Objective:To predict the status of microvascular invasion (MVI) in intrahepatic cholangiocarcinoma (ICC) patients preoperatively based on the radiomics analysis of contrast-enhanced CT to provide imaging evidence for early identification of patients at high risk of recurrence.Methods:Clinical data of 40 ICC patients who underwent radical hepatectomy at Nanjing Drum Tower Hospital from January 2021 to May 2024 were retrospectively collected. Patients were divided into the MVI group ( n=8) and the non-MVI group ( n=32) according to the MVI status of the postoperative pathology report. Whether there were differences in each pathological index between the groups and the efficacy of radiomics analysis of contrast-enhanced CT for the preoperative prediction of MVI were analyzed. The regions of interest (ROI) were outlined on the arterial and venous phase images using the 3D Slicer software. Then, radiomics features were extracted from each ROI based on Python. Finally, the LASSO regression and glm function were used to screen radiomics features and establish a prediction model based on the R language. The established predictive model′s diagnostic efficacy, calibration, and net clinical benefit were evaluated using the receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA), respectively. Normally distributed measurement data were expressed as mean±standard deviation ( ± s) and compared using the t-test. Count data were expressed as frequency and compared using the chi-square test. Results:Patients in the MVI group had more poorly differentiated tumors and a significantly higher proportion of lymph node metastases ( P<0.05). The established radiomics prediction model included six features, 1 first-order statistical feature and 5 gray texture features. The area under the ROC curve was 0.87, the sensitivity was 75.0%, and the specificity was 90.6%. The calibration curve showed good agreement between the predicted MVI and actual MVI status, and the decision curve demonstrated that the model could provide a large net clinical benefit. Conclusion:Radiomics analysis of contrast-enhanced CT can identify the MVI status of ICC patients preoperatively and aid in clinical decision-making, providing vital evidence for individualized and precise treatment of ICC.

Objective To explore the diagnostic value of microRNA(miR)-451a,miR-3613-5p and miR-125b-5p in endometriosis(EMT).Methods A tatol of 35 patients with EMT in the Department of Gynecology,the Affiliated People's Hospital of Fujian University of Traditional Chinese Medicine were selected as the case group from December 2021 to February 2023,30 healthy women of childbearing age were selected as the control group over the same period.The expression levels of miR-451a,miR-3613-5p and miR-125b-5p in the plasma of two groups were measured using real-time quantitative reverse transcription polymerase chain reaction,the diagnostic value of these miRNAs in EMT was evaluated by using receiver operating characteristic(ROC)curve.Results ①The expression levels of miR-451a,miR-3613-5p and miR-125b-5p in case group were higher than those in control group,the difference was statistically significant(P＜0.05).②In case group,there was no significant difference in miRNA expression levels between mild-moderate patients(stage Ⅱ-Ⅲ)and severe patients(stage Ⅳ)(P＞0.05).The expression levels of carbohydrate antigen 125(CA125)in plasma was significantly different(P＜0.05).③The diagnostic efficacy of miRNA for EMT was evaluated through ROC analysis,with a sensitivity of 85.7％and specificity of 40.0％for miR-451a,a sensitivity of 60.0％and specificity of 90.0％for miR-3613-5p,and a sensitivity of 60.0％and specificity of 76.7％for miR-125b-5p.Combined with a sensitivity of 48.6％and specificity of 96.7％.Conclusion Compared to healthy women,the expression levels of miR-451a,miR-3613-5p and miR-125b-5p in plasma of EMT are increased,which are not affected by clinical stage,and are expected to be candidate markers for the non-invasive diagnosis of EMT,and are not affected by clinical staging,making them promising candidate biomarkers for non-invasive diagnosis of EMT.

Objective To establish a method for simultaneous determination of 14 components in Cinnamomi Cortex;To comprehensively evaluate its quality by multivariate statistical analysis technology.Methods HPLC method was used to establish the relative correction factors(RCF)between protocatechuic acid and 13 other components of coumalic acid,coumarin,cinnamyl alcohol,cinnamic acid,2-methoxycinnamic acid,cinnamaldehyde,o-methoxycinnamaldehyde,vanillic,syringic acid,4-hydroxybenzoic acid,procyanidin B2,epicatechin and procyanidin C1 to be measured,and the content of each component was calculated.The QAMS method was validated using external standard method(ESM),and the comprehensive quality of Cinnamomi Cortex was evaluated using PCA,OPLS-DA and EW-TOPSIS methods.Results The methodological verification results of ESM were in accordance with the requirements;the RCF established with protocatechuic acid as the reference had good durability under different experimental conditions,and the difference in content of each component between ESM and QAMS was not significant(P>0.05);the results of multivariate statistical analysis showed that accumulative contribution rate of former 2 principle components was 90.312%.Cinnamaldehyde,2-methoxycinnamic acid,procyanidin B2 and 4-hydroxybenzoic acid had a significant impact on the quality of Cinnamomi Cortex.The results of EW-TOPSIS showed that the Pi value of 16 batches of Cinnamomi Cortex ranged from 0.147 2 to 0.768 1.The quality of Cinnamomi Cortex from different producing areas varied greatly,and the overall quality of Cinnamomi Cortex from Guangxi Province was the best,followed by that from Guangdong Province and Yunnan Province,and the quality of Cinnamomi Cortex from Fujian Province was relatively poor.Conclusion The established QAMS multi-component quantitative method combined with multivariate statistical analysis technology can be used for comprehensive quality evaluation of Cinnamomi Cortex.

Objective:To investigate the risk factors and their warning effectiveness for postoperative intestinal barrier dysfunction (IBD) in patients with severe traumatic brain injury (sTBI).Methods:A retrospective cohort study was conducted to analyze the clinical data of 101 patients with sTBI admitted to Wuxi Branch of Zhongda Hospital Affiliated to Southeast University from May 2020 to February 2023, including 63 males and 38 females, aged 21-81 years [(53.4±14.2)years]. All the patients underwent emergency surgery. The patients were divided into IBD group ( n=67) and non-IBD group ( n=34) according to whether or not they had IBD after surgery. The gender, age, basic diseases (hypertension and diabetes), types of intracranial hematoma (subdural, epidural, and intracerebral hematoma), preoperative Glasgow Coma Scale (GCS), cerebral hernia, intraoperative initial intracranial pressure (iICP), operation time, removal of bone flap, treatment time in ICU, initiation time of enteral nutrition, and use of broad-spectrum antibiotics were recorded in the two groups. Univariate and multivariate binary Logistic regression analyses were conducted to assess the correlations between above-mentioned indicators and incidence of postoperative IBD in sTBI patients and determine the independent risk factors for sTBI. Receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to evaluate the warning effectiveness of each risk factor for IBD. Results:The results of the univariate analysis showed that preoperative GCS, cerebral hernia, intraoperative iICP, removal of bone flap, treatment time in ICU, initiation time of enteral nutrition, and use of broad-spectrum antibiotics were significantly correlated with the incidence of IBD in sTBI patients ( P<0.05 or 0.01), while there were no correlations of IBD with gender, age, basic diseases, types of intracranial hematoma and operation time ( P>0.05). The results of the multivariate binary Logistic regression analysis showed that preoperative GCS≤5 points ( OR=2.49, 95% CI 1.17, 5.32, P<0.05), intraoperative iICP>23 mmHg (1 mmHg=0.133 kPa)( OR=1.20, 95% CI 1.03, 1.39, P<0.05), and initiation time of enteral nutrition>24 hours ( OR=10.03, 95% CI 1.26, 80.21, P<0.05) were highly correlated with postoperative IBD in sTBI patients. The results of the ROC curve analysis showed that intraoperative iICP had the highest warning value (AUC=0.91, 95% CI 0.85, 0.96), followed by preoperative GCS (AUC=0.88, 95% CI 0.82, 0.95), and initiation time of enteral nutrition had the lowest warning value (AUC=0.78, 95% CI 0.69, 0.87). Conclusions:Preoperative GCS≤5 points, intraoperative iICP>23 mmHg, and initiation time of enteral nutrition>24 hours are independent risk factors for postoperative IBD in sTBI patients. The warning value of intraoperative iICP ranks the highest for postoperative IBD in sTBI patients, followed by preoperative GCS, with initiation time of enteral nutrition having the lowest warning value.

Compared with simple stress urinary incontinence (SUI), complicated female SUI is more diverse in etiology and more difficult to treat.Based on domestic and foreign literature and our diagnosis and treatment experience, this paper makes a detailed introduction to the definition, diagnosis, evaluation and clinical treatment of complicated female SUI, so as to provide guidance and reference for the treatment of this disease.

Objective To investigate the effects of the rhein on the mitochondria fission and epithelial-mesenchymal transition(EMT)of breast cancer cells MDA-MB-231.Methods Human breast cancer cells were intervened with rhein,and the cells were divided into control group(0 μmol·L-1),low dose rhein group(100 μmol·L-1),and high dose rhein group(200 μmol·L-1).The proliferation activity of the cells was detected by CCK-8,and migrations was detected by Scratch-healing migration assay.The morphology and distribution of mitochondria were detected by transmission electron microscope,and the expression levels of Dynamin-related protein 1(Drp1),mitofusin2(Mfn2),E-cadherin,Vimentin proteins were detected by Western blot.Results Compared with control group,Rhein significantly reduced the protein expression of Drp1、Vimentin(P<0.05),and increased E-cadherin and Mfn2,thus down-regulating mitochondria fission,inhibiting cell proliferation and migration.High dose Rhein was better than low dose.Conclusion Rhein can inhibit the proliferation and migration of breast cancer cells by reducing the expression of Drp1,Vimentin and up-regulating Mfn2,E-cadherin proteins.

Traumatic cerebrospinal fluid leakage commonly presents in traumatic brain injury patients, and it may lead to complications such as meningitis, ventriculitis, brain abscess, subdural hematoma or tension pneumocephalus. When misdiagnosed or inappropriately treated, traumatic cerebrospinal fluid leakage may result in severe complications and may be life-threatening. Some traumatic cerebrospinal fluid leakage has concealed manifestations and is prone to misdiagnosis. Due to different sites and mechanisms of trauma and degree of cerebrospinal fluid leak, treatments for traumatic cerebrospinal fluid leakage varies greatly. Hence, the Craniocerebral Trauma Professional Group of Neurosurgery Branch of Chinese Medical Association and the Neurological Injury Professional Group of Trauma Branch of Chinese Medical Association organized relevant experts to formulate the " Chinese expert consensus on the diagnosis and treatment of traumatic cerebrospinal fluid leakage in adults ( version 2023)" based on existing clinical evidence and experience. The consensus consisted of 16 recommendations, covering the leakage diagnosis, localization, treatments, and intracranial infection prevention, so as to standardize the diagnosis and treatment of traumatic cerebrospinal fluid leakage and improve the overall prognosis of the patients.

Objective To analysis contraindication detection of radiological workers and explore thevariation trend. Methods Occupational health examination data of radiological workers were selected from 2014 to 2018. Contraindications were identified according to the criteria, and the detection rates and trends were described in each statistical dimension. Results A total of 17197 cases were selected. Among them 74 patients were found contraindication and the detection rate is 0.43%. The major abnormalities were in thyroid gland and crystalline lens; The detection rate of female is higher than that of male (χ² = 25.24，P < 0.01); High age andhigh working age groups showed a higherrate of contraindication detection; The abnormal rate of contraindication increased with the age; The risk of > 30 working years group is 2.541 times that of 1 ～5 working years group (95%CI: 1.32 ～4.88). The abnormal rate of thyroid grand was increased year by year, and the trend test showed statistical significance (χ² = 3.87，P < 0.05). Conclusion Low dose ionizing radiation has a great effect on thyroid gland and crystalline lens of radiation workers, whichhigh age and high working years group should be pay attention to. The contents of occupational health monitoring should be further regulated to safeguard the health of radiation workers so that we can discover the possible health effects and take intervention earlier.

Objective To investigate the effect of measuring value transfer for human serum samples assigned by the reference laboratory network on improving the trueness of seven enzyme activities in clinical laboratories,such as ALT,AST,GGT,LDH,CK,AMY and ALP.Methods Depending on the medical imtitutions at all levels contacted by 5 reference laboratories in North China,South China,East China and Southwest China,the corresponding clinical laboratory measuring value transfer/traceability network was established.The frozen human serum samples with good interehangeability and standard material characteristics,including calibrator,sample 1 and sample 2,were provided by Beijing Aerospace General Hospital,and were assigned by 5 reference labotatories in four regiom.These samples were sent to 48 clinical laboratories.These clinical laboratories measured sample 1 and sample 2 according to their standard operating procedures,and then measured.the two samples again after adjusting their measurement system by using the supplied calibrator.The changes of trueness of detection results in these laboratories were evaluated according to the WS/T 403-2012 standard,and the changes of consistency for ALT and AST before and after measuring value tramfer were investigated.Results The results of AMY,ALP,GGT,CK and LDH calibrator,sample 1 and sample 2 assigned by the established network were 138.7 U/L,278.5 U/L and 68.3 U/L,265.3 U/L,94.5 U/L and 134.4 U/L,195.8 U/L,89.0 U/L and 158.9 U/L,393.7 U/L,260.0 U/L and 645.3 U/L,and 302.0 U/L,250.0 U/L and 452.7 U/L,respectively.The percentages of sample 1 and sample 2 which met the bias requirements of the WS/T 403-2012 standard before measuring value transfer for AMY,ALP and GGT were 65.9％ and 61.0％,76.6％ and 78.7％,and 66.7％ and 70.8％,respectively,while after measuring value transfer,they were 89.2％ and 83.8％,86.7％ and 80.0％,and 85.4％ and 91.7％,respectively.The percentages of sample 2 which met the bias requirements of the WS/T 403-2012 standard before measuring value transfer for CK and LDH were 64.6％ and 58.3％,respectively,while after measuring value trander,they were 93.5％ and 84.8％,respectively.The coefficients of variation (consistency) of sample 1 and sample 2 for ALT and AST before measuring value tramfer were 12.9％ and 11.3％,and 10.2％ and 8.9％,respectively,while after measuring value transfer,they were 9.3％ and 8.2％,and 5.6％ and 5.9％,respectively.Conclusion The calibration of routine measurement systems based on the measuring value transfer for human serum samples assigned by the reference laboratory network may improve the comparability of 7 enzyme actvities measurement results in chnical laboratories at all levels obviously,which deserves to be further spread.

Aim To investigate the antagonistic effect of resveratrol on neuropathic pain and its underlying mechanism. Methods Neuropathic pain was induced by ligation of L5 spinal nerve (SNL) in rats. 90 male Sprague-Dawley rats, fit with intrathecal catheters were divided randomly into six groups ( n = 15 ): naive group; sham group; SNL group; high dosage of res-veratrol group (300μg);middle dosage of resveratrol group ( 30μg ) and low dosage of resveratrol group (3μg). The naive group did not make any process. In sham group, the L5 spinal nerve was only exposed without ligation. Other groups received SNL. Different dosages of resveratrol dissolved in 10μL 100% DMSO were administered by intrathecal injections once a day for 4 days, starting on day 4 after SNL. Paw withdraw-al latency (PWL) was measured on day 1,3,5,7,9, 11,14 days after surgery separately. On day 7 after be-havioral testing, the lumbar segments of the spinal cord were removed to measure the level of SIRT1 and acety-lated-p65(Ac-p65) for western blot. The activation of NF-κB was determined through calculating the percent-age of NF-κB-immunofluorescence positive staining cells in this study. Results Compared with sham groups,the SNL group showed an obvious decrease(P< 0. 05) of PWL and SIRT1 after surgery,whereas Ac-p65 and actived NF-κB significantly increased ( P <0. 05) in the spinal cord. Administration with high and middle dosages of resveratrol markedly attenuated(P <0. 05) SNL-induced thermal hyperalgesia and down-regulation of SIRT1 and blocked (P < 0. 05) the SNL-induced up-regulation of Ac-p65 and actived NF-κB in the spinal cord. Conclusion Intrathecal resveratrol can inhibit the development of neuropathic pain and suppress the activation of NF-κB signaling in SNL rats . The analgesic effect of resveratrol is implemented partly via increasing the level of SIRT1 and deacetylat-ing p65.