Subtype classification of age-related macular degeneration (AMD) based on optical coherence tomography (OCT) images serves as an effective auxiliary tool for clinicians in diagnosing disease progression and formulating treatment plans. To improve the classification accuracy of AMD subtypes, this study proposes a keypoint-based, attention-enhanced residual network (KPA-ResNet). The proposed architecture adopts a 50-layer residual network (ResNet-50) as the backbone, preceded by a keypoint localization module based on heatmap regression to outline critical lesion regions. A two-dimensional relative self-attention mechanism is incorporated into convolutional layers to enhance the representation of key lesion areas. Furthermore, the network depth is appropriately increased and an improved residual module, ConvNeXt, is introduced to enable comprehensive extraction of high-dimensional features and enrich the detail of lesion boundary contours, ultimately achieving higher classification accuracy of AMD subtypes. Experimental results demonstrate that KPA-ResNet achieves significant improvements in overall classification accuracy compared with conventional convolutional neural networks. Specifically, for the wet AMD subtypes, the classification accuracies for inactive choroidal neovascularization (CNV) and active CNV reach 92.8% and 95.2%, respectively, representing substantial improvement over ResNet-50. These findings validate the superior performance of KPA-ResNet in AMD subtype classification tasks. This work provides a high-accuracy, generalizable network architecture for OCT-based AMD subtype classification and offers new insights into integrating attention mechanisms with convolutional neural networks in ophthalmic image analysis.
Tomography, Optical Coherence/methods* ; Humans ; Macular Degeneration/diagnostic imaging* ; Neural Networks, Computer

Heat shock protein 70 (HSP70), an evolutionarily conserved molecular chaperone, serves as a central regulator within tumor immune networks. This review summarizes the multiple immune regulatory mechanisms mediated by HSP70 through its specific domains: promoting antigen presentation and cross-presentation processes; prolonging immune response duration; regulating innate and adaptive immune responses; and interacting with immune checkpoint molecules like programmed death-1 ligand 1 (PD-L1). In translation of clinical research, HSP70 can serve as a vaccine adjuvant to enhance immunogenicity, while its inhibitors can overcome resistance to immunotherapy. Additionally, membrane-bound HSP70 represents a potential immunotherapeutic target, and its targeting strategies show significant synergistic effects when combined with immune checkpoint inhibitors. However, due to the functional redundancy of the molecular chaperone network, the clinical efficacy of single-agent HSP70 inhibition is limited. In-depth elucidation of HSP70's synergistic regulatory mechanisms within the chaperone interaction network has important implications for developing novel tumor immunotherapy strategies.
HSP70 Heat-Shock Proteins/metabolism* ; Humans ; Immunotherapy/methods* ; Neoplasms/immunology* ; Animals ; B7-H1 Antigen/metabolism*

Objective To evaluate the role of quantitative flow ratio(QFR)in percutaneous coronary intervention(PCI)by using regadenoson stress dynamic single-photon emission computed tomography(D-SPECT).Methods We selected 200 patients with unstable angina admitted to Department of Cardiology,Hebei Medical University First Hospital,from June 31,2021 to June 31,2023 for elective PCI.The patients were aged 57.56±8.23 years and were randomly divided into a conventional group(n=100)and a QFR group(n=100)according to a random number table.The trial was conducted using a double-blind method.The conventional group received PCI treatment based on the experience of the physician,while the QFR group received PCI treatment based on the QFR measurement results.All enrolled patients underwent pre-operative and 7-day post-operative D-SPECT stress imaging using regadenoson stress D-SPECT,and their images were acquired from short axis,vertical long axis,and horizontal long axis to calculate the total myocardial perfusion score and the total myocardial ischemia segment number under the distribution of 17 myocardial segments.Results There was no significant difference in the number of myocardial ischemia segments(7.59±3.14 vs.7.48±3.36,P=0.811)or the total myocardial perfusion score(15.87±7.61 vs.15.63±5.97,P=0.860)between the two groups before PCI.The number of myocardial ischemia segments(5.58±3.36 vs.6.51±2.14,P=0.020)and the total myocardial perfusion score(10.55±4.41 vs.12.96±6.50,P=0.002)in the QFR group were significantly better than those in the conventional group 7 days after PCI(P＜0.05).Conclusion Applying QFR guidance for PCI can better improve the degree of myocardial ischemia in patients.

Objective This study utilized regadenoson stress D-SPECT to evaluate the impact of remote ischemic precondi-tioning combined with adenosine injection in patients undergoing percutaneous coronary intervention(PCI)using D-SPECT imaging.Methods Three hundred patients requiring coronary angiography and stent implantation were randomly assigned into two groups utilizing the random number table method.The conventional treatment group(150 patients)and the experimental group(150 patients)received standard treatment for coronary heart disease PCI.The experimental group underwent two sessions of remote ischemic precon-ditioning on the day of PCI,wherein the left and right upper arms were inflated to 200 mmHg with continuous pressure for 5 minutes using a blood pressure cuff.Additionally,during the PCI procedure,adenosine was administered to the experimental group at a rate of 50 μg/(kg·min)until the end of the procedure,with other treatments aligning with the conventional treatment group.Each patient received a coronary SYNTAXⅡscore.Resting D-SPECT and regadenoson stress D-SPECT were employed to evaluate total myocardial perfusion score,total myocardial ischemia segments,and left ventricular ejection fraction across 17 segment distributions before and 7 days after PCI.Results Before PCI,the differences in the number of myocardial ischemic segments,total myocardial perfusion score,and left ven-tricular ejection fraction between the two patient groups were not statistically significant(P>0.05).However,7 days post-PCI,compared with the conventional treatment group,the experimental group exhibited significantly improved numbers of myocardial ischemic segments,total myocardial perfusion score,and left ventricular ejection fraction(P<0.05).Furthermore,the differences in adverse drug reactions between the two patient groups were not statistically significant(P>0.05).Conclusion The combined application of remote ischemic preconditioning and adenosine injection in patients undergoing PCI is deemed safe and effective.

Objective:To investigate the effects of overexpression of Nkx2.5 gene on the anti apoptotic ability of bone marrow mesenchymal stem cells (BMSCs) and cardiac function after myocardial infarction.Methods:A cell ischemia model was established by culturing cells under oxygen glucose deprivation/reoxygenat (OGD/R) conditions. The experiment was divided into four groups: bone marrow mesenchymal stem cells cultured under normal conditions (BMSC group), BMSC group cultured under glucose and oxygen deprivation (BMSC+OGD/R group), overexpressed empty vector BMSC group cultured under glucose and oxygen deprivation(BMSC NC+OGD/R group), and overexpressed Nkx2.5 BMSC group cultured under glucose and oxygen deprivation (BMSC Nkx2.5+OGD/R group). The apoptosis rate of BMSCs in each group was detected via flow cytometry, and BMSC protein was extracted. The expression of caspase-3 and pro-caspase-3, caspase-8 and pro-caspase-8, caspase-9, and cytochrome C protein and expression of Nkx2.5 in the BMSCs of each group were detected by Western blot to determine the anti-apoptotic pathway in vitro. The model of myocardial infarction in mice was established by ligating the left anterior descending branch of coronary artery. The experiment was divided into five groups: sham surgery group, myocardial infarction untreated group, myocardial infarction tail vein injection of BMSC group, myocardial infarction tail vein injection of BMSC empty body group, myocardial infarction tail vein injection of BMSC overexpression Nkx2.5 group. The changes of cardiac function in mice were evaluated by echocardiography. Normal distribution econometric data were compared between groups using convenient analysis, and pairwise comparisons were conducted using LSD-t test. Results:The apoptosis rate of the BMSC+OGD/R group (12.98±1.24)% was higher than that of the BMSC group (7.82±0.42)%, and the difference was statistically significant ( P<0.001). The apoptosis rate of the BMSC NKx2.5+OGD/R group (11.26±0.22)% was lower than that of the BMSC+OGD/R group (12.98±1.24)% and the BMSC NC+OGD/R group (13.14±0.70)%, with statistically significant differences ( P<0.05). Compared to BMSC group ((0.36±0.08), (1.13±0.04), (0.36±0.06), (1.12±0.13), (1.23±0.08), (0.60±0.05), (0.67±0.14)), BMSC+OGD/R group ((1.05±0.10), (0.62±0.04), (1.07±0.09), (0.57±0.07), (0.55±0.08), (1.25±0.09), (0.71±0.04)) and BMSC NC+OGD/R group ((1.16±0.16), (0.64±0.06), (1.19±0.16), (0.56±0.06), (0.50±0.06), (1.28±0.06), (0.73±0.04)), the expression of Caspase-3 (0.72±0.08) and pro-caspase-3(0.89±0.09), Caspase-8 (0.63±0.08) and pro-caspase-8(0.85±0.12), Caspase-9 (0.87±0.09), cytochrome C (0.91±0.10), and Nkx2.5 (1.54±0.16) in BMSC Nkx2.5+OGD/R group was statistically significant (all P<0.05). In vivo experiments showed that the heart ejection fraction (29.05±7.07)% of mice treated with BMSC Nkx2.5 after myocardial infarction was significantly improved compared to the BMSC group (16.57±2.09)% and BMSC NC group (18.08±3.27)% (all P<0.05). Conclusion:BMSC Nkx2.5 may enhance the anti-apoptosis ability of BMSCs and improve cardiac function after myocardial infarction by inhibiting the death receptor pathway and the mitochondrial signal pathway .

Objective To analyze the effect of Hedysari Radix Chinese herbal pieces treatment in acute inferior myocardial infarction patients undergoing percutaneous coronary intervention(PCI).Methods A total of 200 patients with acute inferior myocardial infarction undergoing emergency PCI admitted to department of cardiology of Shijiazhuang People's Hospital from March 31,2020 to March 31,2023 were selected as the study objects.The patients were randomly divided into a control group and a treatment group according to a digital random table method.The control group received routine treatment after PCI,and the patients drank 500 mL of warm water in the morning and afternoon every day,continuing this regimen for up to 30 days post-surgery.The treatment group took 10 g of Hedysari Radix Chinese Herbal pieces in 500 mL of boiling water in the morning and afternoon,soaking it and drinking it coolly and temperately,continuing to take it until 30 days after surgery.Blood pressure,Dopamine dosage,and duration were observed in all patients on 1-5 days after surgery.Major adverse cardiovascular event(MACE),such as cardiac death,myocardial infarction,heart failure,and re-admission were tracked in all patients within 30 days,and adverse reactions and clinical symptom improvement were followed up,using the somatic self-rating scale(SSS).Results The total Dopamine dose in the treatment group was significantly lower than that in the control group(mg:960.4±287.9 vs.1 160.4±610.5,P<0.05),and the duration of use was significantly shorter than that in the control group(hours:60.7±16.9 vs.71.6±20.4,P<0.05).The systolic blood pressure in the treatment group was significantly higher than that in the control group at 1 day after PCI[mmHg(1 mmHg≈0.133 kPa):96.8±19.5 vs.90.2±11.1,P<0.05],until 5 days after PCI(mmHg:106.3±14.4 vs.99.7±13.9,P<0.05),while the changes in diastolic blood pressure were not significant in both groups.The incidence of MACE in the treatment group was significantly lower than that in the control group within 30 days after PCI[4.0%(4/100)vs.13.0%(13/100),P<0.05],and the SSS score was also significantly lower than that in the control group(31.56±11.58 vs.40.72±18.67,P<0.05).Conclusion The effect of Hedysari Radix Chinese herbal pieces treatment can significantly improve clinical efficacy without significant adverse reactions.

Objective To evaluate the comparability of the test results of two immunoassay systems based on the electrochemical luminescence and the fluorescence lateral flow immunoassay for serum procalcitonin (PCT).Methods Roche cobas system was used as the reference system,and fluorescence lateral flow immunoassay system of Shanghai Upper biotech company was used as evaluated system.A total of 141 clinical samples during November,2015 were detected by the two systems to obtain the correlation coefficient and the Kappa values at the two cutoff values(0.5,2.0 ng/ml).Results The two systems showed high correlation (Y=1.008X-0.032,r=0.995,P＜0.001) and low deviation (t=-0.230,P=0.819＞0.05) without statistic significance between two methods.Kappa values were 0.944,0.943 respectively at the two cutoff values (0.5,2.0 ng/ml).Conclusion The test results showed no significant difference between the two immunoassay systems,suggesting a consistency between them for clinical detection of PCT.All the observed indicators reached the clinical diagnostic requirements and the method of quantitative detection of PCT by fluorescence lateral flow immunoassya can be applied for the quick detection of clinical human PCT.

Objective To retrospectively analyse the detection results of human leukocyte antigen(HLA) B27,and discuss its diagnosis value in disease such as ankylosing spondylitis(AS).Methods HLA-B27 detection was performed on 1 335 suspected AS patients treated in the hospital from January 2015 to June 2016 by using multiparameter flow cytometry instrument.The test results showed 201 patients were diagnosed with AS(AS group),1 134 patients were diagnosed with rheumatoid arthritis and other related diseases (non AS group).The test results were shown by using mean fluorescence intensity and positive lymphocyte expression rate.n addition,120 healthy people were enrolled as the control group in the physical examination center of the hospital.Results The positive rate of HLA-B27 screening in suspected AS patients was 15.73% (210/1 335),and the positive rate of HLA-B27 screening in the control group was 2.50% (3/120).The positive rate of HLA-B27 screening,the rate of cell expression and the average fluorescence intensity of AS group were 92.03%(185/201),(85.34±17.99)%,8.74±4.20,significantly higher than the non AS group and the control group(P<0.01).There was no significant difference between the control group and the non AS group (P>0.05).HLA-B27 screening positive patients were mainly concentrated in adolescence,and the positive rate of male was higher than that of female (P<0.05).Conclusion Flow cytometry examination of HLA-B27 can provide important basis for the diagnosis and differential diagnosis of AS.

Objective To investigate the CT,MRI features and differential diagnosis of central nervous system primitive neuroec-todermal tumors (cPNET).Methods The CT and MRI findings of 1 5 cases with cPNET proved by pathology were analyzed retro-spectively,and we summarized the imaging features and differential diagnosis.Results For this group,the average age was (8.82± 2.53)and the male to female ratio was 9 ︰6.All lesions located in supratentorial region,which had relatively large volume (average diameter of 6.3 cm),cystic necrosis (12/15),and no or mild peritumoral edema.cPNET showed isodensity,slight hyperdensity or slight hypodensity on CT plain scan,and demonstrated uniform or inhomogeneous enhancement.On MRI plain scan,solid part showed isointensity or slight hypointensity signal on T1 WI,isointensity or slight hyperintensity signal on T2 WI,hyperintensity sig-nal on DWI(12/15),isointensity(9/15)or slightly hyperintensity signal on FLAIR,and showed obvious uniform,honeycombed or irregular enhancement after enhanced scan,no enhancement in cystic necrosis.Conclusion cPNET have certain characteristics,inclu-ding the lower onset age,relatively large volume with well-defined edge and no or mild peritumoral edema,hyperintensity signal on DWI,isointensity signal on FLAIR.

Objective To establish an HPLC method for determination of 2,3,5,4’-tetrahydroxystibene-2-O-β-D-glucoside(SBGC)and hyperin in the effective fraction of Jiangzhining. Methods HPLC analysis was performed on a C18 column(4.6 mm×250 mm,5 μm),with acetonitrile-0.1% methanoic acid water solution(15.5: 84.5)serving as the mobile phase. The flow rate was 1.0 mL·min-1 ,the wavelength was 340 nm,and the injection volume was 20 μL. Results The calibration curve was linear for SBGC in the range of 24-120 μg·mL-1(r = 0.999 8)and for hyperin in the range of 2.4-12.0 μg·mL-1(r= 0.999 6),respectively.Their average recoveries were 100.07% and 100.14%,respectively.The contents of SBGC and hyperin were 2.26% and 0.23%,respectively Conclusion The method is convenient,precise and reliable for determination of the content of SBGC and hyperin in the effective fraction of Jiangzhining.