Purpose To explore the value of CT-based radiomics in the preoperative prediction of lymphatic invasion of node-negative gastric cancer,and to construct a nomogram combined with clinical variables.Materials and Methods The clinical and CT imaging data of 173 gastric cancer patients with lymph node negative and pathologically confirmed gastric cancer in the Sir Run Run Shaw Hospital from January 2019 to June 2021 were retrospectively analyzed.A total of 60 cases with lymphovascular invasion(LVI)positive patients and 113 cases with LVI negative patients were included,and randomly divided into train cohort(n=121)and test cohort(n=52)at 7∶3.Based on the train cohort,the clinical model,the radiomics model,the fusion model were constructed and verified in the test cohort.Clinical data and conventional CT features included age,gender,tumor marker,tumor location,tumor morphology,enhancement range,etc.The clinical significant variables were selected through univariate and multivariate analysis to establish the clinical model.The tumor regions of interest were segmented and radiomics features were extracted by using the 3D-Slicer software.Key features were screened through least absolute shrinkage and selection operator regression analysis,and then the radiomics model was constructed with random forest algorithm,and converted to random forest score(RF score).The fusion model was constructed via combining clinical significant variables and RF score,and visualized as a nomogram.The receiver operator characteristic curve and area under curve(AUC)were used to evaluate the prediction performance of the models.Decision curve analysis was used to calculate the clinical practicability.Results The radiomics model was superior to the clinical model.The radiomics model AUC of the train cohort and the test cohort were 0.872(0.810 to 0.935)and 0.827(0.707 to 0.947),the clinical model AUC were 0.767(0.682 to 0.852)and 0.761(0.610 to 0.913).The nomogram further improved the predictive efficiency,the AUC in train cohort and test cohort reached 0.898(0.842 to 0.953)and 0.844(0.717 to 0.971),respectively.Decision curve analysis demonstrated clinical benefits of nomogram.Conclusion The radiomics model can be used to preoperatively predict LVI of node-negative gastric cancer.The nomogram can further improve the prediction efficiency.

Objective:To observe the relationship between early quality of life symptom clusters and psychological stress and its influencing factors,so as to lay a foundation for clinical timely control of symptom clusters,improving of psychological stress state,and improving the early quality of life after lung cancer surgery.Methods:A total of 248 patients with lung cancer who received surgical treatment in our hospital from Oct 2021 to Oct 2023 were selected to evaluate their general condition,quality of life,symptom clusters,and psychological stress by general situation questionnaire,Functional Assessment of Cancer Therapy(FACT),Anderson Symptom Assessment Scale,and Symptom Self-Rating Scale(SCL-90).Pearson method was used to analyze the correlation between FACT score symptom clusters and SCL-90 score.On the basis of multivariable logistic regression analysis,cumulative ratio regression model was used to analyze the early quality of life after lung cancer surgery.Results:A total of 239 patients with lung cancer were enrolled.FACT-L score was(53.66±6.85),SCL-90 score was(109.24±11.97),symptom clusters score was(104.03±16.83),including 117 patients in low group,69 patients in middle group,and 53 patients in high group,48.95%,28.87%and 22.18%,respectively.Pearson analysis showed that FACT score was negatively correlated with SCL-90 score and symptom clusters(r value was-0.779 and-0.737,respectively,P＜0.05).Multivariate cumulative ratio logistic regression analysis showed that seven factors including clustered airway management and sleep quality were protective factors for early quality of life after lung cancer surgery(P＜0.05),and malnutrition,pain degree,operation duration,SCL-90 score and symptom clusters score were risk factors for early quality of life after lung cancer surgery(P＜0.05).Conclusions:The influencing factors of early postoperative quality of life of lung cancer patients come from many aspects.Clinical prevention and control strategies can be formulated according to the influencing factors to improve the level of early postoperative quality of life of lung cancer patients.

Objective To monitor the antifungal resistance of clinical isolates of Candida spp.in the East China region.Methods MALDI-TOF MS or molecular methods were used to re-identify the strains collected from January 2018 to December 2022.Antifungal susceptibility testing was performed using the broth microdilution method.The susceptibility test results were interpreted according to the breakpoints of 2022 Clinical and Laboratory Standards Institute(CLSI)documents M27 M44s-Ed3 and M57s-Ed4.Results A total of 3 026 strains of Candida were collected,65.33％of which were isolated from sterile body sites,mainly from blood(38.86％)and pleural effusion/ascites(10.21％).The predominant species of Candida were Candida albicans(44.51％),followed by Candida parapsilosis complex(19.46％),Candida tropicalis(13.98％),Candida glabrata(10.34％),and other Candida species(0.79％).Candida albicans showed overall high susceptibility rates to the 10 antifungal drugs tested(the lowest rate being 93.62％).Only 2.97％of the strains showed dose-dependent susceptibility(SDD)to fluconazole.Candida parapsilosis complex had a SDD rate of 2.61％and a resistance rate of 9.42％to fluconazole,and susceptibility rates above 90％to other drugs.Candida glabrata had a SDD rate of 92.01％and a resistance rate of 7.99％to fluconazole,resistance rates of 32.27％and 48.24％to posaconazole and voriconazole non-wild-type strains(NWT),respectively,and susceptibility rates above 90％to other drugs.Candida tropicalis had resistance rates of 29.55％and 26.24％to fluconazole and voriconazole,respectively,resistance rates of 76.60％and 21.99％to posaconazole and echinocandins non-wild-type strains(NWT),and a resistance rate of 2.36％to echinocandins.Conclusions The prevalence and species distribution of Candida spp.in the East China region are consistent with previous domestic and international reports.Candida glabrata exhibits certain degree of resistance to fluconazole,while Candida tropicalis demonstrates higher resistance to triazole drugs.Additionally,echinocandins resistance has emerged in Candida albicans,Candida glabrata,Candida tropicalis,and Candida parapsilosis.

As a novel and promising antitumor target, AXL plays an important role in tumor growth, metastasis, immunosuppression and drug resistance of various malignancies, which has attracted extensive research interest in recent years. In this study, by employing the structure-based drug design and bioisosterism strategies, we designed and synthesized in total 54 novel AXL inhibitors featuring a fused-pyrazolone carboxamide scaffold, of which up to 20 compounds exhibited excellent AXL kinase and BaF3/TEL-AXL cell viability inhibitions. Notably, compound 59 showed a desirable AXL kinase inhibitory activity (IC₅₀: 3.5 nmol/L) as well as good kinase selectivity, and it effectively blocked the cellular AXL signaling. In turn, compound 59 could potently inhibit BaF3/TEL-AXL cell viability (IC₅₀: 1.5 nmol/L) and significantly suppress GAS6/AXL-mediated cancer cell invasion, migration and wound healing at the nanomolar level. More importantly, compound 59 oral administration showed good pharmacokinetic profile and in vivo antitumor efficiency, in which we observed significant AXL phosphorylation suppression, and its antitumor efficacy at 20 mg/kg (qd) was comparable to that of BGB324 at 50 mg/kg (bid), the most advanced AXL inhibitor. Taken together, this work provided a valuable lead compound as a potential AXL inhibitor for the further antitumor drug development.

Abdominal pain is a prominent syndrome in patients with irritable bowel syndrome (IBS), which greatly affects the quality of life of patients. Due to the complexity of etiology and great individual variation, abdominal pain treatment in IBS patients is still a clinical difficulty. The treatment of IBS pain includes non ‑ drug therapy (lifestyle intervention such as diet and exercise, gut microbiota modulation), drug therapy (antispasmodics, peppermint oil, antidepressants, non ‑ absorbed antibiotic) and psychological behavior intervention. This article reviewed the status and progress of pain treatment in IBS, so as to provide evidences for clinicians.

Objective: Viscoelasticity is an essential feature of nerves, although little is known about their viscous properties. The discovery of shear wave dispersion (SWD) imaging has presented a new approach for the non-invasive evaluation of tissue viscosity.The present study investigated the feasibility of using SWD imaging to evaluate diabetic neuropathy using the sciatic nerve in a diabetic rat model. Materials and Methods: This study included 11 diabetic rats in the diabetic group and 12 healthy rats in the control group.Bilateral sciatic nerves were evaluated 3 months after treatment with streptozotocin. We measured the nerve cross-sectional area (CSA), nerve stiffness using shear wave elastography (SWE), and nerve viscosity using SWD imaging. The motor nerve conduction velocity (MNCV) was also measured. These four indicators and the histology of the sciatic nerves were then compared between the two groups. The performance of CSA, SWE, and SWD imaging in distinguishing the two groups was assessed using receiver operating characteristic (ROC) analysis. Results: Nerve CSA, stiffness, and viscosity in the diabetic group was significantly higher than those in the control group (all p < 0.05). The results also revealed a significantly lower MNCV in the diabetic group (p = 0.005). Additionally, the density of myelinated fibers was significantly lower in the diabetic group (p = 0.004). The average thickness of the myelin sheath was also lower in the diabetic group (p = 0.012). The area under the ROC curve for distinguishing the diabetic neuropathy group from the control group was 0.876 for SWD imaging, which was significantly greater than 0.677 for CSA (p = 0.030) and 0.705 for SWE (p = 0.035). Conclusion Sciatic nerve viscosity measured using SWD imaging was significantly higher in diabetic rats. The viscosity measured using SWD imaging performed well in distinguishing the diabetic neuropathy group from the control group.Therefore, SWD imaging may be a promising method for the evaluation of diabetic neuropathy.

Pulmonary embolism is the cardiovascular disease caused by endogenous or exogenous emboli blocking the pulmonary artery system. Pulmonary embolism is clinically very common and has a high recurrence rate. Its etiology is complicated. Pulmonary embolism recurrence can be caused by many factors, which affect its prognosis. Complicated diseases, residual thrombosis, anticoagulation therapy and respiratory disorders are the main factors that lead to pulmonary embolism recurrence. Some blood test indicators can also reflect the recurrence of pulmonary embolism. This paper reviews the risk factors and prevention strategies of pulmonary embolism recurrence, with the purpose of reducing recurrence rate, improving prognosis and thereby providing objective evidence for clinical practice.

Objective:To explore the value of low-dose CT in pregnancy with COVID-19.Methods:A retrospective analysis was performed on the clinical characteristics, laboratory tests, and chest CT findings of 12 pregnant women with COVID-19 diagnosed by nucleic acid testing in the Renmin Hospital of Wuhan University from January 20, 2020 to February 16, 2020. Two radiologists blinded to the reconstruction algorithm independently scored subjective image quality on a 5-point Likert scale. Image quality score ≥ 3 was acceptable in clinics. The CT radiation doses were recorded, including CT volume dose index (CTDI vol), dose length product (DLP), and effective radiation dose ( E). Two radiologists observed the distribution, shape, density, and other characteristics of lung lesions, and they also decided whether hilar, mediastinal lymphadenopathy, and pleural changed. Results:A total of 12 pregnant women with COVID-19, 8 had cough, 4 had fever, 2 had chest tightness, and 1 had dyspnea and diarrhea each. The CT image quality score of all patients was 3-4, with an average of 3.46, which fully met the clinical diagnosis requirements. The CTDI vol value was 1.13-4.31 mGy, with an average of 3.02 mGy. The DLP value was 34.48-75.29 mGy·cm, with an average of 55.48 mGy·cm. The Evalue was 0.48-1.05 mSv, with an average of 0.78 mSv. In all cases, chest CT examination showed abnormal manifestations after clinical symptoms, including unilateral lung lesions in 5 cases and bilateral lung lesions in 7 cases, 1 case of ground-glass opacity, 1 case of solidification, 7 cases of ground-glass and consolidation, 1 case of strip opacity, ground-glass, and consolidation and strip cable shadow coexisted in 2 cases. Conclusions:The application of low-dose CT scan in pregnant women with COVID-19 is completely feasible. CT mainly manifested as bilateral lung patchy and flaky ground-glass opacity with consolidation. Active and effective treatment can help recover and improve prognosis.

Objective: To evaluate the effect of abdominal massage on gastrointestinal tolerance in critically patients with nasogastric tube feeding. Methods: The Chinese Biomedical Literature Database, China National Knowledge Infrastructure, The Wang fang database, Chinese Science and Technology Periodical Database, Cochrane Libraty, PubMed, Embase, CENTRAL were searched. Two researchers conducted quality evaluation and data extraction on studies that met the inclusion criteria. Data were analyzed with RevMan5.3 software. Results: Eight randomized controlled trials were included, including 628 patients. The results of Meta-analysis showed that abdominal massage could reduce the gastric residual volume of critically ill patients (WMD=-45.45, 95%CI -56.62--34.28, P<0.01), and reduce the incidence of gastric retention (OR=0.13, 95%CI 0.06 -0.29, P<0.01), incidence of abdominal distension (OR=0.23, 95% CI 0.13-0.43, P<0.01), incidence of vomiting (OR=0.14, 95% CI 0.06-0.36, P<0.01). Conclusions For critically ill patients with nasogastric tube feeding, abdominal massage can reduce the gastric residual volume and reduce the incidence of gastric retention, distension and vomiting.

Objective: To evaluate the effect and mechanism of down-regulating the expression of REV7 on the radiosensitivity of human colon cancer cell HCT116. Methods: HCT116 cells were cultured and the expression of REV7 was down-regulated by RNA interference technique. HCT116 cells were divided into the blank group, negative control transfected with negative RNA oligo group and REV7 expression down-regulation transfected with REV7 RNA oligo group, respectively. The cell proliferation was determined by colony formation assay. The expression levels of the proteins of relevant genes were detected by Western blot. The level of cell apoptosis and non-homologous end joining was evaluated. Results: The colony formation rate was significantly reduced in THE REV7 siRNA group after 6Gy irradiation (P<0.05). The down-regulating efficiency rate of REV7 gene was>60% in the REV7 siRNA group. The expression levels of γH₂AX and Caspase9 were significantly up-regulated, whereas those of KU80 and XRCC4 were remarkably down-regulated in the REV7 siRNA group (all P<0.05). Conclusions The radiosensitivity of human colon cancer cell HCT116 can be increased by down-regulating the expression of REV7. The underlying mechanism may be related to the lower incidence rate of non-homologous end joining.