Abnormal amino acid metabolism promotes tumor progression by inducing malignant behaviors in tumor cells and altering the immune landscape within the tumor microenvironment. However, the underlying mechanisms remain unclear. In this study, we constructed colorectal cancer (CRC) organoids and patient-derived tumor xenograft (PDX) models, performing multifaceted validation to confirm that T-complex protein 1 subunit epsilon (CCT5), mediates the biosynthesis of aspartate and enhances sensitivity to anti-PD-L1 immunotherapy. Mechanistically, CCT5 directly binds to asparagine synthetase (ASNS) and promotes the synthesis of aspartate (Asn). The Asn-mTORC1 axis facilitates tumor cell proliferation while upregulating PD-L1 expression, which leads to a reduction in the number of effector CD8⁺ T cells. Treatment with l-asparaginase (ASNase) combined with anti-PD-L1 therapy effectively reverses the growth of CRC characterized by high CCT5 expression. In summary, we identify CCT5 as a potential biomarker to guide the combined use of ASNase and anti-PD-L1 antibodies in CRC treatment.

Objective To investigate the frequency and dose of X-ray computed tomography (CT) medical exposure in Shantou City, and to evaluate the collective effective dose burden of residents caused by CT medical exposure. Methods The study subjects were selected using the stratified random sampling method from CT scanners in all medical institutions in Shantou City in 2020. CT application units were divided into the four tiers of municipal hospitals, district hospitals, subdistrict hospitals, and private hospitals, and 50% of the hospitals in each tier were randomly selected according to the number of hospitals in the tier. The study analyzed CT dose index results, CT scanning standard conditions, and the distribution of characteristic doses of medical exposure to evaluate the dose burden of residents in Shantou City caused by CT medical exposure. Results There were 51 CT scanners in medical institutions in Shantou City. By the end of 2020, the average number of CT scanners per million population was 9.30, and the frequency of CT medical exposure was 135.24 per 1000 population. Jinping District had the highest number of CT scanners per million population (23.2), while Chaoyang District had the lowest number of CT scanners per million population (3.6). The median and range of effective doses for different scan regions were 1.65 (0.76, 4.49) mSv in the head, 4.12 (1.90, 53.21) mSv in the chest, 5.96 (2.68, 10.25) mSv in the abdomen, and 10.30 (4.12, 12.67) mSv in the lumbar spine. By the end of 2020, the effective dose to the public in Shantou City was 6080.67 Sv·person, and the average annual effective dose per person was 1.10 mSv. Conclusion Medical exposure is the most important factor affecting resident dose burden, particularly the overuse of medical exposure examinations. CT examination is the most significant component of medical exposure causing resident dose burden. Reducing unnecessary medical exposure, ensuring the rational use of CT examination, and properly utilizing personal protective equipment are effective measures to minimize the dose burden on examinees.

BACKGROUND:Cervical spondylosis is a chronic degenerative disease that has become one of the most common and frequent diseases threatening human health.At present,the initial diagnosis of the cervical spine and its surrounding structures mainly relies on the interpretation of medical images by radiologists,which not only requires a high level of technical requirements for operators,but also has the disadvantages of strong subjectivity,high labor intensity,and low efficiency.With the rapid development of artificial intelligence technology,its powerful data processing and image recognition capabilities have shown broad application prospects in the medical field.Deep learning has also made certain progress in the research of spinal diseases.OBJECTIVE:To summarize the current status and research progress in the application of artificial intelligence technology in cervical spine imaging images in recent years,evaluating the performance of artificial intelligence models as well as future trends and challenges to be overcome.METHODS:The first author searched the relevant articles in WanFang,CNKI,and PubMed in June 2024.The Chinese search terms were"artificial intelligence,deep learning,cervical spine."English serach terms were"artificial intelligence,Al,cervical vertebrae,cervical."Finally,101 articles were included and analyzed.RESULTS AND CONCLUSION:(1)Artificial intelligence technology can realize automatic segmentation of cervical vertebrae and measurement of curvature change by segmentation,classification,landmarks recognition of medical image parts,detect cervical vertebral fracture,nerve root,and spinal cord type cervical spondylosis,identify cervical spine ossification of posterior longitudinal ligament,and predict post-surgery related risk factors and cervical vertebra maturation classification.(2)Although artificial intelligence technology has shown great potential in the field of cervical spine research,it is still in the early stages of exploration and rapid development,with unlimited room for development and innovation.

OBJECTIVE To investigate the effects of Chuangling Ye(CLY)on diabetic foot ulcer(DFU)model mice based on the nuclear factor erythroid 2-related factor 2(Nrf2)/solute carrier family 7 member 11(SLC7A11)/glutathione peroxidase 4(GPX4)pathway and explore its potential mechanism.METHODS In animal experiments,streptozotocin(STZ)-induced diabetic mice with full-thickness skin defects were divided into control,model,positive control(recombinant human epidermal growth factor,rhEGF),and CLY low-and high-dose groups(n=10).After 14 days of intervention,wound healing rate was measured.Serum inflammatory factors(IL-6,TNF-α,IL-1β)were detected by ELISA,while oxidative stress markers(SOD,MDA,GSH)and tissue ferrous iron(Fe2+)levels were measured by colorimetric assays.Mitochondrial ultrastructure was observed via transmission electron microscopy(TEM).Nrf2,SLC7A11,and GPX4 expression in wound tissues were analyzed by qPCR and Western blot.In cell experiments,a high glucose(HG)-induced ferroptosis model in human umbilical vein endothelial cells(HUVECs)was established and divided into control,HG,CLY,and CLY combined with pathway inhibitors(ML385,Erastin,RSL3)groups.CCK-8 was used to detect cell via-bility,FerroOrange was used to detect Fe2+content,DCFH-DA and C11-BODIPY 581/591 probes were used to detect intracellular ROS and lipid ROS content,and Western blot was used to detect the expression of proteins such as Nrf2/SLC7A11/GPX4.RESULTS Animal experiments showed that compared with the model group,the wound healing rate in the low-and high-dose CLY groups was significantly improved(P<0.01);the serum IL-6,IL-1β,and TNF-α levels were significantly decreased(P<0.01);the MDA con-tent was significantly reduced(P<0.01),and the SOD activity and GSH content were significantly restored(P<0.05).Colorimetric a-nalysis showed that the low-and high-dose CLY significantly reduced the abnormally elevated Fe2+levels in DFU wounds(P<0.05,P<0.001).Electron microscopy showed that the mitochondrial cristae structure was improved in the low-and high-dose groups.qPCR showed that high-dose CLY upregulated the expression levels of Rno-Nfe2l2(Nrf2),Rno-Slc7a11,Rno-Gpx4,and Rno-Acsl4 mR-NA,and inhibited the expression level of Rno-Acsl4 mRNA(P<0.001).Western blot results showed that CLY upregulated the expres-sion of Nrf2,SLC7A11,GPX4,and FTH1 in DFU wound tissues(P<0.01),while downregulated the level of ACSL4(P<0.01).Cell experiments showed that treatment with CLY increased the survival rate of high glucose-stimulated HUVECs(P<0.001).However,the protective effect of CLY was significantly inhibited after the addition of ML385,Erastin,or RSL3(P<0.01).Treatment with CLY significantly decreased the Fe2+content(P<0.001),which was reversed by ML385,Erastin,or RSL3.The levels of ROS and lipid ROS were also significantly reduced(P<0.001),while the addition of ML385,Erastin,or RSL3 partially weakened the antioxidant effect of CLY.Western blot results showed that CLY significantly upregulated the expression of Nrf2、SLC7A11 and GPX4(P<0.001)and downregulated the expression of 4-HNE and COX2(P<0.01),and ML385,Erastin,or RSL3 could reverse this protective effect.CONCLUSION CLY promotes DFU healing by activating the Nrf2/SLC7A11/GPX4 pathway to inhibit ferroptosis,mitigate oxidative stress,and suppress inflammation,providing a novel therapeutic target for DFU.

Objective:To analyze the current situation and potential profile of self-disgust in peritoneal dialysis patients and explore the influencing factors of different categories of hemodialysis patients.Methods:Using convenient sampling method, 466 patients with peritoneal dialysis from 3 tertiary hospitals of Cangzhou People′s Hospital, Cangzhou Integrated Traditional Chinese and Western Medicine Hospital, Cangzhou Central Hospital were selected as the survey object from April to June 2023. A cross-sectional survey was conducted using the general data questionnaire, Questionnaire for the Assessment of Self-Disgust, Social Avoidance and Distress Scale and Perceived Social Support Scale. The potential profile of self-disgust in peritoneal dialysis patients was analyzed, and the influencing factors of different potential categories were analyzed by multiple Logistic regression.Results:Finally, 458 patients were included, with 283 males and 175 females, aged (48.68 ± 13.85) years old. The Questionnaire for the Assessment of Self-Disgust was scored (38.24 ± 5.25) points, the Social Avoidance and Distress Scale was scored (22.32 ± 3.78) points, the Perceived Social Support Scale was scored (53.59 ± 8.64) points in peritoneal dialysis patients. The level of self-disgust in peritoneal dialysis patients could be divided into 3 sections: self-pity (28.38%, 130/458), self-reflection (52.18%, 239/458) and self-acceptance (19.44%, 89/458). The results of multiple Logistic regression analysis showed that age, number of comorbidities, dialysis age, Social Avoidance and Distress Scale and Perceived Social Support Scale scores were the influencing factors of self-disgust in peritoneal dialysis patients ( OR values were 0.804-2.019, all P<0.05). Conclusions:The self-disgust in peritoneal dialysis patients was at a high level and somewhat heterogeneous. Clinical workers should focus on self-pity and self-reflective peritoneal dialysis patients, and provide targeted interventions to reduce the level of patient self-disgust according to the influencing factors of different potential categories of patients.

OBJECTIVE To investigate the effects of Chuangling Ye(CLY)on diabetic foot ulcer(DFU)model mice based on the nuclear factor erythroid 2-related factor 2(Nrf2)/solute carrier family 7 member 11(SLC7A11)/glutathione peroxidase 4(GPX4)pathway and explore its potential mechanism.METHODS In animal experiments,streptozotocin(STZ)-induced diabetic mice with full-thickness skin defects were divided into control,model,positive control(recombinant human epidermal growth factor,rhEGF),and CLY low-and high-dose groups(n=10).After 14 days of intervention,wound healing rate was measured.Serum inflammatory factors(IL-6,TNF-α,IL-1β)were detected by ELISA,while oxidative stress markers(SOD,MDA,GSH)and tissue ferrous iron(Fe2+)levels were measured by colorimetric assays.Mitochondrial ultrastructure was observed via transmission electron microscopy(TEM).Nrf2,SLC7A11,and GPX4 expression in wound tissues were analyzed by qPCR and Western blot.In cell experiments,a high glucose(HG)-induced ferroptosis model in human umbilical vein endothelial cells(HUVECs)was established and divided into control,HG,CLY,and CLY combined with pathway inhibitors(ML385,Erastin,RSL3)groups.CCK-8 was used to detect cell via-bility,FerroOrange was used to detect Fe2+content,DCFH-DA and C11-BODIPY 581/591 probes were used to detect intracellular ROS and lipid ROS content,and Western blot was used to detect the expression of proteins such as Nrf2/SLC7A11/GPX4.RESULTS Animal experiments showed that compared with the model group,the wound healing rate in the low-and high-dose CLY groups was significantly improved(P<0.01);the serum IL-6,IL-1β,and TNF-α levels were significantly decreased(P<0.01);the MDA con-tent was significantly reduced(P<0.01),and the SOD activity and GSH content were significantly restored(P<0.05).Colorimetric a-nalysis showed that the low-and high-dose CLY significantly reduced the abnormally elevated Fe2+levels in DFU wounds(P<0.05,P<0.001).Electron microscopy showed that the mitochondrial cristae structure was improved in the low-and high-dose groups.qPCR showed that high-dose CLY upregulated the expression levels of Rno-Nfe2l2(Nrf2),Rno-Slc7a11,Rno-Gpx4,and Rno-Acsl4 mR-NA,and inhibited the expression level of Rno-Acsl4 mRNA(P<0.001).Western blot results showed that CLY upregulated the expres-sion of Nrf2,SLC7A11,GPX4,and FTH1 in DFU wound tissues(P<0.01),while downregulated the level of ACSL4(P<0.01).Cell experiments showed that treatment with CLY increased the survival rate of high glucose-stimulated HUVECs(P<0.001).However,the protective effect of CLY was significantly inhibited after the addition of ML385,Erastin,or RSL3(P<0.01).Treatment with CLY significantly decreased the Fe2+content(P<0.001),which was reversed by ML385,Erastin,or RSL3.The levels of ROS and lipid ROS were also significantly reduced(P<0.001),while the addition of ML385,Erastin,or RSL3 partially weakened the antioxidant effect of CLY.Western blot results showed that CLY significantly upregulated the expression of Nrf2、SLC7A11 and GPX4(P<0.001)and downregulated the expression of 4-HNE and COX2(P<0.01),and ML385,Erastin,or RSL3 could reverse this protective effect.CONCLUSION CLY promotes DFU healing by activating the Nrf2/SLC7A11/GPX4 pathway to inhibit ferroptosis,mitigate oxidative stress,and suppress inflammation,providing a novel therapeutic target for DFU.

BACKGROUND:Cervical spondylosis is a chronic degenerative disease that has become one of the most common and frequent diseases threatening human health.At present,the initial diagnosis of the cervical spine and its surrounding structures mainly relies on the interpretation of medical images by radiologists,which not only requires a high level of technical requirements for operators,but also has the disadvantages of strong subjectivity,high labor intensity,and low efficiency.With the rapid development of artificial intelligence technology,its powerful data processing and image recognition capabilities have shown broad application prospects in the medical field.Deep learning has also made certain progress in the research of spinal diseases.OBJECTIVE:To summarize the current status and research progress in the application of artificial intelligence technology in cervical spine imaging images in recent years,evaluating the performance of artificial intelligence models as well as future trends and challenges to be overcome.METHODS:The first author searched the relevant articles in WanFang,CNKI,and PubMed in June 2024.The Chinese search terms were"artificial intelligence,deep learning,cervical spine."English serach terms were"artificial intelligence,Al,cervical vertebrae,cervical."Finally,101 articles were included and analyzed.RESULTS AND CONCLUSION:(1)Artificial intelligence technology can realize automatic segmentation of cervical vertebrae and measurement of curvature change by segmentation,classification,landmarks recognition of medical image parts,detect cervical vertebral fracture,nerve root,and spinal cord type cervical spondylosis,identify cervical spine ossification of posterior longitudinal ligament,and predict post-surgery related risk factors and cervical vertebra maturation classification.(2)Although artificial intelligence technology has shown great potential in the field of cervical spine research,it is still in the early stages of exploration and rapid development,with unlimited room for development and innovation.

Objective:To analyze the current situation and potential profile of self-disgust in peritoneal dialysis patients and explore the influencing factors of different categories of hemodialysis patients.Methods:Using convenient sampling method, 466 patients with peritoneal dialysis from 3 tertiary hospitals of Cangzhou People′s Hospital, Cangzhou Integrated Traditional Chinese and Western Medicine Hospital, Cangzhou Central Hospital were selected as the survey object from April to June 2023. A cross-sectional survey was conducted using the general data questionnaire, Questionnaire for the Assessment of Self-Disgust, Social Avoidance and Distress Scale and Perceived Social Support Scale. The potential profile of self-disgust in peritoneal dialysis patients was analyzed, and the influencing factors of different potential categories were analyzed by multiple Logistic regression.Results:Finally, 458 patients were included, with 283 males and 175 females, aged (48.68 ± 13.85) years old. The Questionnaire for the Assessment of Self-Disgust was scored (38.24 ± 5.25) points, the Social Avoidance and Distress Scale was scored (22.32 ± 3.78) points, the Perceived Social Support Scale was scored (53.59 ± 8.64) points in peritoneal dialysis patients. The level of self-disgust in peritoneal dialysis patients could be divided into 3 sections: self-pity (28.38%, 130/458), self-reflection (52.18%, 239/458) and self-acceptance (19.44%, 89/458). The results of multiple Logistic regression analysis showed that age, number of comorbidities, dialysis age, Social Avoidance and Distress Scale and Perceived Social Support Scale scores were the influencing factors of self-disgust in peritoneal dialysis patients ( OR values were 0.804-2.019, all P<0.05). Conclusions:The self-disgust in peritoneal dialysis patients was at a high level and somewhat heterogeneous. Clinical workers should focus on self-pity and self-reflective peritoneal dialysis patients, and provide targeted interventions to reduce the level of patient self-disgust according to the influencing factors of different potential categories of patients.

Objective To retrospectively analyse the clinical characteristics of complex anal fistula and the distribution of TCM syndrome in infants and young children.Methods The clinical data of 118 children with complex anal fistula who were hospitalised in the Second Affiliated Hospital of Hunan University of Traditional Chinese Medicine from 1 January 2019 to 1 January 2023 were retrospectively analysed for gender,age,fistula,internal and external orifices,and distribution of TCM syndrome.Results Totally 115 cases(97.5%)were male and 3 cases(2.5%)were female among the 118 cases,with statistically significant differences(P<0.05);they occurred within 1 year of age;among them,there were 93 cases(78.8%)of low complex anal fistula,and 25 cases(21.2%)of high complex anal fistula;there were 2 fistulas(76.3%),followed by 3 fistulas(21.2%)and 4 fistulas(2.5%);the relationship between the number of internal and external orifices was dominated by external orifices = internal orifices(71.2%),and the internal and external orifices were mostly located at the 3 and 9 points(truncation);dampness-heat pouring downward was the most common syndrome(58.5%),followed by foetal toxin(23.7%),and spleen deficiency and dampness(17.8%).Conclusion Complex anal fistula in infants and young children occurred in male children less than 1 year old,and most of them were low complex anal fistula with two fistulas,and the internal and external orifices were mostly distributed in the 3 and 9 points(truncation),and dampness-heat pouring downward was the main TCM syndrome.

BACKGROUND:As a unique structure of the cervical spine,the occurrence,development and progression of the uncovertebral joint directly affect the stability and range of motion of the cervical spine,and are also closely related to the pathogenesis of cervical spondylosis.A thorough understanding of the developmental characteristics of the uncovertebral joint is of great significance for the pathogenesis,diagnosis,and treatment of cervical spondylosis. OBJECTIVE:By using imaging and three-dimensional reconstruction technology to measure and observe the cervical uncinate process-related angle in a large sample of different age groups,the aim is to reveal the characteristics of its changes with age and vertebral growth,as well as its relationship with cervical spine stability. METHODS:Using a retrospective research design,we collected 1 447 cases of raw CT imaging data that meet the study requirements for complete cervical spine segments.The raw data were imported into Mimics 21.0 software in DICOM format for post-processing and measurement of angle of uncinate process and sagittal angle of uncinate process.The data were grouped based on gender,age,and side. RESULTS AND CONCLUSION:(1)With the increase of vertebral sequence,the angle of uncinate process increased in a V-shaped shape,and the lowest peak was at C5.The overall population showed a sharp peak with the increase of age,and the peak value mostly occurred in the age range of 30-39 years.(2)The sagittal angle of the uncinate process increased like a fishhook with the increase of the vertebral sequence,and the overall angle of the uncinate process increased with age,and the peak value mostly occurred in the age range of 20-29 years.The uncinate process angle and sagittal angle showed only partial significant differences between sides and genders(P<0.05).(3)It is concluded that the angle of the uncinate process increased with the increase of vertebral sequence in a V-shaped manner.The sagittal angle of the uncinate process increases like a fish hook with increasing vertebral order,while the two angles generally peak with increasing age.The angle of the uncinate process is about 131°,which may be closely related to the stability of the cervical spine,while the sagittal angle of the uncinate process is about 14°,and its function may play a certain role in limiting the excessive rotation of the cervical spine.