Pleural mesothelioma （PM） is a rare malignant tumor originating from the pleura. Most patients are already in the advanced stage at the time of diagnosis， resulting in a low overall survival rate. MicroRNA （miRNA）， as key regulators of tumor epigenetic modification， have an intertwined interactive network with PM drug resistance. The mechanisms of drug resistance in PM to chemotherapeutic drugs include increasing drug efflux， reducing drug intake， enhancing DNA repair， and altering drug targets. The mechanisms of resistance to targeted therapy drugs include activating alternative signaling pathways， establishing a favorable tumor microenvironment， and triggering epithelial-mesenchymal transition. MiRNA plays a key part in the aforementioned resistance mechanisms， with some miRNAs promoting the drug sensitivity of cancer cells， while others contribute to increased drug resistance. In light of these key regulatory functions， targeting the dysregulated expression of endogenous miRNAs in the process of resistance formation using miRNA antagonists or miRNA mimics may be an effective therapeutic strategy to reverse drug resistance in PM.

Objective To observe the daily bladder and bowel preparation of patients with prostate cancer by cone-beam computed tomography (CBCT), and analyze its impact on the precise implementation of radiotherapy for prostate cancer and side effects. Methods We retrospectively analyzed 38 patients with prostate cancer who underwent volumetric modulated arc therapy. The number of radiation fractions for each patient ranged from 25 to 35. A CBCT scan was performed before each daily radiation therapy, and the number of scans for each patient ranged from 25 to 40. Setup errors were adjusted to ensure that the tumor was targeted and the rectum wall was not in the high-dose target area of the prostate. There were 93 instances where treatment could not be successfully implemented and re-preparation and re-scanning were required. We calculated the success rate of treatment and setup errors, compared radiotherapist-adjusted error values under different bladder and bowel preparation conditions, and recorded radiotherapy-related side effects. Results The success rate of treatment in the 38 patients was (92.14 ± 5.25)%. Among the 93 instances of seriously inadequate preparation, 48.4% were due to insufficient bladder filling, and 30.1% were due to intestinal bloating. Radiotherapy side effects were negatively correlated with the success rate of treatment (r = −0.393, P = 0.015). When bladder filling was sufficient, there were no significant differences in radiotherapist-adjusted error values in the left-right (LR), superior-inferior (SI), and anterior-posterior (AP) directions between adequate and inadequate bowel preparation (P > 0.05). When the bladder was moderately or insufficiently filled, there were significant differences in radiotherapist-adjusted error values in the LR, SI, and AP directions between adequate and inadequate bowel preparation (P < 0.05). Conclusion Insufficient bladder filling and intestinal bloating are the main factors influencing the successful implementation of radiotherapy for prostate cancer. When the bladder is sufficiently filled, bowel preparation does not affect prostate position change.

Background: SM-like (LSM) genes a family of RNA-binding proteins, are involved in mRNA regulation and can function as oncogenes by altering mRNA stability. However, their roles in B-cell progression and tumorigenesis remain poorly understood. Methods: We analyzed gene expression profiles and overall survival data of 123 patients with mantle cell lymphoma (MCL). The LSM index was developed to assess its potential as a prognostic marker of MCL survival. Results: Five of the eight LSM genes were identified as potential prognostic markers for survival in MCL, with particular emphasis on the LSM.index. The expression levels of these LSM genes demonstrated their potential utility as classifiers of MCL. The LSM.index-high group exhibited both poorer survival rates and lower RNA levels than did the overall transcript profile. Notably, LSM1 and LSM8 were overexpressed in the LSM.index-high group, with LSM1 showing 2.5-fold increase (p < 0.001) and LSM8 depicting 1.8-fold increase (p < 0.01) than those in the LSM.index-low group.Furthermore, elevated LSM gene expression was associated with increased cell division and RNA splicing pathway activity. Conclusions The LSM.index demonstrates potential as a prognostic marker for survival in patients with MCL. Elevated expression of LSM genes, particularly LSM1 and LSM8, may be linked to poor survival outcomes through their involvement in cell division and RNA splicing pathways. These findings suggest that LSM genes may contribute to the aggressive behavior of MCL and represent potential targets for therapeutic interventions.

Objective To observe the value of dual-energy CT(DECT)radiomics combined with clinical and CT features for predicting differentiation degree of gastric adenocarcinoma(GAC).Methods Totally 254 patients with GAC were prospectively analyzed and divided into high-grade group(low differentiation GAC,n=88)and low-grade group(middle-high differentiation GAC,n=166)according to pathological results.The patients were also divided into training set(n=203,including 70 high-grade and 133 low-grade GAC)and verification set(n=51,including 18 high-grade and 33 low-grade GAC)at the ratio of 8∶2.Radiomics features were extracted and screened based on venous phase single-level(40,70,100 and 140 keV)DECT,and a multi-energy radiomics model was constructed to predict GAC classification.Univariate analysis and multivariate logistic regression were used to analyze clinical and CT features as well as DECT parameters in training set to construct a clinic-CT model.Then a combined model was constructed through combining clinic-CT model with radiomics model.The predictive efficacy of the models were evaluated,and the calibration degree of the combined model was assessed.Results The area under the curve(AUC)of clinic-CT model,multi-energy radiomics model and combined model was 0.74,0.75 and 0.78 in training set,and 0.73,0.77 and 0.78 in verification set,respectively.Except for AUC of combined model was higher than that of clinic-CT model in training set(P＜0.05),no significant difference of AUC was found among models in training set nor verification set(all P＞0.05).The calibration degree of combined model was good in both training set and verification set(both P＞0.05).Conclusion DECT radiomics combined with clinical and CT features could effectively predict differentiation degree of GAC.

Objective:To assess the quality of low-keV monoenergetic images using deep learning image reconstruction (DLIR) algorithm combined with dual energy CT (DECT) in gastric cancer and to compare them with images from the conventional adaptive statistical iterative reconstruction (ASiR-V) algorithm.Methods:In this cross-sectional study, DECT images of 31 gastric cancer patients in the First Affiliated Hospital of Zhengzhou University were prospectively collected from September 2022 to March 2023. The 55 keV monoenergy images were reconstructed using the DLIR algorithm at low-, medium-, and high-intensity levels (DLIR-L, DLIR-M, and DLIR-H) based on arterial phase and venous phase images, respectively. The 70 keV 40% mixing coefficient (ASiR-V40%) images were reconstructed using the ASiR-V algorithm. In the objective evaluation of images, the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) for both lesions and muscle were calculated across four sets of reconstructed images. In the subjective evaluation of images, scores were assigned to the overall image quality, lesion visibility, and diagnostic confidence for each set of reconstructed images. Comparisons of SNR and CNR between the 4 groups were made by One-way repeated-measures ANOVA or Friedman′s test. Comparisons of scores were made by Friedman′s test. The P value of pairwise comparison was adjusted using Bonferroni correction methods. Results:In the objective evaluations, CNR lesion, SNR lesion and SNR muscle were highest on the 55 keV DLIR-H images in the arterial and venous phases, and showed a gradually increasing trend on the 70 keV ASiR-V40%, 55 keV DLIR-L, DLIR-M, DLIR-H images ( P<0.05). In subjective evaluations, compared to the 70 keV ASiR-V40% images, overall image quality scores were numerically higher for the 55 keV DLIR-H ( P>0.05), similar or slightly worse for the 55 keV DLIR-M, and significantly lower for the 55 keV DLIR-L ( P<0.05). The lesion visibility and diagnostic confidence on the 55 keV DLIR reconstruction images were higher in both arterial and venous phases than 70 keV ASiR-V40% images ( P<0.05). Conclusions:Compared to the conventional 70 keV ASiR-V40% images, the 55 keV DLIR-H images had higher lesion contrast and diagnostic confidence with lower image noise. The 55 keV DLIR-M images had comparable overall image quality to 70 keV ASiR-V40% images, but the former had higher lesion contrast and diagnostic confidence. The 55 keV DLIR-L was unable to improve image quality to the level of 70 keV ASiR-V40%.

Background: SM-like (LSM) genes a family of RNA-binding proteins, are involved in mRNA regulation and can function as oncogenes by altering mRNA stability. However, their roles in B-cell progression and tumorigenesis remain poorly understood. Methods: We analyzed gene expression profiles and overall survival data of 123 patients with mantle cell lymphoma (MCL). The LSM index was developed to assess its potential as a prognostic marker of MCL survival. Results: Five of the eight LSM genes were identified as potential prognostic markers for survival in MCL, with particular emphasis on the LSM.index. The expression levels of these LSM genes demonstrated their potential utility as classifiers of MCL. The LSM.index-high group exhibited both poorer survival rates and lower RNA levels than did the overall transcript profile. Notably, LSM1 and LSM8 were overexpressed in the LSM.index-high group, with LSM1 showing 2.5-fold increase (p < 0.001) and LSM8 depicting 1.8-fold increase (p < 0.01) than those in the LSM.index-low group.Furthermore, elevated LSM gene expression was associated with increased cell division and RNA splicing pathway activity. Conclusions The LSM.index demonstrates potential as a prognostic marker for survival in patients with MCL. Elevated expression of LSM genes, particularly LSM1 and LSM8, may be linked to poor survival outcomes through their involvement in cell division and RNA splicing pathways. These findings suggest that LSM genes may contribute to the aggressive behavior of MCL and represent potential targets for therapeutic interventions.

Background: SM-like (LSM) genes a family of RNA-binding proteins, are involved in mRNA regulation and can function as oncogenes by altering mRNA stability. However, their roles in B-cell progression and tumorigenesis remain poorly understood. Methods: We analyzed gene expression profiles and overall survival data of 123 patients with mantle cell lymphoma (MCL). The LSM index was developed to assess its potential as a prognostic marker of MCL survival. Results: Five of the eight LSM genes were identified as potential prognostic markers for survival in MCL, with particular emphasis on the LSM.index. The expression levels of these LSM genes demonstrated their potential utility as classifiers of MCL. The LSM.index-high group exhibited both poorer survival rates and lower RNA levels than did the overall transcript profile. Notably, LSM1 and LSM8 were overexpressed in the LSM.index-high group, with LSM1 showing 2.5-fold increase (p < 0.001) and LSM8 depicting 1.8-fold increase (p < 0.01) than those in the LSM.index-low group.Furthermore, elevated LSM gene expression was associated with increased cell division and RNA splicing pathway activity. Conclusions The LSM.index demonstrates potential as a prognostic marker for survival in patients with MCL. Elevated expression of LSM genes, particularly LSM1 and LSM8, may be linked to poor survival outcomes through their involvement in cell division and RNA splicing pathways. These findings suggest that LSM genes may contribute to the aggressive behavior of MCL and represent potential targets for therapeutic interventions.

Objective:To explore the correlation between medical narrative ability, empathy ability and general self-efficacy of clinical nurses.Methods:A total of 106 clinical nurses from Jiaozuo People's Hospital were selected as the research object by convenient sampling. The Narrative Competence Scale, Empathy Ability Scale and General Self-efficacy Scale (GSES) were used to investigate and analyze the correlation of clinical nurses' medical narrative ability, empathy ability and general self-efficacy.Results:Among 106 clinical nurses, the scores of the Narrative Competence Scale, Empathy Ability Scale and GSES were (149.38±21.03) , (108.89±16.32) , and (24.31±5.17) respectively. The medical narrative ability of clinical nurses was positively correlated with empathy ability and general self-efficacy ( r=0.627, 0.569; P<0.001) , and empathy ability was positively correlated with general self-efficacy ( r=0.518, P<0.001) . Conclusions:The medical narrative ability, empathy ability and general self-efficacy of clinical nurses are positively correlated, suggesting that the training and management of clinical nurses should be strengthened to promote the improvement of their various abilities.

Objective To determine the serum IgM and IgG antibody levels post-COVID-19 vaccination， and provide scientific evidence for COVID-19 antibody response after vaccination. Methods A total of 980 healthy persons were included in Kunming Third People’s Hospital from July through August， 2021， which had been vaccinated with COVID-19 vaccines and then tested for anti-SARS-CoV-2 IgM and IgG antibodies. Results After the COVID-19 vaccination， 469 persons （positive rate， 47.86%） were positive for anti-IgG antibody. Of them， 75 were males with （positive rate， 39.06%）， and the average IgG level was 0.618 （0.180， 2.526） AU·mL^-1［M（Q₁，Q₃）］； 394 were females （50.00%）， and the IgG level was 0.999 （0.305， 3.334） AU·mL^-1. In addition， 53 persons （5.41%） were anti-IgM antibody positive. Of them， 14 were males （positive rate， 7.29%）， and the average IgM level was 0.057 （0.026， 0.195） AU·mL^-1； 39 were females （4.95%）， and the IgM level was 0.047 （0.027， 0.110） AU·mL^-1. The positive rate of anti-IgG antibody was highest in those aged ≤30 years， which was 51.02% in male （n=25） and 55.88% in female （n=133）. The anti-IgG response differed significantly by gender （χ²=7.401， D=0.135 1， P<0.05）， whereas the anti-IgM response was not significantly different （χ²=1.656， P>0.05）. Among the age groups， anti-IgG antibody level was higher in those aged ≤30 and 51-70 years， with 158 （55.05%） and 122 （52.36%） persons， respectively； the average antibody level was 1.209 （0.426， 4.386） AU·mL^-1 and 1.074 （0.191， 7.670） AU·mL^-1， respectively. The differences in the positive rates of IgG and IgM antibodies and the levels of IgG antibodies among different age groups were statistically significant （P<0.05）. Using Kruskal-Wallis test and Spearman correlation analysis， it showed a high correlation between the IgG and IgM antibodies （r=0.836 4， H=64.82， 20.09， P<0.05）. Conclusion The Anti-SARS-CoV-2 IgG antibody remains high six months post-COVID-19 vaccination， while anti-IgM antibody is low. The IgM and IgG response are higher in the young and elderly. The response differs by gender and age， demonstrating a correlation.

Objective:To investigate the efficacy and safety of peritoneal dialysis (PD) in end-stage renal disease (ESRD) patients with liver cirrhosis (LC).Methods:Clinical data of PD patients receiving regular treatment followed up for≥6 months, and aged≥18 years in the Third Affiliated Hospital of Hebei Medical University Peritoneal Dialysis Center from January 1, 2013 to March 31, 2020 were retrospectively collected. The patients were divided into LC-PD group and non-LC-PD group according to whether they had LC or not. Propensity score matching (PSM) was used to match the LC-PD group and the non-LC-PD group with 1∶4 ratio. The baseline clinical data, dialysis adequacy, peritonitis and clinical outcomes between the two groups were compared. Kaplan-Meier survival curve and Log-rank test were used to compare the survival rate and technical survival rate between the two groups.Results:A total of 241 PD patients were included in this study. After PSM, 13 cases in LC-PD group and 52 cases in non-LC-PD group were included. Compared with non-LC-PD group, patients in LC-PD group had lower baseline urine volume ( Z=-3.546, P<0.001) and serum albumin ( Z=-2.609, P=0.009). At the follow-up of 3, 6, 12 and 24 months, total serum protein ( t=-3.319, P=0.002), serum albumin ( t=-4.019, P<0.001), triglyceride ( Z=-2.263, P=0.024), and serum phosphorus ( Z=-2.173, P=0.030) in the LC-PD group were lower than those in non-LC-PD group. During the follow-up period of 2 years, the patients in the LC-PD group had significantly higher serum albumin than baseline values ( χ2=16.901, P=0.001), and there was no statistically significant difference between the two groups ( χ2=0.155, P=0.694). The decline rate of residual kidney Kt/V in the LC-PD group was slower than that in the non-LC-PD group ( χ2=44.589, P<0.001). The incidence of peritonitis in LC-PD group was higher than that in the non-LC-PD group, with a statistically significant difference (0.59/patient-year vs 0.20/patient-year, Z=-2.135, P=0.033). The composition ratio of pathogenic bacteria in both groups was mainly gram-positive bacteria (10/25 vs 11/30) and proportion of Streptococcus in LC-PD group was higher than that in non-LC-PD group (4/10 vs 0/11, P=0.035). The proportion of Escherichia coli in the first peritonitis was higher than that in LC-PD group (4/9 vs 1/22, P=0.017). The Kaplan-Meier survival curve results showed no statistically significant difference in survival rate (Log-rank χ2=0.491, P=0.484) and technical survival rate (Log-rank χ2=0.408, P=0.523) between the two groups. Conclusions:PD is a safe and effective treatment mode for ESRD patients with LC, and the survival rate and technical survival rate are comparable to those patients without LC. The incidence of peritonitis in patients with LC-PD in our dialysis center is higher than that in the non-LC-PD patients, and gram-positive bacterial infections are the mainstay, suggesting that attention should be paid to strengthening patient management and training.