The application of cerebrovascular intervention brings the diagnosis and treatment of cerebrovascular disease into a brand-new domain. Many neurological physicians have become physicians of cerebrovascular intervention by training. In the big teaching hospitals carrying out cerebrovascular intervention, advanced physicians are the hard strength in the lot of cerebrovascular intervention. The training aiming at cerebrovascular intervention and comprehensive abilities affects both the training results and the therapeutic results of cerebrovascular intervention. Therefore, it is an important issue to explore how to consummate and standard the training methods of advanced physicians studying cerebrovascular intervention.

Objective:To investigate Intraflagellar Transport 80 (IFT80) protein expression in bone, lung, pancreatic, stomach, in-testinal, prostate, breast, and ovarian cancers to explore its mechanism in cancer cell proliferation and to diagnose and identify new tar-gets in cancer treatment. Methods:Immunohistochemistry was used to investigate the expression of IFT80 in gastric cancer tissue of different stages and in eight other kinds of human cancer tissues. We studied the relationship between cancer cell proliferation and inhi-bition of IFT80. Immunofluorescence method and cell culture were used to study the cilia and IFT80. Results:Results showed the fol-lowing:a) the expression of IFT80 was high in gastric and lung carcinoma tissues, moderate in breast and colorectal cancers, low in bone and ovarian cancers, and nearly absent in prostate and pancreatic cancers;b) inhibition of IFT80 in the A549 cancer cell line accel-erated cell proliferation and resulted in shorter, lower quality cilia;and c) IFT80 was abundantly expressed in cancer tissues of well-dif-ferentiated stage-IIA gastric cancer and normal gastric tissues, but was hardly expressed in late-stage, poorly differentiated gastric can-cer. IFT80 could have various degrees of expression in gastric carcinoma of other stages and differentiation. Conclusions:Different can-cer organs showed variation in IFT80 expression. IFT80 can be distributed in the organs with mechanical motion function, such as lungs and stomach. IFT80 is distributed on the cell cilia and can adjust the number and length of the cilia by reducing IFT80 protein ex-pression. Through a variety of ways, IFT80 directly or indirectly participates in the proliferation of cancer cells. Thus, the lowest or nearly zero expression of IFT80 can be seen in cancer tissues of high-grade malignancy, such as advanced cancers with poor differentia-tion.

Objective To analyze the application of intraoperative neurophysiological monitoring combined with neuronavigation multi-modal fusion technology in the brainstem glioma resection. Methods One hundred twenty patients with brainstem glioma were divided into observation group and control group. The control group was treated by traditional operation, while the observation group was treated by intraoperative nerve electrophysiological monitoring combined with neuronavigation multimodal fusion technology. The general condition, clinical efficacy, KPS score, complications and survival rate of the two groups were compared. Results The effect was significantly better in the observation group(76.66%)than in control group(53.33%)( x2=11.962,P=0.001).KPS scores were significantly higher in the observation group (27.91 ±1.98) than in the control group (12.11 ±2.13)(t=32.669, P<0.001). Conclusions Intraoperative nerve electrophysiological monitoring plus neuronavigation multimodality fusion technology can improve clinical efficacy and quality of life in patients with brainstem glioma.

Objective To research the influence of hypoxic preconditioning in anti-oxidative ability of brain tissues and neurological functions in rats after traumatic brain injury.Methods Forty eight adult male Sprague Dawley rats were randomly divided into sham-operated group,hypoxic preconditioning group (HPC),traumatic brain injury group (TBI) and hypoxic preconditioning+traumatic brain injury group (HPCT,n=12).The HPC rat models were made by hypobaric chamber for 3 d (50 kPa,3 h/d) and TBI were induced by Feeney's improved equipment.All rats were killed 24 h after injury,and the neurological functions of each group were evaluated by modified neurologieal severity scale (mNSS);the neuronal survival around contusion area was detected by NeuN immunohistochemical staining,and the protein and mRNA expressions of nuclear transcription factor-related factor 2 (Nrf2) and thioredoxin reductases 2 (TrxR2) in the brain tissues were detected by Western blotting and real-time quantitative PCR.Results The mNSS scores in the TBI and HPCT groups were significantly higher as compared with those in the sham-operated and HPC groups (P＜0.05),but those in the HPCT group was significantly lower than those in the TBI group (P＜0.05).The neuronal survival in the TBI and HPCT groups was decreased as compared with that in the sham-operated and HPC groups (NeuN expressions:0.274±0.033,0.281±0.042 vs 0.124±0.014,0.150±0.019),with significant difference (P＜0.05),while that in the HPCT group was statistically increased as compared with that in the TBI group (P＜0.05).The expressions of Nrf2 and TrxR2 in the brain tissues of TBI and HPCT groups were significantly increased as compared with those in the sham-operated and HPC groups (P＜0.05),and those in the HPCT group was significantly up-regulated as compared with those in the TBI group (P＜0.05).Conclusion HPC can increase the anti-oxidative ability and relieve the neurological functions missing after TBI.

Objective To explore the effect of hypoxic preconditioning (HPC) on endoplasmic reticulum stress after traumatic brain injury in rats.Methods Forty-eight Sprague Dawley rats were randomly divided into HPC group (HPC modeling) and non-HPC group (without HPC modeling),with 24 rats in each group.And then,each of the group was further divided into four sub-groups (n=6):three sub-groups after traumatic brain injury (TBI) for one,3 and 7 days (TBI modeling,and drawing and observation after various TBI treatment times),and a control sub-group (without any treatment).HPC models were induced in the low-pressure oxygen chamber for 3 h daily continuing for 3 d.TBI models were established by modified Freeny's freely falling equipment.Modified neurological severity scale (mNSS) scores of the rats were recorded after brain injury.C/EBP homologous protein (CHOP) mRNA and protein expressions were detected by quantitative real-time PCR (qRT-PCR) and Western blotting.TUNEL was used to evaluate the apoptotic rate and the correlation between CHOP levels and apoptotic rate was analyzed.Results The rnNSS scores,relative CHOP mRNA and protein expressions,and apoptotic rate in the one,3 and 7 days subgroups after TBI were significantly higher than those in the control group (P＜0.05);and these levels peaked at 3 d;the mNSS scores,relative CHOP mRNA and protein expressions,and apoptotic rate in HPC group were significantly lower than those in the non-HCP group (P＜0.05);and the correlation analysis showed the CHOP expressions were positively correlated with apoptotic rate in the in HPC group and non-HCP group (r=0.957,P=0.000;r=0.966,P=0.000).Conclusion HPC can down-regulate the expression of pro-apoptotic protein CHOP which participates in endoplasmic reticulum stress pathway,reduce neuronal apoptosis and improve neurological function.

Objective To compare the clinical choosing principles of sedated colonoscopy with con-ventional colonoscopy. Methods Outpatients who were willing to accept colonoscopy with or without seda-tion were prospectively recruited,which were assigned to sedated colonoscopy group(n=362)and conven-tional colonoscopy group(n=323). All patients and endoscopists were asked to answer a self-administered questionnaire. The colonoscopy completion,operation time,procedure-related discomfort,and questionnaire results of the two groups were compared and statistically analyzed. Results The completion rate was 98. 9%in the sedated colonoscopy group(358/362)and 89. 8% in the conventional colonoscopy group(290/323) ( P=0. 337 ). The operation time of sedated and conventional group were( 5. 60 ± 3. 25 ) minutes and (7. 71 ± 5. 70)minutes respectively(P<0. 001). And the average cost was CNY 886. 54 per patient in se-dated group and CNY 386. 00 per patient in the conventional group. Patient satisfaction score of conventional group and sedated group were 4(3-4)and 3(2-3)points(P<0. 001),while endoscopist satisfaction score was 4(3-4)and 4(4-4)(P<0. 001). A total of 354 patients(97. 79%)in the sedated group and 225 pa-tients(69. 66%)in the conventional group showed willingness to repeat the identical colonoscopy( P <0. 001). Patients who were male(P=0. 035),having no past abdominal operations(P<0. 001),or no ab-dominal pain during colonoscopy( P =0. 015 )in the conventional group preferred to repeat conventional colonoscopy. Conclusion Although the examination time of conventional colonoscopy is longer than sedated colonoscopy,it could reduce anesthesia risk and the cost. Conventional colonoscopy remains an irreplaceable examination of colorectal diseases in developing countries. Physicians should not only focus on patients'com-fort during endoscopy,but also help patients make a decision based on their actual situation and endoscopic indications to make the best of medical resources.

Objective To investigate whether Danhong injection can enhance the therapeutic effect of neural stem cell (NSC) transplantation in repairing cerebral ischemia injury by regulating the nuclear factor E2-related factor 2 (Nrf2) signaling pathway. Methods Forty male SD rats were randomly divided into the NSC transplantation group (NSC group), Danhong injection group (DH group), NSC+ Danhong injection group (N+D group), NSC+ Danhong injection group +ML385 group(N+D+M group) and PBS control group (PBS group), 8 rats in each group. All rat models of cerebral ischemia were established by embolization of the middle cerebral artery. Reperfusion was performed at 1.5 h after embolization. All rats in each group received corresponding interventions at 3 d after reperfusion. The neurological function score was evaluated before and 1, 2, 4 weeks after NSC transplantation. All rats were sacrificed at 4 weeks after NSC transplantation. The parameters related to oxidative stress were detected. The expression levels of neuron-specific nuclear protein (NeuN) and von Willebrand factor (vWF) were determined by immunofluorescence staining. Results Before NSC transplantation, the neurological function scores did not significantly differ among different groups (all P > 0.05). At postoperative 1, 2 and 4 weeks, the neurological function scores in the NSC, DH and N+D groups were significantly lower than those in the PBS and N+D+M groups (all P < 0.05). Compared with the PBS and N+D+M groups, the malondialdehyde (MDA) levels were significantly decreased, whereas the superoxide dismutase (SOD) and glutathione peroxidase (GPX) levels were considerably increased in the NSC, DH and N+D groups (all P < 0.05). The GPX level in the N+D+M group was significantly lower than that in the PBS group (P < 0.05). Immunofluorescence staining showed that the transplant NSC in the rat brain migrated to the surrounding area of cerebral infarction and survived, and expressed neuronal marker NeuN and neovascularization marker vWF. However, the number of living NSC in the N+D+M group was significantly lower compared with those in the remaining groups. Conclusions Danhong injection may improve the microenvironment of stem cell transplantation, enhance the survival rate of transplant NSC and improve the therapeutic effect of NSC transplantation for cerebral ischemia injury probably by regulating the Nrf2 signaling pathway.

Objective The study aimed to construct and validate a predictive model for pulmonary nodules(PN)nature based on clinicopa-thological features,imaging,and serum biomarkers,so as to provide scientificdecision-making for early diagnosis and treatment of lung cancer.Methods A retrospective was performed on 816 PN patients with definited pathological diagnosis who received surgical resection analysisor lung biopsy in the Department of Thoracic Surgery and Oncology of Shenzhen Traditional Chinese Medicine Hospital from January 2019 to February 2023.Among them,113 cases that did not meet the inclusion criteria were excluded,and the remaining 703 cases were included in the study.The study based on the clinicopathologic features(age,gender,smoking history,smoking cessation history and family history of cancer),chest imaging(maximum diameter of nodule,location of lesion,clear border,Lobulation,spiculation,vascular convergence sign,vacuole,calcification,air bronchial sign,emphysema,nodule type and pleural indentation,nodule number)and serum carcinoembryonic antigen(CEA),cytokeratin 19 fragment(CYFRA21-1),squamous cell carcinoma antigen(SCCA)in patients with PN.These cases were randomly divided into a modeling group(n=552,237 benign,315 malignant)and a validation group(n=151,85 benign,66 malignant).First,univariate analysis was performed to screen for statistically significant predictors of nodules nature.Then,multivariate regression analysis was performed to screen for independent predictors of nodules nature.Finally,the prediction model of PN nature was constructed by logistic regression analysis.Subsequently,the validation group data were entered into the proposed model and Mayo clinic(Mayo)model,veterans affairs(VA)model,Brock University(Brock)model,Peking University(PKU)model and Guangzhou Medical University(GZMU)model,respectively.PN malignancy probability was calculated.The receiver operating characteristic(ROC)curves were plotted.The diagnostic efficiency of each model was compared according to the area under the curve(AUC).Results There were statistically significant variables including age,family history of cancer,maximum nodule diameter,nodule type,upper lobe of lung,calcification,vascular convergence sign,lobulation,clear border,spiculation,and serum CEA,SCCA,CYFRA21-1 using univariate analysis.Multiple regression analysis showed that age,CEA,clear border,CYFRA21-1,SCCA,upper lobe of lung,maximum nodule diameter,family history of cancer,spiculation and nodule type were independent predictors of PN nature.The prediction model equation constructed in this study is as follows:f(x)= ex/(1+ex),X=(-6.318 8+0.020 8×Age+0.527 4×CEA-0.928 4×clear border+0.294 6×Cyfra21-1+0.294×maximum nodule diameter+1.220 1×family history of cancer +0.573 2×upper lobe of lung +0.064 8×SCCA +1.461 5×Spiculation +1.497 6×nodule type).The AUC(0.799 vs 0.659,0.650)of the proposed model was significantly higher compared with Mayo model and VA model,and there were statistically significant differences(Z=3.029,2.638,P=0.003,0.008).However,compared with Brock model,PKU model and GZMU model,the differences of AUC(0.799 vs 0.762,0.773,0.769)were not statistically significant(Z=1.063,0.686,0.757,P=0.288,0.493,0.449).Conclusion The prediction model for PN nature established in this study is accurate and reliable,which can help clinics with early diagnosis and early intervention,and this prediction model deserves to be popularized.

Background/Aims: The accuracy of endosonographers in diagnosing gastric subepithelial lesions (SELs) using endoscopic ultrasonography (EUS) is influenced by experience and subjectivity. Artificial intelligence (AI) has achieved remarkable development in this field. This study aimed to develop an AI-based EUS diagnostic model for the diagnosis of SELs, and evaluated its efficacy with external validation. Methods: We developed the EUS-AI model with ResNeSt50 using EUS images from two hospitals to predict the histopathology of the gastric SELs originating from muscularis propria. The diagnostic performance of the model was also validated using EUS images obtained from four other hospitals. Results: A total of 2,057 images from 367 patients (375 SELs) were chosen to build the models, and 914 images from 106 patients (108 SELs) were chosen for external validation. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the model for differentiating gastrointestinal stromal tumors (GISTs) and non-GISTs in the external validation sets by images were 82.01%, 68.22%, 86.77%, 59.86%, and 78.12%, respectively. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy in the external validation set by tumors were 83.75%, 71.43%, 89.33%, 60.61%, and 80.56%, respectively. The EUS-AI model showed better performance (especially specificity) than some endosonographers.The model helped improve the sensitivity, specificity, and accuracy of certain endosonographers. Conclusions We developed an EUS-AI model to classify gastric SELs originating from muscularis propria into GISTs and non-GISTs with good accuracy. The model may help improve the diagnostic performance of endosonographers. Further work is required to develop a multi-modal EUS-AI system.

Objective To explore the epidemiological characteristics of 45 year-old or older human immunodeficiency virus (HIV)-infected persons and patients with acquired immune deficiency syndrome (AIDS) in Chengdu. Methods Epidemiological methods were used to analyze the data of 45 year-old or older patients with HIV/AIDS reported in Chengdu from 2018 to 2020. Results From 2018 to 2020, there were 219 newly reported cases aged 45 and above (35.67%) with HIV/AIDS in Chengdu, and the differences among them were statistically significant (χ²=6.45, P<0.05). Among the subjects, HIV infected cases accounted for 72.60%, males accounted for 75.80%, most subjects were 56 - 65 years old (48.86%), living in Jinjiang District (39.73%), working in service industries (36.99%), divorced or widowed (67.58%), and Han people (72.15%). There were no significant differences in above characteristics of HIV-infected persons and patients with AIDS from 2018 to 2020 (χ²=0.29, 0.22, 5.65, 1.92, 5.68, 1.12, 2.12, 0.39, P>0.05). 75.34% of the patients were infected through heterosexual transmission, and 50.68% were detected at treatment. The proportion of patients whose first CD4 cell test result was lower than 200/μL was relatively higher (43.84%). Nearly 81.28% of the patients received antiviral therapy, and the mortality reached 16.89%. From 2018 to 2020, the difference in transmission route, sample source, the first examination results of CD4 cells, antiviral treatment, or prognosis was not statistically significant (χ²=1.29, 3.59, 1.56, 0.01, 0.35, P>0.05). Fever (62.10%), fatigue (42.01%), and lymph node enlargement (28.77%) were main symptoms of the patients. 51.14% were detected in outpatient examinations, and most patients were accompanied by at least one opportunistic infection. Cytomegalovirus infection (56.16%) and Mycobacterium tuberculosis infection (36.53%) were main virus infection types. From 2018 to 2020, there was no significant difference in symptoms, visiting departments or combined infection (χ²=0.07-3.00, 3.00, 0.20-2.61, P>0.05). Conclusion The prevalence of HIV/AIDS is relatively severe in 45 year-old or older people in Chengdu. The constituent ratio and the incidence rate show an upward trend. Therefore, individualized prevention and control strategies should be formulated for 45 year-old or older people to effectively suppress the transmission of HIV/AIDS in the middle-aged and the elderly.