Objective To detect the nodal occult micrometastasis in stage Ⅰ non-small-cell lung cancer(NSCLC),and further investigate the main factor of affecting the nodal occult micrometastasis and the rule of micrometastasis in stage Ⅰ NSCLC. Methods Occult micrometastatic tumor cells by in hilar and subcarinal lymph nodes(LN)were detected immunohistochemistry (SP method),which were removed from 91patients with completely resected stage Ⅰ NSCLC.The monoclonal antibody muhicytokeratin(MCK)was used as a micrometastatic marker.Another 45 hilar LN removed from benign pulmonary lesion patients and 45 hilar LN removed from Ⅱ and Ⅲ stage NSCLC were detected, respectively by conventional histopathologic examination as negative and positive control.Results Micrometastasis was detected in all lymph nodes that were removed from stageⅡand Ⅲ NSCLC.but no one was detected in lymph nodes that were removed from benign pulmonary lesion patients.There were 45 positive cases in 91 patients.The rate of micrometastasis in stage Ⅰ NSCLC was 49%(45/91).among them 39 subcarinal lymph nodes and 11 hilar lymph nodes were detected as positive,5 cases were detected as positive both in subcrinal and hilar lymph nodes.Logistic regression analysis indicated that tumor size,stage and differentiation affected micrometastasis significantly,odd ratios(OR) were 8.444,6.946 and 14.566 respectively.The multivariate analysis indicated that cell difierentiation and T stage may be the adverse factors for nodal micrometastasis,odd ratios(OR)were 7.028and 14.509 respectively.Conclusion There is nodal micrometastasis in completely resected stage Ⅰ NSCLC patients.The micrometastasis frequency of stage ⅠB is significantly higher than stage ⅠA;It is necessary for stage ⅠB NSCLC to be given chemotherapy after operation;cell differentiation and T stage may be the adverse factors for nodal micrometastasis.The method of lymph node micrometastasis is from hilum to mediastinum.The skip micrometastasis may be taken place in adenocarcinoma.

Objective To investigate the clinical value of magnetic resonance cholangiopancreatography (MRCP) in diagnosing biliary tract variability. Methods The accuracy of MRCP was verified by comparing the biliary tract variability found by preoperative MRCP examination with the biliary variability found during surgery. Results The accuracy of biliary tract variability by preoperative MRCP and intraoperative confirmation was 96. 7％. It turned out that the presence of biliary variability could be detected. Conclusion As a noninvasive imaging examination method, MRCP has high accuracy in the diagnosis of biliary tract variability.

A GC-LSTM model is proposed based on the characteristics of global optimization of genetic algorithm.The model automatically and iteratively searches the optimal hyper-parameter configuration of the C-LSTM model through the genetic algorithm of a specific genetic strategy,and it is configured using the genetic iteration results and validated on the MIT-BIH arrhythmia database according to the classification criteria of the Association for the Advancement of Medical Instrumentation.The testing shows that the classification accuracy,sensitivity,accuracy and F1 value of GC-LSTM model are 99.37%,95.62%,95.17%and 95.39%,respectively,higher than those of the manually established model,and it is also advantageous over the existing mainstream methods.Experimental results demonstrate that the proposed method can achieve better classification performance while avoiding a large number of experimental parameters.

Objective:To investigate the relationship between double mutations of myosin heavy chain gene (MYH6) p.Gly743Arg and p.Glu1389Lys and the cardiac phenotype.Methods:Patients carrying double mutations in the MYH6 gene p.Gly743Arg and p.Glu1389Lys were screened from 52 unrelated left ventricular hypertrophy (LVH) who were admitted to the Second Hospital of Chongqing Medical University from 2015 to 2020, and the genetic testing of peripheral blood of patients by second-generation whole-exome sequencing assay technology and genomic DNA of their family members Sanger sequencing was performed to validate the genomic DNA of the family members. The cardiac phenotype was evaluated by electrocardiogram, coronary computed tomography angiography (CTA), echocardiography, and cardiac magnetic resonance imaging (MRI) as adjuncts.Results:All whole-exome gene were detected in 52 unrelated patients with LVH, of which 1 patient (1.9%) had double mutations in MYH6 gene p.Gly743Arg and p.Glu1389Lys (proband). Two members of the maternal line of this patient carried p.Glu1389Lys mutation, but there was no obvious clinical phenotype. Two members of the paternal line carried p.Gly743Arg mutation and had obvious clinical phenotype of bradycardia, but there was no LVH. The male proband, aged 21 years old, presented with LVH and sinus bradycardia but no coronary artery stenosis on CTA before treatment, MRI showed that the left ventricular end diastolic diameter was 58 mm. After treatment with angiotensin receptor-enkephalinase inhibitor (ARNI), electrocardiogram showed that the heart rate increased significantly (from 43 bpm to 72 bpm). Echocardiography showed that the left ventricular end diastolic diameter decreased significantly (from 60 mm to 49 mm).Conclusions:The p.Glu1389Lys mutation of the MYH6 gene may not manifest the phenotype of heart disease. MYH6 gene p.Gly743Arg mutation may be manifested asymptomatic sinus bradycardia, but there is no LVH phenotype. The cardiac disease phenotype caused by the double mutations of p.Gly743Arg and p.Glu1389Lys in the MYH6 gene is more obvious. Asymptomatic LVH and sinus bradycardia can appear in adolescence, but the LVH phenotype can be reversed in a short period of time after ARNI treatment.

Objective:To investigate the value and influence factors of preoperative and intraoperative localization of ectopic hyperparathyroidism (EHPT).Methods:Results of 99mTc-sestamibi ( 99mTc-MIBI), neck ultrasound, contrast CT and intraoperative local venous parathyroid hormone (IOLVPTH) were retrospectively analyzed in 205 patients with primary hyperparathyroidism (PHPT) suspected of EHPT. Results:Incidence of EHPT was 16.6% (34 cases), and 36 ectopic lesions were detected. The proportion of EHPT in antero-superior mediastinum, intrathyroidal, in the retropharyngeal region, in carotid sheath, in the prevertebral region and intrapericardial were 44.1% (15 cases), 29.4% (10 cases), 11.8% (4 cases), 5.9% (2 cases), 5.9% (2 cases) and 2.9% (1 cases), respectively. Contrast CT was the most sensitive (86.1%, 31 lesions/36 lesions) for EHPT, followed by 99mTc-MIBI (66.7%, 24 lesions/36 lesions), IOLVPTH monitoring (61.8%, 21 lesions/34 lesions) and neck ultrasound (55.6%, 20 lesions/36 lesions). Contrast CT was most sensitive,100% in detecting deep-located EHPT lesions, whereas IOLVPTH had advantages in detecting intrathyroidal EHPT lesions, with a sensitivity of 100.0%.The combined use of 99mTc-MIBI and neck ultrasound showed a sensitivity of 77.8% in the localization of EHPT. Conclusions:Contrast CT is highly sensitive in the localization of EHPT. The combined use of preoperative imaging and IOLVPTH monitoring helps to higher localization for EHPT.

Objective:To evaluate whether underdilated stent could reduce the occurrence of hepatic encephalopathy (HE) after transjugular intrahepatic portosystemic shunt (TIPS) creation.Methods:A total of 197 patients with decompensated liver cirrhosis, who had underwent TIPS creation at Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, were analyzed retrospectively, including 110 males and 87 females with age 25-79 (54±11) years old. Uncovered and covered stents with 8 mm diameter were implanted in all subjects, and then dilated by balloon catheters with 6 mm or 8 mm diameter. The patients were divided into two groups, including underdilated group (6 mm, n=105) and control group (8 mm, n=92).Kaplan-Meier curves were used to illustrate cumulative rate of HE, and the differences were assessed with the log-rank test. Multivariate analyses with a Cox regression model were conducted to explore the risk factors for HE. Results:During a median follow-up period of 29 (12-54) months, 16 (15.2%) patients developed HE in the underdilated group and 27 (29.3%) patients in the control group. There was a significant difference in the cumulative rate of HE ( P=0.014), but no statistical differences were found in terms of variceal rebleeding, shunt dysfunction and survival between the two groups ( P=0.608, P=0.659, P=0.968). In multivariated analysis, group assignment (underdilated vs. control, HR=0.291, 95% CI 0.125-0.674, P=0.004) was identified as an independent risk factor for HE after TIPS creation. Conclusion:Underdilated TIPS could reduced the risk of HE compared with completely dilated TIPS, with comparable risk of variceal rebleeding, shunt dysfunction and mortality. And it is worthy of applying this technique to a large sample of patients in clinical practice.

Objective To explore the efficacy of the resolving depression and tranquilizing herbal sachets in alleviating sleep disorders of soldiers in naval vessels. Methods Fifty-nine soldiers with sleep disorders (PSQI scale score ≥8 and SAS scale score ≥50) were selected before training at sea, and were randomly divided into sachet treatment group, mindfulness meditation group and control group. During the training period, the sachet treatment group was given traditional Chinese medicine sachet treatment, the mindfulness meditation group was trained in mindfulness meditation, and the control group was not given any intervention. Results Compared with the control group, the PSQI and SAS scores of soldiers in both the experimental sachet treatment group and the positive meditation group were significantly improved; compared with the pre-intervention data, the PSQI and SAS scores of both the positive meditation group and the sachet treatment group were significantly decreased, and the degree of decrease was comparable. Conclusion The homemade improving depression and tranquilizing TCM sachets have the effect of alleviating the sleep disorders of naval troops served on vessels, which is equivalent to mindfulness meditation. It is easy to use and operate, which is suitable for promotion in the military.

OBJECTIVE To establish an analytical method based on ultra-performance liquid chromatography-quadrupole-time- of-flight mass spectrometry （UPLC-Q-TOF/MS） combined with UNIFI platform for rapid identification of the chemical constituents in Abrus cantoniensis Hance. METHODS The chromatographic separation was performed on ACQUITY PRM HSS T3 FIT column for gradient elution with the mobile phase consisted of 0.1% formic acid aqueous solution-acetonitrile. The flow rate was 0.3 mL/min， and injection volume was 2 μL. Electrospray ionization was used to collect the mass spectrometry data of the chemical constituents of A. cantoniensis Hance with full information tandem mass spectrometry technology in positive and negative ion modes. The chemical constituent database of A. cantoniensis Hance was established. Targeted and non-targeted analyses were conducted based on UNIFI platform， and chemical constituents were further identified in combination with accurate molecular mass， secondary fragment ion information and equivalence with reference substances and literature data， etc. RESULTS Totally 46 compounds of A. cantoniensis Hance were successfully identified， including 19 flavonoids， 8 triterpenoids， 3 alkaloids， 5 organic acids and 11 other components. Among them， 11 compounds were firstly found in A. cantoniensis Hance， and 9 compounds were confirmed by reference substance. CONCLUSIONS The analytical method based on UPLC-Q-TOF/MS combined with UNIFI platform can quickly identify the chemical constituents of A. cantoniensis Hance. Flavonoids and triterpenes are the main components in A. cantoniensis Hance.

The recent discovery of activator compounds binding to an allosteric site on the NAD

Aldehyde oxidase (AOX) is a molybdoenzyme that is primarily expressed in the liver and is involved in the metabolism of drugs and other xenobiotics. AOX-mediated metabolism can result in unexpected outcomes, such as the production of toxic metabolites and high metabolic clearance, which can lead to the clinical failure of novel therapeutic agents. Computational models can assist medicinal chemists in rapidly evaluating the AOX metabolic risk of compounds during the early phases of drug discovery and provide valuable clues for manipulating AOX-mediated metabolism liability. In this study, we developed a novel graph neural network called AOMP for predicting AOX-mediated metabolism. AOMP integrated the tasks of metabolic substrate/non-substrate classification and metabolic site prediction, while utilizing transfer learning from ¹³C nuclear magnetic resonance data to enhance its performance on both tasks. AOMP significantly outperformed the benchmark methods in both cross-validation and external testing. Using AOMP, we systematically assessed the AOX-mediated metabolism of common fragments in kinase inhibitors and successfully identified four new scaffolds with AOX metabolism liability, which were validated through in vitro experiments. Furthermore, for the convenience of the community, we established the first online service for AOX metabolism prediction based on AOMP, which is freely available at https://aomp.alphama.com.cn.