Objective:To comparatively analyze the diagnostic value of patent foramen ovale and the degree of right-to-left shunt among the traditional Valsalva maneuver (VM), the modified Valsalva maneuver (mVM) and the compression of the inferior vena cava combined with modified Valsalva maneuver (CM).Methods:A total of 132 patients with migraine, dizziness, chest pain and other symptoms in Longgang District People′s Hospital of Shenzhen from January 2021 to December 2021 were prospectively enrolled. The detection rate of patent foramen ovale and the degree of right-to-left shunt were assessed among the rest state and after performing the auxiliary maneuvers including VM, mVM and CM respectively.Results:After performing the auxiliary maneuvers, the detection rate of patent foramen ovale was significantly increased (88.6% vs 59.8%) with statistical significance (χ 2=36.026, P<0.001). There was a significant difference in the degree of right-to-left shunt among the three auxiliary maneuvers (χ 2=25.581, P<0.001). CM was the most effective for the detection of the large right-to-left shunt, and the difference was statistically significant compared with VM and mVM ( P<0.001, P=0.002). Conclusions:Auxiliary maneuvers is crucial for the diagnosis of patent foramen ovale. Compared with VM and mVM, performing CM can further improve the detection rate of patent foramen ovale and increase the degree of right-to-left shunt.

Objective:To assess the discriminatory value of the Thyroid Follicular Tumor Ultrasound Risk Stratification System (F-TIRADS) in differentiating follicular thyroid carcinoma (FTC) from follicular thyroid adenoma (FTA), and to compare its performance with other risk stratification systems(RSS).Methods:A retrospective analysis was conducted on 325 patients (327 thyroid nodules) diagnosed postoperatively as FTC or FTA at Affiliated Hospital of Qingdao University from January 2016 to December 2023. The cases were divided into FTC group (81 nodules) and FTA group (246 nodules). The nodules were classified based on F-TIRADS, the 2020 Chinese Thyroid Imaging Reporting and Data System (C-TIRADS), the 2015 American Thyroid Association guidelines (ATA guidelines), and the 2017 European Thyroid Association Thyroid Imaging Reporting and Data System (EU-TIRADS) by two ultrasound physicians. Multivariate Logistic regression analysis was used to identify independent predictors associated with FTC. Diagnostic performance of the 4 RSS was compared using postoperative pathological results as the gold standard.Results:Multivariate Logistic regression analysis showed maximum diameter, solid composition, hypoechogenicity, unclear or angular margins, marginal or ring calcifications, trabecular structure, and central blood flow were independent predictors of FTC( OR=1.914, 3.427, 9.926, 9.163, 45.918, 3.191, 8.936, respectively; all P<0.05). Within each RSS, the actual malignancy rate increased with higher risk categories, aligning closely with the recommended malignancy rates (except for ATA guidelines). The optimal cut-off values for distinguishing FTC from FTA were FTC risk 50%-90% in F-TIRADS, C-TIRADS 4B, moderately suspicious nodules in ATA guidelines, and EU-TIRADS 4, with areas under the curve of 0.916, 0.808, 0.827, and 0.836, respectively. F-TIRADS demonstrated the best overall performance (sensitivity: 82.72%, specificity: 82.93%), with significant differences compared with C-TIRADS, ATA guidelines, and EU-TIRADS (all P<0.05). Conclusions:F-TIRADS is highly effective in distinguishing FTA from FTC, outperforming C-TIRADS, ATA Guidelines, and EU-TIRADS. Clinicians should pay close attention to solid hypoechoic nodules with unclear or angular margins, marginal or ring calcifications, central blood flow, or a trabecular structure.

Objective:To assess the consistency of ultrasound and dual-energy computed tomography (DECT) in the diagnosis of gouty arthritis(GA), reasons of the differences were further analyzed.Methods:The ultrasound and DECT images of 150 knee joints from 147 patients diagnosed with gout at the Gout Specialty Clinic of Qingdao University Affiliated Hospital from February 2022 to October 2023 were retrospectively analyzed. According to anatomy, the knee joint was anatomically segmented into five regions: intra-articular, anterior, posterior, medial, and lateral.Location of monosodium urate (MSU) deposition was meticulously recorded. The Kappa consistency test was employed to assess the consistency of the two examination results in different regions of the knee joint. The McNemar chi-square test was utilized to conduct a differential analysis between DECT and ultrasound results.Results:Double contour sign(DCS) (81.2%, 92/112) was the most common intra-articular ultrasound sign in knee joints with GA. In the extra-articular region, MSU was commonly deposited in and around the popliteal tendon (ultrasound: 51.6%, 66/128; DECT: 54.7%, 70/128). Corresponding MSU deposits on DECT were found in 9 of 92 joints with DCS and in 9 of 49 joints with aggregates detected on ultrasound.In the assessment of MSU deposits, ultrasound showed an overall higher positive rate than DECT (87.3% vs. 72.3%, P=0.001), with poor consistency between the two examinations (Kappa=0.153). In distinct anatomical regions, ultrasound and DECT showed high consistency in the medial (Kappa=0.697) and lateral (Kappa=0.718) sides and the difference was not statistically significant ( P>0.05). Intra-articular (Kappa=0.289) and anterior (Kappa=0.303) regions exhibited only fair consistency, with statistically significant diagnostic differences ( P<0.05). When exclusively assessing cases with tophus, ultrasound and DECT demonstrated high consistency in the medial and lateral aspects(Kappa=0.685, 0.748) without statistical difference ( P>0.05). In the anterior region, the consistency between the two examinations was moderate (Kappa=0.256), while in the intra-articular region, the consistency of the two methods was lower (Kappa=0.147), and the differences was statistically significant ( P<0.001). Conclusions:Both ultrasound and DECT exhibit good diagnostic capabilities for gouty knee arthritis.However, the consistency between the two techniques varies in different anatomical locations. Clinical assessment should be tailored based on the specific anatomical position. DECT has an advantage in evaluating intra-articular MSU deposits, while ultrasound is more sensitive to detect early and scattered MSU deposits.

Objective To investigate the clinical effect of Jiaotai Shugan decoction in adjuvant treatment of type 2 diabetes mellitus(T2DM)complicated with depression with liver qi stagnation type.Methods From June 2022 to June 2023,90 patients with T2DM complicated with depression with liver qi stagnation type treated in the Second People's Hospital of Lishui City were selected,who were randomly divided into control group and observation group,with 45 cases in each group.Both groups were treated with basic treatment of diabetes,control group was given escitalopram to improve the emotion,while observation group was further given Jiaotai Shugan decoction.After 8 weeks,the clinical effective rate were evaluated by Hamilton depression scale-24(HAMD-24)and patient health questionnaire-9(PHQ-9)scores,the levels of 5-hydroxytrytamine(5-HT),noradrenaline(NE),brain-derived neurotrophic factor(BDNF),fasting blood glucose(FPG),2-hour postprandial blood glucose(2hPG)and haemoglobinA1c(HbA1c)were detected,and adverse reactions were recorded.Results The clinical total effective rates of observation group was higher than that of control group,and the difference was statistically significant(P＜0.05).8 weeks after treatment,HAMD-24 and PHQ-9 scores of observation group were lower than those of control group(P＜0.01).The levels of 5-HT,NE and BDNF of observation group were higher than those of control group(P＜0.01).The levels of FPG,2hPG and HbA1c in observation group were lower than those in control group(P＜0.01);There was no significant difference in adverse reactions between two groups(P＞0.05).Conclusion Modified Jiaotai Shugan decoction is effective in treating T2DM complicated with depression with liver qi stagnation type,can reduce HAMD-24 and PHQ-9 scores,increase the levels of 5-HT,NE,BDNF,and reduce the levels of FPG,2hPG,HbA1c.There was no obvious adverse reactions.

Jasmonic acid (JA), a plant endogenously synthesized lipid hormone, plays an important role in response to stress. This manuscript summarized the biosynthesis and metabolism of JA and its related regulatory mechanisms, as well as the signal transduction of JA. The mechanism and regulatory network of JA in plant response to biotic and abiotic stresses were systematically reviewed, with the latest advances highlighted. In addition, this review summarized the signal crosstalk between JA and other hormones in regulating plant resistance to various stresses. Finally, the problems to be solved in the study of plant stress resistance mediated by JA were discussed, and the application of new molecular biological technologies in regulating JA signaling to enhance crop resistance was prospected, with the aim to facilitate future research and application of plant stress resistance.
Signal Transduction ; Cyclopentanes ; Oxylipins ; Plant Growth Regulators