Objective To evaluate the diagnostic values of the breast imaging reporting and data system-MRI (BI-RADS-MRI)description about non-masslike enhancement by data mining. Methods Fifty-five patients with non-masslike enhancement lesions showed on breast contrast-enhanced MRI were evaluated using two data mining algorithms (Logistic regression and decision tree) and 10-fold cross-validation methods. Results There were 28 malignant and 27 benign lesions. The most frequent findings of the malignant lesions were clustered ring enhancement and clumped enhancement [ 12 and 4 lesions, respectively; 84. 2% (16/19) in decision trees, partial regression coefficients in Logistic model were 2. 128 and 1.723, respectively], whereas homogenous, stippled, reticular internal and linear ductal enhancement were the most frequent findings in benign lesions [ 4、9、1 and 7 lesions, respectively; 72. 4% (21/29) in decision tree, partial regression coefficients in Logistic model were 0.357 (homogenous), 1. 861 (stippled) and 18. 870( reticular), respectively]. 10-fold cross-validation indicated that decision tree (C5.0) achieved an accuracy of 69.3% with a sensitivity of 66.7% and a specificity of 71.7% in comparison to the Logistic regression model with an accuracy of 57. 0%, a sensitivity of 43.3% and a specificity of 71.7%. Conclusions The diagnosis efficacy of non-masslike enhancement interpretation according to BI-RADS-MRI is not high. It is very important to find more potential features of non-masslike enhancement to improve the diagnosis accuracy.

Objective To investigate the pathological and magnetic resonance imaging(MRI)characteristics of orbital diffuse large B-cell lymphoma(DLBCL).Methods A total of 48 patients with orbital DLBCL were selected via a retrospective case-control study in the orbital DLBCL group,and 5 1 patients with DLBCL of primary central nervous system during the same period were included in primary DLBCL group.The clinical characteristics and MRI features of the orbital DLBCL group were analyzed,and the pathological characteristics and peripheral blood platelet-to-lymphocyte ratio(PLR),neutrophil-to-lymphocyte ratio(NLR),and lymphocyte-to-monocyte ratio(LMR)were com-pared between the two groups.Results The main clinical manifestations of orbital DLBCL patients in-cluded local orbital mass in 48 cases(100.00％),limited ocular motility in 38 cases(79.17％),ex-ophthalmos in 33 cases(68.75％),decreased visual acuity in 25 cases(52.08％),diplopia in 17 cases(35.42％),and epistaxis in 9 cases(18.75％).Orbital DLBCL predominantly occurred in the extraconal space(54.17％),with lesions mostly located above the orbit(52.08％).T1-weighted im-ages mainly showed intermediate signal intensity(60.42％),T2-weighted images mainly showed in-termediate(56.25％)and high signal intensity(29.17％),diffusion-weighted images mainly showed high signal intensity(58.33％),and apparent diffusion coefficient maps mainly showed low signal intensity(60.42％).There were no statistically significant differences in histopathological subtype,CD20 positive expression,CD79a positive expression,CD45RO positive expression,International Prognostic Index score,and pathological stage between the two groups(P＞0.05).The PLR in the orbital DLBCL group was higher,while NLR and LMR were lower than that in the primary DLBCL group(P＜0.05).Conclusion Orbital DLBCL exhibits specific clinical manifestations and MRI characteristics.MRI can serve as the primary diagnostic tool,and its combination with pathological immunohistochemical analysis and peripheral blood PLR,NLR,and LMR test results can improve the accuracy and timeliness of diagnosis.

Objective To investigate the pathological and magnetic resonance imaging(MRI)characteristics of orbital diffuse large B-cell lymphoma(DLBCL).Methods A total of 48 patients with orbital DLBCL were selected via a retrospective case-control study in the orbital DLBCL group,and 5 1 patients with DLBCL of primary central nervous system during the same period were included in primary DLBCL group.The clinical characteristics and MRI features of the orbital DLBCL group were analyzed,and the pathological characteristics and peripheral blood platelet-to-lymphocyte ratio(PLR),neutrophil-to-lymphocyte ratio(NLR),and lymphocyte-to-monocyte ratio(LMR)were com-pared between the two groups.Results The main clinical manifestations of orbital DLBCL patients in-cluded local orbital mass in 48 cases(100.00％),limited ocular motility in 38 cases(79.17％),ex-ophthalmos in 33 cases(68.75％),decreased visual acuity in 25 cases(52.08％),diplopia in 17 cases(35.42％),and epistaxis in 9 cases(18.75％).Orbital DLBCL predominantly occurred in the extraconal space(54.17％),with lesions mostly located above the orbit(52.08％).T1-weighted im-ages mainly showed intermediate signal intensity(60.42％),T2-weighted images mainly showed in-termediate(56.25％)and high signal intensity(29.17％),diffusion-weighted images mainly showed high signal intensity(58.33％),and apparent diffusion coefficient maps mainly showed low signal intensity(60.42％).There were no statistically significant differences in histopathological subtype,CD20 positive expression,CD79a positive expression,CD45RO positive expression,International Prognostic Index score,and pathological stage between the two groups(P＞0.05).The PLR in the orbital DLBCL group was higher,while NLR and LMR were lower than that in the primary DLBCL group(P＜0.05).Conclusion Orbital DLBCL exhibits specific clinical manifestations and MRI characteristics.MRI can serve as the primary diagnostic tool,and its combination with pathological immunohistochemical analysis and peripheral blood PLR,NLR,and LMR test results can improve the accuracy and timeliness of diagnosis.

Objective:To explore the effect of "Internet +" combined with multidisciplinary out of hospital management in hospital-home transitional period management of patients after lumbar internal fixation.Methods:From October 2021 to September 2022, convenience sampling was used to select 176 patients who underwent lumbar internal fixation at the Department of Orthopedics of the First Affiliated Hospital of Zhengzhou University. According to the admission time, patients enrolled from October 2021 to March 2022 were included in the control group, and patients enrolled from April to September 2022 were included in the observation group, with 88 cases in each group. The control group implemented routine out of hospital follow-up management, while the observation group implemented "Internet +" combined with multidisciplinary out of hospital management. After three months of intervention, the recovery of lumbar and back function [Oswestry Disability Index (ODI) and Macnab score], surgical efficacy (NaKa grading), nursing satisfaction, and readmission rate were compared between the two groups.Results:After three months, the ODI score of the observation group was lower than that of the control group, and the Macnab score was higher than that of the control group, the NaKa grading was better than that of the control group, with statistically significant differences ( P<0.05). In the observation group and control group, the total effective rate of surgery, nursing satisfaction, and readmission rate were 88.64% (78/88) vs. 67.05% (59/88), 94.32% (83/88) vs. 78.41% (69/88), 4.55% (4/88) vs. 17.05% (15/88), respectively. The total effective rate and nursing satisfaction of the observation group were higher than those of the control group, and the readmission rate was lower than that of the control group, with statistical differences ( P<0.05) . Conclusions:"Internet +" combined with multidisciplinary out of hospital management can effectively improve the recovery of lumbar function in hospital-home transitional period management of patients after lumbar internal fixation, enhance the surgical efficacy and nursing satisfaction, and reduce the readmission rate.

Objective To investigate the clinical values of continuous hemoperfusion on the level of inter-leukin-18(IL-18)and prognosis in patients with acute paraquat poisoning(APP). Methods A total of 112 pa-tients with APP treated in our hospital from Jun 2013 to Jul 2017 were divided into two groups:control group(56 cases,routine drug and single hemoperfusion)and therapy group(56 cases,treated by continuous hemoperfusion based on control group).All APP patients were treated with continuous veno venous hemofiltration(CVVH)at 24 hours after treatment.Within admission 24 hours,3 days and 7 days after treatment,IL-18,lactic acid(Lac),ar-terial oxygen partial pressure(PaO2),alanine aminotransferase(ALT),creatinine(Cr)and creatine kinase(CK-MB)of patients were detected,28-day survival was recorded.Pearson correlation test was used to analyze the corre-lation between IL-18 in patients with APP and the survival rate. Results In admission,there were no differences in the levels of IL-18,Lac,PaO2,ALT,Cr and CK-MB between the two groups(P>0.05).At 3 days after treat-ment,the levels of IL-18,Lac,ALT,Cr and CK-MB were higher than those before treatment,and the therapy group was lower than the control group,while PaO2was lower than those before treatment,and the therapy group was higher than the control group(P<0.05);At 7 days after treatment,the two groups both had lower levels of IL-18,Lac,ALT,Cr and CK-MB than those after 3 days treatment,and the therapy group was lower than the con-trol group,while PaO2was lower than those after 3 days treatment,and the therapy group was higher than the con-trol group(P<0.05);There were 39 deaths in the therapy group and 49 deaths in the control group,the therapy group had a lower 28-day mortality rate than control group,the difference was statistically significant(69.64% vs 87.50%,χ2=5.303,P=0.021). The level of serum IL-18 in patients with APP was negatively correlated with the survival rate(r =-0.209,P = 0.027).Conclusions Therapeutic effect of continuous hemoperfusion in APP pa-tients is superior to single hemoperfusion. It could decrease the levels of IL-18,Lac,ALT,Cr and CK-MB,im-prove PaO2 and reduce the mortality rate of patients.The clinical curative effect is distinct.

A purified polysaccharide with a galactose backbone(SPR-1,Mw 3,622 Da)was isolated from processed Polygonati Rhizoma with black beans(PRWB)and characterized its chemical properties.The backbone of SPR-1 consisted of[(4)-β-D-Galp-(1]9→ 4,6)-β-D-Galp-(1 → 4)-α-D-GalpA-(1 → 4)-α-D-GalpA-(1 →4)-α-D-Glcp-(1 → 4,6)-α-D-Glcp-(1 → 4)-α/β-D-Glcp,with a branch chain of R1:β-D-Galp-(1 → 3)-β-D-Galp-(1 → connected to the →4,6)-β-D-Galp-(1 → via O-6,and a branch chain of R2:α-D-Glcp-(1 →6)-α-D-Glcp-(1 → connected to the →4,6)-α-D-Glcp-(1 → via O-6.Immunomodulatory assays showed that the SPR-1 significantly activated macrophages,and increased secretion of NO and cytokines(i.e.,IL-1β and TNF-α),as well as promoted the phagocytic activities of cells.Furthermore,isothermal titration calorimetry(ITC)analysis and molecular docking results indicated high-affinity binding between SPR-1 and MD2 with the equilibrium dissociation constant(KD)of 18.8 μM.It was suggested that SPR-1 activated the immune response through Toll-like receptor 4(TLR4)signaling and downstream responses.Our research demon-strated that the SPR-1 has a promising candidate from PRWB for the TLR4 agonist to induce immune response,and also provided an easily accessible way that can be used for PR deep processing.

OBJECTIVE: To rapidly identify the two morphologies and chemical properties of similar herbal medicines, Blumea riparia and B. megacephala as the basis for chemical constituent analysis. METHODS: UPLC-Q-Exactive-MS/MS was utilized for profiling and identification of the constituents in B. riparia and B. megacephala. Chemical pattern recognition (CPR) was further used to compare and distinguish the two herbs and to identify their potential characteristic markers. Then, an HPLC method was established for quality evaluation. RESULTS: A total of 93 constituents are identified, including 54 phenolic acids, 35 flavonoids, two saccharides, one phenolic acid glycoside, and one other constituent, of which 67 were identified in B. riparia and B. megacephala for the first time. CPR indicates that B. riparia and B. megacephala samples can be distinguished from each other based on the LC-MS data. The isochlorogenic acid A to cryptochlorogenic acid peak area ratio calculated from the HPLC chromatograms was proposed as a differentiation index for distinguishing and quality control of B. riparia and B. megacephala. CONCLUSION This study demonstrates significant differences between B. riparia and B. megacephala in terms of chemical composition. The results provide a rapid and simple strategy for the comparison and evaluation of the quality of B. riparia and B. megacephala.