accuracy of 83.5% in predicting SPP (including normal spermatogenesis and hypospermatogenesis) and SAP (including MA and SCOS). In the identification of SCOS and MA, DL on fusion data yielded better diagnostic performance with an AUC of 0.979 (95% CI: 0.969-0.989), a sensitivity of 89.7%, a specificity of 97.1%, and an accuracy of 92.1%. Our study provides a noninvasive method to predict testicular histology for patients with azoospermia, which would avoid unnecessary testicular biopsy.
Humans ; Male ; Azoospermia/diagnostic imaging* ; Deep Learning ; Testis/pathology* ; Retrospective Studies ; Adult ; Ultrasonography/methods* ; Sperm Retrieval ; Sertoli Cell-Only Syndrome/diagnostic imaging*

OBJECTIVES: To analyze the clinical characteristics of diffuse panbronchiolitis (DPB) in children and to enhance the clinical diagnosis and treatment of this disease. METHODS: A retrospective analysis was conducted on the clinical data of 6 children diagnosed with DPB who were hospitalized at The First Affiliated Hospital of Guangzhou Medical University from January 2011 to December 2019. RESULTS: Among the 6 patients, there were 2 males and 4 females; the age at diagnosis ranged from 7 to 12 years. All patients presented with cough, sputum production, and exertional dyspnea, and all had a history of sinusitis. Two cases showed positive serum cold agglutinin tests, and 5 cases exhibited pathological changes consistent with chronic bronchiolitis. High-resolution chest CT in all patients revealed centrilobular nodules diffusely distributed throughout both lungs with a tree-in-bud appearance. Five patients received low-dose azithromycin maintenance therapy, but 3 showed inadequate treatment response. After empirical anti-tuberculosis treatment, non-tuberculous Mycobacteria were found in the bronchoalveolar lavage fluid. Follow-up over 2 years showed 1 case cured, 3 cases significantly improved, and 2 cases partially improved. CONCLUSIONS The clinical presentation of DPB is non-specific and can easily lead to misdiagnosis. In cases where DPB is clinically diagnosed but does not show improvement with low-dose azithromycin treatment, special infections should be considered.
Humans ; Male ; Female ; Bronchiolitis/drug therapy* ; Retrospective Studies ; Child ; Haemophilus Infections/diagnosis*

OBJECTIVES: To investigate the clinical features of children with STAT gene mutations, and to explore corresponding immunotherapy strategies. METHODS: A retrospective analysis was performed for the clinical data of 10 children with STAT gene mutations who were admitted to the Department of Pediatrics of the First Affiliated Hospital of Guangzhou Medical University, from October 2015 to October 2024. Exploratory immunotherapy was implemented in some refractory cases, and the changes in symptoms, imaging manifestations, and cytokine levels were assessed after treatment. RESULTS: For the 10 children, the main clinical manifestations were recurrent rash since birth (7/10), cough (8/10), wheezing (5/10), expectoration (4/10), and purulent nasal discharge (4/10). Genotyping results showed that there was one child with heterozygous loss-of-function (LOF) mutation in the STAT1 gene, four children with heterozygous LOF mutation in the STAT3 gene, and five children with heterozygous gain-of-function (GOF) mutation in the STAT3 gene. Two children with LOF mutation in the STAT3 gene showed decreased interleukin-6 levels and improved clinical symptoms and imaging findings after omalizumab treatment. Three children with GOF mutation in the STAT3 gene achieved effective disease control after treatment with methylprednisolone (0.5 mg/kg per day). Two children with GOF mutation in the STAT3 gene received treatment with JAK inhibitor and then showed some improvement in symptoms. CONCLUSIONS STAT gene mutation screening should be considered for children with recurrent rash and purulent respiratory tract infections. Targeted immunotherapy may improve prognosis in patients with no response to conventional treatment.
Humans ; Male ; Immunotherapy ; Female ; Child, Preschool ; Child ; Gain of Function Mutation ; Retrospective Studies ; Infant ; Loss of Function Mutation ; STAT Transcription Factors/genetics*

Aim To clarify the protective effect of Banxia-Xiexin decoction(BD)on chronic atrophic gastritis(CAG).Methods After establishing a CAG model,BD was used for 4 weeks.The pathological changes in the gastric mucosa were observed through HE staining,while serum biomarkers were detected u-sing ELISA.The expression of key factors in the Hip-po/YAP signaling pathway was examined by RT-qPCR and Western blot.Finally,the expression of YAP and p-YAP proteins was detected by immunefluorescence.Results After BD intervention,the thickness of the gastric mucosa layer,intestinal metaplasia,and inflam-mation in CAG rats showed significant dose-dependent improvement.BD could reduce the expression of IL-6,IL-1β,and TNF-α in the serum of CAG rats,increase the expression of IL-10,and elevate PGR and G-17 lev-els.Following BD intervention,YAP1 was largely phosphorylated and inactivated,with significant increa-ses in p-YAP/YAP protein expression levels and fluo-rescence intensity.Additionally,the protein and mRNA expression levels of MST1 and LATS1 were elevated,indicating the activation of the Hippo/YAP signaling pathway.Conclusions BD exerts a significant phar-macological effect in the treatment of CAG,and its mechanism may be related to the upregulation of MST1-LATS1 protein expression,leading to the inacti-vation of YAP through phosphorylation.

As global greenhouse gases continue rising, the urgency of more ambitious action is clearer than ever before. China is the world's biggest emitter of greenhouse gases and one of the countries affected most by climate change. The evidence about the impacts of climate change on the environment and human health may encourage China to take more decisive action to mitigate greenhouse gas emissions and adapt to climate impacts. This article aimed to review the evidence of environmental damages and health risks posed by climate change and to provide a new science-based perspective for the delivery of sustainable development goals. Over recent decades, China has experienced a strong warming pattern with a growing frequency of extreme weather events, and the impacts of climate change on China's environment and human health have been consistently observed, with increasing O ₃ air pollution, decreases in water resources and availability, land degradation, and increased risks for both communicable and non-communicable diseases. Therefore, China's climate policy should target the key factors driving climate change and scale up strategic measures to curb carbon emissions and adapt to inevitable increasing climate impacts. It provides new insights for not only China but also other countries, particularly developing and emerging economies, to ensure climate and environmental sustainability whilst pursuing economic growth.
Climate Change ; China ; Humans ; Greenhouse Gases ; Air Pollution ; Sustainable Development ; Environment

Aim To clarify the protective effect of Banxia-Xiexin decoction(BD)on chronic atrophic gastritis(CAG).Methods After establishing a CAG model,BD was used for 4 weeks.The pathological changes in the gastric mucosa were observed through HE staining,while serum biomarkers were detected u-sing ELISA.The expression of key factors in the Hip-po/YAP signaling pathway was examined by RT-qPCR and Western blot.Finally,the expression of YAP and p-YAP proteins was detected by immunefluorescence.Results After BD intervention,the thickness of the gastric mucosa layer,intestinal metaplasia,and inflam-mation in CAG rats showed significant dose-dependent improvement.BD could reduce the expression of IL-6,IL-1β,and TNF-α in the serum of CAG rats,increase the expression of IL-10,and elevate PGR and G-17 lev-els.Following BD intervention,YAP1 was largely phosphorylated and inactivated,with significant increa-ses in p-YAP/YAP protein expression levels and fluo-rescence intensity.Additionally,the protein and mRNA expression levels of MST1 and LATS1 were elevated,indicating the activation of the Hippo/YAP signaling pathway.Conclusions BD exerts a significant phar-macological effect in the treatment of CAG,and its mechanism may be related to the upregulation of MST1-LATS1 protein expression,leading to the inacti-vation of YAP through phosphorylation.

Objective:To explore the potential value of endoplasmic reticulum stress-related genes(ERSRGs)in assessing the prognosis of breast cancer patients,and to construct a risk scoring model and a prognostic nomogram.Methods:ERSRGs were retrieved from the Genecards data-base,and three machine learning algorithms,namely"LASSO","RF",and"Xgboost",were used in the TCGA database to screen for core prognostic genes and establish a corresponding risk scoring model.The model was externally validated using the GSE20685 and GSE86166 datasets.Based on the risk scoring model,nomograms were further constructed to predict the 3-year and 5-year overall survival(OS)rates of breast cancer patients.The expression of the model genes at the pro-tein and single-cell levels was assessed through the Human Protein Atlas(HPA)and a single-cell sequencing dataset(GSE176078).Results:A total of 1301 ERSRGs were screened from the Genecards database.Among them,237 ERSRGs were differentially expressed between breast cancer and normal tissues.Univariate Cox regression analysis revealed that 22 ERSRGs were as-sociated with the prognosis of breast cancer patients.Through the three machine learning algo-rithms of LASSO,RF,and Xgboost,five ERSRGs(MAP2K6,IFNG,VIM,TH,CEMIP)were identi-fied as core genes related to the prognosis of breast cancer,and an ERSRGs-related risk scoring model and prognostic nomogram were constructed.Both internal and external dataset validations showed significant differences among patients in different risk groups.The C-index,ROC curve,and calibration curve all indicated that the nomogram had good predictive performance.Conclu-sion:In this study,the nomogram constructed based on the ERSRGS-related risk score model can accurately predict the prognosis of breast cancer patients,which can provide certain reference for clinical diagnosis,treatment and the development of new tumor therapeutic targets.

Objective:To explore the potential value of endoplasmic reticulum stress-related genes(ERSRGs)in assessing the prognosis of breast cancer patients,and to construct a risk scoring model and a prognostic nomogram.Methods:ERSRGs were retrieved from the Genecards data-base,and three machine learning algorithms,namely"LASSO","RF",and"Xgboost",were used in the TCGA database to screen for core prognostic genes and establish a corresponding risk scoring model.The model was externally validated using the GSE20685 and GSE86166 datasets.Based on the risk scoring model,nomograms were further constructed to predict the 3-year and 5-year overall survival(OS)rates of breast cancer patients.The expression of the model genes at the pro-tein and single-cell levels was assessed through the Human Protein Atlas(HPA)and a single-cell sequencing dataset(GSE176078).Results:A total of 1301 ERSRGs were screened from the Genecards database.Among them,237 ERSRGs were differentially expressed between breast cancer and normal tissues.Univariate Cox regression analysis revealed that 22 ERSRGs were as-sociated with the prognosis of breast cancer patients.Through the three machine learning algo-rithms of LASSO,RF,and Xgboost,five ERSRGs(MAP2K6,IFNG,VIM,TH,CEMIP)were identi-fied as core genes related to the prognosis of breast cancer,and an ERSRGs-related risk scoring model and prognostic nomogram were constructed.Both internal and external dataset validations showed significant differences among patients in different risk groups.The C-index,ROC curve,and calibration curve all indicated that the nomogram had good predictive performance.Conclu-sion:In this study,the nomogram constructed based on the ERSRGS-related risk score model can accurately predict the prognosis of breast cancer patients,which can provide certain reference for clinical diagnosis,treatment and the development of new tumor therapeutic targets.

Objective To observe the clinical efficacy of modified Shehuang Ointment(mainly composed of Cnidii Fructus,Phellodendri Chinensis Cortex,and Zanthoxyli Pericarpium)for the treatment of facial seborrheic dermatitis(SD).Methods Seventy-two patients with facial SD were randomly divided into observation group and control group,with 36 patients in each group.Both groups of patients were given oral use of Acrivastine Capsules and Vitamin B6 Tablets,and additionally,the observation group was given topical application of modified Shehuang Ointment and the control group was given topical application of 2%Ketoconazole cream.The course of treatment covered 4 weeks.The changes of clinical symptom scores and dermatology life quality index(DLQI)scores in the two groups were observed before and after treatment,and the clinical efficacy and safety of the two groups were also evaluated.Results(1)After 4 weeks of treatment,the total effective rate of the observation group was 88.89%(32/36),and that of the control group was 72.22%(26/36).The intergroup comparison showed that the efficacy of the observation group was significantly superior to that of the control group,and the difference was statistically significant(P＜0.05).(2)After treatment,the clinical symptom scores of erythema,scales,grease,rash area,itchiness and other clinical symptoms of the patients in the two groups were significantly decreased compared with those before treatment(P＜0.05),and the clinical symptom scores of the observation group were significantly lower than those of the control group,the differences being statistically significant(P＜0.05).(3)After treatment,the DLQI scores of patients in the two groups were significantly lower than those before treatment(P＜0.05),and the DLQI scores in the observation group were significantly lower than those in the control group after treatment,the difference being statistically significant(P＜0.05).(4)During the treatment period,no significant adverse reactions occurred in the two groups of patients,with high safety.Conclusion The conventional western medicine treatment combined with topical application of modified Shehuang Ointment exerts certain effect in the treatment of facial SD,which can effectively relieve the clinical symptoms and improve the quality of life of patients.

Objective To summarize the epidemiological and clinical features of infectious diseases of the central nervous system(CNS)by a single-center analysis.Methods A retrospective analysis was conducted on the data of 1247 cases of CNS infectious diseases diagnosed and treated in the First Medical Center of PLA General Hospital from 2001 to 2020.Results The data for this group of CNS infectious diseases by disease type in descending order of number of cases were viruses 743(59.6％),Mycobacterium tuberculosis 249(20.0％),other bacteria 150(12.0％),fungi 68(5.5％),parasites 18(1.4％),Treponema pallidum 18(1.4％)and rickettsia 1(0.1％).The number of cases increased by 177 cases(33.1％)in the latter 10 years compared to the previous 10 years(P<0.05).No significant difference in seasonal distribution pattern of data between disease types(P>0.05).Male to female ratio is 1.87︰1,mostly under 60 years of age.Viruses are more likely to infect students,most often at university/college level and above,farmers are overrepresented among bacteria and Mycobacterium tuberculosis,and more infections of Treponema pallidum in workers.CNS infectious diseases are characterized by fever,headache and signs of meningeal irritation,with the adductor nerve being the more commonly involved cranial nerve.Matagenomic next-generation sequencing improves clinical diagnostic capabilities.The median hospital days for CNS infectious diseases are 18.00(11.00,27.00)and median hospital costs are ￥29,500(￥16,000,￥59,200).The mortality rate from CNS infectious diseases is 1.6％.Conclusions The incidence of CNS infectious diseases is increasing last ten years,with complex clinical presentation,severe symptoms and poor prognosis.Early and accurate diagnosis and standardized clinical treatment can significantly reduce the morbidity and mortality rate and ease the burden of disease.