Objective This study aims to explore the application value of spectral CT and perfusion CT parameters in the pathological classification and prognostic assessment of lung cancer.Methods A total of 94 lung cancer patients confirmed by pathology at Shanghai Chest Hospital from January 2023 to November 2024 were included in the study,including 49 cases of lung adenocarcinoma(LUAD),30 cases of lung squamous cell carci-noma(LUSC),and 15 cases of small cell lung cancer(SCLC).All patients underwent spectral CT combined with perfusion scanning using a 256-slice Revolution Apex from GE.Two radiologists independently measured the spectral and perfusion parameters of the three groups of images,including spectral curve slope(K),iodine concentration in the lesion area(ICL),effective atomic number(Zeff),surface permeability(PS),and perfusion index(PI),and established a lung cancer pathological subtype discrimination prediction model based on spectral CT radiomics features.All subjects were randomly divided into a training group and a validation group at a ratio of 3∶1.The discrimination efficacy of the spectral discrimination model between different pathological subtypes and the discrimination efficacy of arterial and venous phase images were compared in multiple dimensions.The performance of the model was evaluated using the receiver operating characteristic(ROC)curve.Results Statistical analysis showed that the spectral curve slope,ICL,NIC,and Zeff of LUAD patients were significantly higher than those of LUSC and SCLC patients(P<0.05),while there were no significant differences in these parameters between LUSC and SCLC patients(P>0.05).Among the perfusion CT parameters,surface permeability(PS)showed significant differences among the three groups(P<0.05),while blood volume(BV),blood flow(BF),perfusion index(PI),time to peak(TTP),and mean transit time(MTT)did not show statistical differences.The multi-factor logistic regression model based on spectral parameters showed strong discriminatory performance:the area under the curve(AUC)of the LUAD and LUSC discrimination model was 0.806/0.77(training group/test group)in the arterial phase and 0.867/0.9(training group/test group)in the venous phase;the AUC of the LUAD and SCLC discrimination model was 0.885/0.883(training group/test group)in the arterial phase and 0.851/0.776(training group/test group)in the venous phase.Conclusion This study indicates that the multi-dimensional functional metabolic analysis indicators of spectral and perfusion CT imaging have significant value in the differential diagnosis of lung cancer pathological subtypes.The diagnostic model constructed by combining multiple spectral parameters can significantly improve the discrimination efficacy of lung adenocarcinoma,squamous cell carcinoma,and small cell lung cancer,providing precise imaging evidence for the formulation of individualized treatment plans.

Objective This study aims to explore the application value of spectral CT and perfusion CT parameters in the pathological classification and prognostic assessment of lung cancer.Methods A total of 94 lung cancer patients confirmed by pathology at Shanghai Chest Hospital from January 2023 to November 2024 were included in the study,including 49 cases of lung adenocarcinoma(LUAD),30 cases of lung squamous cell carci-noma(LUSC),and 15 cases of small cell lung cancer(SCLC).All patients underwent spectral CT combined with perfusion scanning using a 256-slice Revolution Apex from GE.Two radiologists independently measured the spectral and perfusion parameters of the three groups of images,including spectral curve slope(K),iodine concentration in the lesion area(ICL),effective atomic number(Zeff),surface permeability(PS),and perfusion index(PI),and established a lung cancer pathological subtype discrimination prediction model based on spectral CT radiomics features.All subjects were randomly divided into a training group and a validation group at a ratio of 3∶1.The discrimination efficacy of the spectral discrimination model between different pathological subtypes and the discrimination efficacy of arterial and venous phase images were compared in multiple dimensions.The performance of the model was evaluated using the receiver operating characteristic(ROC)curve.Results Statistical analysis showed that the spectral curve slope,ICL,NIC,and Zeff of LUAD patients were significantly higher than those of LUSC and SCLC patients(P<0.05),while there were no significant differences in these parameters between LUSC and SCLC patients(P>0.05).Among the perfusion CT parameters,surface permeability(PS)showed significant differences among the three groups(P<0.05),while blood volume(BV),blood flow(BF),perfusion index(PI),time to peak(TTP),and mean transit time(MTT)did not show statistical differences.The multi-factor logistic regression model based on spectral parameters showed strong discriminatory performance:the area under the curve(AUC)of the LUAD and LUSC discrimination model was 0.806/0.77(training group/test group)in the arterial phase and 0.867/0.9(training group/test group)in the venous phase;the AUC of the LUAD and SCLC discrimination model was 0.885/0.883(training group/test group)in the arterial phase and 0.851/0.776(training group/test group)in the venous phase.Conclusion This study indicates that the multi-dimensional functional metabolic analysis indicators of spectral and perfusion CT imaging have significant value in the differential diagnosis of lung cancer pathological subtypes.The diagnostic model constructed by combining multiple spectral parameters can significantly improve the discrimination efficacy of lung adenocarcinoma,squamous cell carcinoma,and small cell lung cancer,providing precise imaging evidence for the formulation of individualized treatment plans.

Objective:To retrieve and summarize relevant evidence on nutritional management in patients with diabetic foot ulcers.Methods:Databases and websites, including UpToDate, BMJ Best Practice, Joanna Briggs Institute Evidence-Based Practice Center, Cochrane Library, Medlive, PubMed, Embase, CINAHL, Wanfang Database, China National Knowledge Infrastructure, as well as the websites of the International Diabetic Foot and the International Diabetes Federation, were systematically searched for literature related to nutritional management in patients with diabetic foot ulcers. Records of guidelines, systematic reviews, evidence summaries, clinical decisions, expert consensus, and randomized controlled trials published from database establishment to June 30, 2023 were screened. Two researchers independently evaluated the search results and included eligible literature as per quality criteria.Results:This study ultimately included 31 pieces of publication, comprising 6 guidelines, 1 expert consensus, 9 systematic reviews, 1 best clinical practice, and 14 randomized controlled trials. A total of 35 pieces of evidence were summarized, covering the six domains of nutritional assessment, dietary methods, modes of nutritional support, nutrients, hydration, and nutrition education and follow-up for patients with diabetic foot ulcers.Conclusions:This study summarized the best evidence on nutritional management for patients with diabetic foot ulcers in a scientific and robust manner. Clinicians, management decision-makers, and policy implementers can develop individualized nutritional support plans for patients with diabetic foot ulcers based on actual conditions, to promote wound healing, improve patient physical and mental health and enhance patient quality of life.

Objective:To summarize the clinical and genetic characteristics of mental retardation disorder (MRD) with TRIO gene variant in children.Methods:Case series study. The data of 9 children with TRIO gene variants were collected retrospectively from August 2019 to March 2024 in Department of Neurology, Beijing Children′s Hospital, Capital Medical University and Department of Pediatrics, the Third Affiliated Hospital of Zhengzhou University. The data included gender, age, intellectual and motor development, appearance, seizures, neuroimaging and genetic results. The clinical features and genotype-phenotype correlations were summarized.Results:Of the 9 children, 6 boys and 3 girls, 4 MRD63 children presented with moderate to severe developmental delays accompanied by macrocephaly; 5 MRD44 children had mild to moderate developmental delays with microcephaly. A total of 5 children had dysmorphic facial features (flat occiput, thick eyebrows, unibrow, large ears, short fingers, pale skin, yellow hair, and strabismus), 2 children experienced seizures (1 child with myoclonic seizure and 1 with absence seizure), 4 children had feeding difficulties, 1 child had congenital cataracts, 1 child had congenital heart disease, 1 child had recurrent infections, and 1 child had tiger-striped changes in the fundus examination. TRIO gene variants carried by the 9 children were all de novo, involving 8 variant sites, including 7 missense variants and 1 frameshift variant, c.3232C>T/p.R1078W (2 cases), c.3920A>G/p.Y1307C, c.4112A>T/p.H1371L, c.4283G>T/p.R1428L, c.4394A>G/p.N1465S, c.6041T>C/p.I2014T, c.6821G>A/p.R2274H, c.7027delC/p.Q2343Sfs*70. Among them, 2 sites are located in the Spectrin domain, 4 sites are in the GEFD1 domain, 2 sites are in the GEFD2 domain, and 1 site (frameshift variant) is in the PH2-SH3 domain. The individual with frameshift variant exhibit absence seizures, mild developmental delay, and the mildest phenotype. The child with myoclonic seizures was treated with valproic acid and levetiracetam for seizure control, while the child with absence epilepsy was treated with valproic acid and lamotrigine for seizure control. All 9 children underwent regular rehabilitation exercises, making slow progress.Conclusions:TRIO gene related MRD is characterized by varying degrees of developmental delay, and often accompanied by macrocephaly or microcephaly, dysmorphic facial features, and with or without seizures. The main variant types are missense variants, which are mostly concentrated in the Spectran domain and GEFD domain. p. R1078W may be a relative hotspot variant. The phenotype caused by the frameshift variant is relatively milder.

Objective:To retrieve and summarize relevant evidence on nutritional management in patients with diabetic foot ulcers.Methods:Databases and websites, including UpToDate, BMJ Best Practice, Joanna Briggs Institute Evidence-Based Practice Center, Cochrane Library, Medlive, PubMed, Embase, CINAHL, Wanfang Database, China National Knowledge Infrastructure, as well as the websites of the International Diabetic Foot and the International Diabetes Federation, were systematically searched for literature related to nutritional management in patients with diabetic foot ulcers. Records of guidelines, systematic reviews, evidence summaries, clinical decisions, expert consensus, and randomized controlled trials published from database establishment to June 30, 2023 were screened. Two researchers independently evaluated the search results and included eligible literature as per quality criteria.Results:This study ultimately included 31 pieces of publication, comprising 6 guidelines, 1 expert consensus, 9 systematic reviews, 1 best clinical practice, and 14 randomized controlled trials. A total of 35 pieces of evidence were summarized, covering the six domains of nutritional assessment, dietary methods, modes of nutritional support, nutrients, hydration, and nutrition education and follow-up for patients with diabetic foot ulcers.Conclusions:This study summarized the best evidence on nutritional management for patients with diabetic foot ulcers in a scientific and robust manner. Clinicians, management decision-makers, and policy implementers can develop individualized nutritional support plans for patients with diabetic foot ulcers based on actual conditions, to promote wound healing, improve patient physical and mental health and enhance patient quality of life.

Purpose To investigate the relationship and clinical significance of high-risk human papillomavirus infection and expression of c-jun and c-fos protein in cervical carcinoma.Methods Cervista HR-HPV testing,immunohistochemical SP method were employed to detect the infection of HR-HPV,c-jun and c-fos protein in 70 cases of CSCC,60 cases of cervical intraepithelial neoplasia and 20 cases of chronic cervicitis.The correlation between c-jun and c-fos protein expression and of HR-HPV infection was analyzed.Results Of the 70 cases of CSCC,the positive HR-HPV was 69 cases,the positive rate in HR-HPV in A9 group was the highest (85％,59/69).The positive expression of c-jun and c-fos were 80％ (56/70),85.7％ (60/70) in 70 cases CSCC,70％ (21/30) and 70％ (21/30) in 30 cases of cervical high grade intraepithelial neoplasia,and 20％ (6/30),23.3％ (7/30) in 30 cases cervical low grade intraepithelial neoplasia,but the positive expression rates of c-jun and c-fos in the 20 cases of chronic cervicitis were 0.Expression of c-jun and c-fos in cervical cancer group was higher than that in the chronic cervicitis group and low grade intraepithelial neoplasia (P ＜ 0.05).The expression of c-jun and c-fos was statistically significant in different groups of clinical stage and pathologic grading in the CSCC (P ＜ 0.05).Additionally,the expression of c-jun and c-fos was positively correlated with the infection of HR-HPV in CSCC (P ＜ 0.01).Conclusion The infection of HR-HPV has significant subtype-specific and has a positive correlation with the expression of c-jun and c-fos in CSCC,which suggests that AP-1 pathway activation after HRHPV infection may be associated with the occurrence and development of cervical carcinoma.

OBJECTIVE:To investigate the effects of hyperbaric oxygen combined with flupentixol and melitracen on depres-sion improvement,extremity motor function and ability of daily living and activity in patients with post-stroke depression (PSD). METHODS:60 PSD patients were divided into control group and observation group according to random number table,with 30 cases in each group. Both groups received routine clinical treatment,comprehensive rehabilitation therapy and psychotherapy. The control group was additionally given Flupentixol and melitracen tablets,orally,one tablet each time,in the morning;3 days later, one tablet each time,in the morning and noon,for 4 weeks. Other anti-depressive agents were not given during treatment. Observa-tion group was additionally given hyperbaric oxygen,0.12 MPa,for 90 min,qd,5 times a week,for 4 weeks,on the basis of control group. Depression degree [Hamilton depression scale (HAMD) and Self-rating depression scale(SDS)],extremity motor function [Fugl-Mayer motor function assessment (FMA)] and ability of daily living and activity [modified Barthel index (MBI)] were scored in 2 groups before and after treatment,and ADR was observed. RESULTS:After 4 weeks of treatment,HAMD and SDS of 2 groups were decreased significantly compared to before treatment,while FMA and MBI were increased significantly;the improvement of observation group was significantly better than that of control group,with statistical significance(P<0.05). No ob-vious ADR was found in 2 groups. CONCLUSIONS:Hyperbaric oxygen combined with flupentixol and melitracen can effectively improve PSD,relieve negative emotion and improve extremity motor function and ability of daily living and activity.

Brain Diseases ; pathology ; Histiocytosis, Sinus ; pathology ; Humans ; Skull ; pathology

A sandwich format immunochromatographic assay for detecting foot-and-mouth disease virus (FMDV) serotypes was developed. In this rapid test, affinity purified polyclonal antibodies from Guinea pigs which were immunized with sucking-mouse adapted FMD virus (A/AV88(L) strain) were conjugated to colloidal gold beads and used as the capture antibody, and affinity purified polyclonal antibodies from rabbits which were immunized with cell-culture adapted FMD virus (A/CHA/09 strain) were used as detector antibody. On the nitrocellulose membrane of the immunochromatographic strip, the capture antibody was laid on a sample pad, the detector antibody was printed at the test line(T) and goat anti-guinea pigs IgG antibodies were immobilized to the control line(C). The lower detection limit of the test for a FMDV 146S antigen is 11.7ng/ml as determined in serial tests after the strip device was assembled and the assay condition optimization. No cross reactions were found with FMDV serotype C, Swine vesicular disease (SVD), Vesicular stomatiti svirus (VSV) and vesicular exanthema of swine virus (VES) viral antigens with this rapid test. Clinically, the diagnostic sensitivity of this test for FMDV serotypes A was 88.7% which is as same as an indirect-sandwich ELISA. The specificity of this strip test was 98.2% and is comparable to the 98.7% obtained with indirect-sandwich ELISA. This rapid strip test is simple, easy and fast for clinical testing on field sites;no special instruments and skills are required, and the result can be obtained within 15 min. To our knowledge, this is the first rapid immunochromatogarpic assay for serotype A of FMDV.