Objective:To explore the value of the vesical imaging-reporting and data system (VI-RADS) score based on multiparametric MRI (mpMRI) combined with quantitative tumor MRI parameters in assessing the muscle invasion of bladder cancer.Methods:The study was a case-control study. The data of 87 bladder cancer patients confirmed by pathology who underwent mpMRI of the bladder were retrospectively collected from the First Medical Center of Chinese PLA General Hospital between January 2019 and April 2023 The pathological findings were used as the gold standard to categorize them into the muscle invasive bladder cancer (MIBC) group (29 cases) and non-muscle invasive bladder cancer (NMIBC) group (58 cases). Quantitative parameters were measured based on preoperative mpMRI images, including the length of tumor bladder wall contact, the perpendicular distance between the bladder tumor and the tangent of the bladder wall, the maximal diameter of the bladder tumor, and the volume of the bladder tumor. Bladder cancer was classified according to the VI-RADS scoring criteria. The Mann-Whitney U test was used for intergroup comparisons. Multivariate logistic regression analysis was performed to obtain the independent risk factors related to muscle invasion of bladder cancer and to establish the model. The receiver operating characteristic curves were analyzed for MRI quantitative parameters and logistic regression models, and area under the curve (AUC) comparisons were performed using the DeLong test. Results:The differences in tumor bladder wall contact length, perpendicular distance from the tumor to the tangent line of the bladder wall, maximum diameter, bladder tumor volume, and the VI-RADS scores were statistically significant between the MIBC group and the NMIBC group ( P<0.05). Multifactorial logistic regression analysis showed that tumor bladder wall contact length ( OR=21.07, 95% CI 3.56-124.89, P=0.001) and VI-RADS score ( OR=11.90, 95% CI 3.53-40.12, P<0.001) were the independent risk factors for evaluating the muscle invasion of bladder cancer. The difference between the VI-RADS score and the tumor bladder wall contact length for assessing muscular infiltration of bladder cancer had AUCs of 0.802 (95% CI 0.704-0.899) and 0.759 (95% CI 0.652-0.865). The combined model of VI-RADS score combined with tumor bladder wall contact length had an AUC of 0.891 (95% CI 0.812-0.970), which was higher than the diagnostic efficacy of applying tumor bladder wall contact length or VI-RADS score alone ( Z=3.05, 2.37, P=0.002, 0.018). Conclusion:Tumor contact length with the bladder wall is an independent risk factor for assessing muscle invasion of bladder cancer and the combination of VI-RADS score may enhances diagnostic accuracy.

Objective:To explore the value of the vesical imaging-reporting and data system (VI-RADS) score based on multiparametric MRI (mpMRI) combined with quantitative tumor MRI parameters in assessing the muscle invasion of bladder cancer.Methods:The study was a case-control study. The data of 87 bladder cancer patients confirmed by pathology who underwent mpMRI of the bladder were retrospectively collected from the First Medical Center of Chinese PLA General Hospital between January 2019 and April 2023 The pathological findings were used as the gold standard to categorize them into the muscle invasive bladder cancer (MIBC) group (29 cases) and non-muscle invasive bladder cancer (NMIBC) group (58 cases). Quantitative parameters were measured based on preoperative mpMRI images, including the length of tumor bladder wall contact, the perpendicular distance between the bladder tumor and the tangent of the bladder wall, the maximal diameter of the bladder tumor, and the volume of the bladder tumor. Bladder cancer was classified according to the VI-RADS scoring criteria. The Mann-Whitney U test was used for intergroup comparisons. Multivariate logistic regression analysis was performed to obtain the independent risk factors related to muscle invasion of bladder cancer and to establish the model. The receiver operating characteristic curves were analyzed for MRI quantitative parameters and logistic regression models, and area under the curve (AUC) comparisons were performed using the DeLong test. Results:The differences in tumor bladder wall contact length, perpendicular distance from the tumor to the tangent line of the bladder wall, maximum diameter, bladder tumor volume, and the VI-RADS scores were statistically significant between the MIBC group and the NMIBC group ( P<0.05). Multifactorial logistic regression analysis showed that tumor bladder wall contact length ( OR=21.07, 95% CI 3.56-124.89, P=0.001) and VI-RADS score ( OR=11.90, 95% CI 3.53-40.12, P<0.001) were the independent risk factors for evaluating the muscle invasion of bladder cancer. The difference between the VI-RADS score and the tumor bladder wall contact length for assessing muscular infiltration of bladder cancer had AUCs of 0.802 (95% CI 0.704-0.899) and 0.759 (95% CI 0.652-0.865). The combined model of VI-RADS score combined with tumor bladder wall contact length had an AUC of 0.891 (95% CI 0.812-0.970), which was higher than the diagnostic efficacy of applying tumor bladder wall contact length or VI-RADS score alone ( Z=3.05, 2.37, P=0.002, 0.018). Conclusion:Tumor contact length with the bladder wall is an independent risk factor for assessing muscle invasion of bladder cancer and the combination of VI-RADS score may enhances diagnostic accuracy.

Objective:To evaluate the diagnostic efficacy and practicality of the Jaundice color card (JCard) as a screening tool for neonatal jaundice.Methods:Following the standards for reporting of diagnostic accuracy studies (STARD) statement, a multicenter prospective study was conducted in 9 hospitals in China from October 2019 to September 2021. A total of 845 newborns who were admitted to the hospital or outpatient department for liver function testing due to their own diseases. The inclusion criteria were a gestational age of ≥35 weeks, a birth weight of ≥2 000 g, and an age of ≤28 days. The neonate′s parents used the JCard to measure jaundice at the neonate′s cheek. Within 2 hours of the JCard measurement, transcutaneous bilirubin (TcB) was measured with a JH20-1B device and total serum bilirubin (TSB) was detected. The Pearson′s correlation analysis, Bland-Altman plots and the receiver operating characteristic (ROC) curve were used for statistic analysis.Results:Out of the 854 newborns, 445 were male and 409 were female; 46 were born at 35-36 weeks of gestational age and 808 were born at ≥37 weeks of gestational age. Additionally, 432 cases were aged 0-3 days, 236 cases were aged 4-7 days, and 186 cases were aged 8-28 days. The TSB level was (227.4±89.6) μmol/L, with a range of 23.7-717.0 μmol/L. The JCard level was (221.4±77.0) μmol/L and the TcB level was (252.5±76.0) μmol/L. Both the JCard and TcB values showed good correlation ( r=0.77 and 0.80, respectively) and agreements (96.0% (820/854) and 95.2% (813/854) of samples fell within the 95% limits of agreement, respectively) with TSB. The JCard value of 12 had a sensitivity of 0.93 and specificity of 0.75 for identifying a TSB ≥205.2?μmol/L, and a sensitivity of 1.00 and specificity of 0.35 for identifying a TSB ≥342.0?μmol/L. The TcB value of 205.2?μmol/L had a sensitivity of 0.97 and specificity of 0.60 for identifying TSB levels of 205.2 μmol/L, and a sensitivity of 1.00 and specificity of 0.26 for identifying TSB levels of 342.0 μmol/L. The areas under the ROC curve (AUC) of JCard for identifying TSB levels of 153.9, 205.2, 256.5, and 342.0 μmol/L were 0.96, 0.92, 0.83, and 0.83, respectively. The AUC of TcB were 0.94, 0.91, 0.86, and 0.87, respectively. There were both no significant differences between the AUC of JCard and TcB in identifying TSB levels of 153.9 and 205.2 μmol/L (both P>0.05). However, the AUC of JCard were both lower than those of TcB in identifying TSB levels of 256.5 and 342.0 μmol/L (both P<0.05). Conclusions:JCard can be used to classify different levels of bilirubin, but its diagnostic efficacy decreases with increasing bilirubin levels. When TSB level are ≤205.2 μmol/L, its diagnostic efficacy is equivalent to that of the JH20-1B. To prevent the misdiagnosis of severe jaundice, it is recommended that parents use a low JCard score, such as 12, to identify severe hyperbilirubinemia (TSB ≥342.0 μmol/L).

Objective:To investigate applications of nonconsecutive aerobic resistance training among women with gestational diabetes mellitus, to provide reference for pregnancy health care.Methods:The convenient sampling method was adopted, a total of 110 gestational diabetes mellitus pregnant women were selected who established card and regular obstetric check-up in Zhongshan City People's Hospital from June 2019 to June 2020 as the study subjects. They were divided into experimental group and control group according to the random number table method, each group contained 55 cases. Both groups were given routine pregnancy health care, based on this, the control group received aerobic walking for 6 times a week, and the experimental group was implemented nonconsecutive aerobic resistance training for 6 times a week. The fasting blood glucose and 2 h postprandial blood glucose levels of the two groups were compared at the time of enrollment, the 4th week, the 8th week and the 12th week of intervention, childbirth outcome was also compared between two groups.Results:At the 8th week and the 12th week of intervention, the levels of fasting blood glucose were (5.15 ± 0.48), (4.85 ± 0.37) mmol/L in the experimental group, lower than (5.36 ± 0.46), (5.18 ± 0.48) mmol/L in the control group; at the 4th, 8th and 12th week of intervention, 2 h postprandial blood glucose levels were (6.45 ± 0.52), (6.34 ± 0.44), (6.21 ± 0.40) mmol/L in the experimental group, lower than (6.73 ± 0.56), (6.74 ± 0.48), (6.49 ± 0.45) mmol/L in the control group, the difference was statistically significant ( t values were 2.19-4.30, P<0.05). The natural delivery rate in the experimental group was 85.7% (42/49), which was higher than 69.2% (36/52) in the control group; the incidence of perineal injury and respiratory distress were 12.2% (6/49) and 2.0% (1/49) in the experimental group, lower than 28.9% (15/52) and 15.4% (8/52) in the control group, the difference was statistically significant ( χ2 = 3.89, 4.22, P<0.05). Conclusions:Nonconsecutive aerobic resistance training can effectively control blood glucose, increase the natutal delivery rate and improve delivery outcomes of women with gestational diabetes mellitus.

Objective:To explore the mechanism underlying microRNA (miR) -125a-mediated inhibition of proliferation of keratinocytes.Methods:After 24-hour pretreatment with interleukin (IL) -23, human HaCaT keratinocytes were divided into miR-125a group and miR-NC group transfected with a miR-125a overexpression plasmid and a control plasmid, respectively. Cell counting kit-8 (CCK8) assay was performed to evaluate the proliferative ability of HaCaT cells in the two groups at 0, 24, 48 and 72 hours after transfection, real-time fluorescence-based quantitative PCR to determine the mRNA expression of miR-125a and IL-23 receptors (IL-23R) in the two groups 24 hours after transfection, and Western blot analysis to determine the protein expression of IL-23R, Janus kinase 2 (JAK2) , protein kinase B (AKT) and phosphorylated AKT (p-AKT) in the two groups 48 hours after transfection. Dual-luciferase reporter assay was performed to verify the targeting relationship between miR-125a and IL-23R. Comparison of means between two groups was carried out by using t test, and changes in the proliferative ability of HaCaT cells over time were evaluated by using repeated measures analysis of variance. Results:After plasmid transfection, the relative expression of miR-125a was significantly higher in the miR-125a group (6.377 ± 0.745) than in the miR-NC group (0.700 ± 0.222; t=7.305, P=0.002) . At 0, 24 and 48 hours after transfection, there was no significant difference in cellular proliferative ability between the miR-125a group and the miR-NC group ( t=0.663, 0.623 and 1.930, respectively, all P > 0.05) ; at 72 hours after transfection, the cellular proliferative ability was significantly lower in the miR-125a group than in the miR-NC group ( t=4.407, P < 0.05) . The IL-23R mRNA expression was significantly lower in the miR-125a group than in the miR-NC group ( t=3.082, P < 0.05) . Compared with the miR-NC group, the miR-125a group showed significantly decreased protein expression of IL-23R, JAK2 and p-AKT ( t=11.715, 6.996, 12.424, P < 0.001,=0.002, < 0.001, respectively) . Dual-luciferase reporter assay showed targeted binding of miR-125a to IL-23R. Conclusion:MiR-125a may inhibit the proliferation of keratinocytes by negatively regulating the IL-23R/JAK2/AKT signaling pathway.

Objective:To investigate the correlation between microRNA-125a (miR-125a) expression and inflammatory cytokine levels in skin lesions of patients with psoriasis vulgaris, and to evaluate the effect of miR-125a on the proliferation of a human immortalized keratinocyte cell line HaCaT.Methods:Totally, lesional and adjacent non-lesional skin tissues were collected from 40 patients with psoriasis vulgaris in the Seventh People′s Hospital of Shenyang from 2017 to 2018, and real-time fluorescence-based quantitative reverse transcription PCR was performed to determine the expression of miR-125a in the skin tissues, as well as the mRNA expression of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), IL-6, and IL-17 in the lesional skin tissues. HaCaT cells were divided into 4 groups to be transfected with a miR-125a overexpression plasmid (miR-125a overexpression group), an overexpression control plasmid (overexpression control group), a miR-125a interference plasmid (miR-125a interference group) and an interference control plasmid (interference control group), respectively. Cell counting kit-8 (CCK8) assay was performed to assess the proliferative ability of HaCaT cells in the groups at 0, 24, 48, 72 hours after transfection, and double-antibody sandwich enzyme-linked immunosorbent assay (ELISA) to detect the levels of TNF-α, IL-1β, IL-6 and IL-17 in the culture supernatant of HaCaT cells. Spearman rank correlation test was used for correlation analysis, and t test for the comparison of means between two groups. Results:The relative expression of miR-125a was significantly lower in the lesional skin tissues (expressed as 2 -ΔΔCt, 0.389 ± 0.354) than in the non-lesional skin tissues (1.106 ± 0.396, t = 7.717, P < 0.001) in patients with psoriasis vulgaris. The expression of miR-125a was negatively correlated with the mRNA expression of TNF-α, IL-1β and IL-17 in psoriatic lesions ( r = -0.447, -0.424, -0.436, all P < 0.01). Immediately and 24 hours after transfection with the plasmids, there was no significant difference in the cell proliferative ability between the miR-125a overexpression group and overexpression control group ( t = 0.282, 1.445, respectively, both P > 0.05), or between the miR-125a interference group and interference control group ( t = 0.120, 1.543, respectively, both P > 0.05). Forty-eight and 72 hours after the transfection, the cell proliferative ability was significantly lower in the miR-125a overexpression group than in the overexpression control group ( t = 3.222, 4.563, respectively, both P < 0.05), but significantly higher in the miR-125a interference group than in the interference control group ( t = 3.036, 3.269, respectively, both P < 0.05). In addition, the miR-125a overexpression group showed significantly decreased levels of TNF-α and IL-1β compared with the overexpression control group ( t = 4.318, 3.813, respectively, both P < 0.05) . Conclusions:MiR-125a is lowly expressed in skin lesions of patients with psoriasis vulgaris. MiR-125a can inhibit the proliferation of keratinocytes, and may play a protective role in the occurrence and development of psoriasis.

Through the introduction of the gerontological nursing practice standards, the development course of practice, the scope of practice and gerontological nursing certification examination outline of American Nurses Credentialing Center in the US, the opinion about the development of gerontological nursing practice in our country is proposed. It is necessary to accelerate the cultivation of geriatric specialist nursing talent, and establishment of the scope and standards of gerontological nursing practice and geriatric specialized nurse certification system to cope with the development of aging society and improve gerontological nursing professional level in our country.

Objective To investigate the lens and pituitary dose impacted by additional filtration and collection field in head and neck DSA examinations. Methods All images were acquired by a Philips ALLura Xper FD 20 DSA machine. The combination of the different collection fields (48 cm, 42 cm, 31 cm, 22 cm) and additional filtrations (0.9 mmCu+1.0 mmAl, 0.4 mmCu+1.0 mmAl, 0.1 mmCu+1.0 mmAl) were adjusted when the anthropomorphic phantom filled with dosimeter was scanned in anterioposterior and lateral positions with 2D?DSA and 3D?DSA. The dose area product (DAP), air kerma (AK) and the radiation dose values of bilateral lens and pituitary were measured and recorded. The 2D and 3D?DSA regional absorption dose on lens and pituitary were analyzed using t' test, the correlations between DAP and AK parameters and different regional absorption doses were evaluated by Pearson rank correlation coefficient. Results Absorption doses of left lens, right lens and pituitary with 2D?DSA (n=12) were as following:(2.77 ± 0.68), (6.23 ± 3.54), (8.65 ± 2.62) mGy, while the parameters with 3D?DSA (n=12) were (1.78 ± 0.82), (2.18±1.15), (3.32±0.64) mGy, respectively;the results revealed a significant difference (t'=3.20, 3.76 and 6.85, P<0.01). DAP [(8 739±5 731) mGy·cm2] had a relationship with absorption dose of pituitary, left lens and right lens [(5.988 ± 3.299),( 2.258 ± 0.872),( 4.207 ± 3.303) mGy, r values were 0.766, 0.684, 0.727; P<0.01]. AK values was (31 ± 23) mGy and it had a relationship with pituitary absorption dose (r value was 0.894, P<0.01). The lens dose was reduced when the additional filtration was increased and the collection field was decreased, the radiation dose of the pituitary was reduced when both the additional filtration and the collection field were increased. Conclusions In the head and neck DSA examinations, the radiation dose of the lens and the pituitary had different changes with the different additional filters and collecting fields. The organ dose with 3D?DSA was significantly less than that with 2D?DSA.

Objective To investigate the effect of different additional filtration thickness of DSA on image quality and radiation dose with cerebral angiography. Methods Prospective collected 90 patients with DSA examination of the whole cerebral artery, patients were divided into A, B and C group according to the time of the examination, each group included 30 cases. Patients underwent conventional DSA, the additional filtration of group A, B and C were (1.0 mmAl+0.1 mmCu), (1.0 mmAl+0.4 mmCu) and (1.0 mmAl+0.9 mmCu), respectively. Dose area product (DAP), air kerma (AK), tube current and tube voltage of anteroposterior and lateral radiography of the whole brain were recorded, and scored the image quality. Eye lens organ dose values were obtained by using simulation phantom and LiF dosemeter under A, B and C groups with three different additional filtrations for cerebral angiography. The image quality scores and the radiation dosewere analyzed by one-way ANOVA tests or Kruskal-Wallis tests. Results The image quality comprehensive score of three groups showed significant difference (F=40.07,P<0. 01), which were (3.8±0.4), (3.6 ± 0.5) and (3.0 ± 0.6), respectively. The DAP and AK value of anteroposterior and lateral radiography of three groups also showed significant difference (P<0.05), B and C group were lower than the A group. Left and right eye lens organ dose were decreased along with the increase of the additional filtration thickness, and the difference between the 3 groups also had significant difference (P<0.01). Conclusion Both the image quality and radiation dose can acquire when conducted the whole brain DSA with 1.0 mmAl+0.4 mmCu additional filtration.

Objective To investigate the expression of nuclear factor-kappa Bp65 (NF-κBp65)and Toll-like receptor 4(TLR4)protein in the brain tissues of 7-day-old Sprague-Dawley(SD) rats with cerebral hypoxia-ischemia encephalopathy (HIE) and to explore the role of TLR4 and NF-κBp65 in the pathogenesis of neonatal rats with hypoxic-ischemic brain damage.Methods Seven-day SD rats were randomly divided into the experimental group and the control group.Brain pathological changes were observed in light microscopy at 6 h、12 h、24 h、72 h、7 d after HIE.The expression of TLR4 and NF-κBp65 in brain tissues were analyzed by immunohistochemistry method.Results NF-κBp65 and TLR4 were expressed in the neuron and microglia of control group and experimental group.The expression were most significant at cerebral cortex and hippocamp.However,the expression of NF-κBp65and TLR4 began to increase at HIE 6h:NF-κBp65 (0.219 3 ± 0.024 7,0.215 7 ±0.030 4)and TLR4(0.327 1 ±0.033 3,0.303 9 ±0.037 9),and achieved the hightest at HIE 24h:NF-κBp65 (0.3564±0.0235,0.3365 ±0.023 2)and TLR4(0.434 2 ±0.0428,0.4193 ±0.041 3),then decreased at HIE 72 h:NF-κBp65 (0.289 2 ± 0.032 0,0.260 9 ± 0.021 2) and TLR4 (0.300 5 ± 0.020 9,0.282 0 ± 0.022 6),and HIE 7 d:NF-κBp65(0.247 9 ±0.0340,0.242 1 ±0.025 4) and TLR4(0.274 4 ±0.0288,0.257 1 ±0.027 5).Conclusion There is a positive correlation between NF-κBp65 and TLR4 in rats with HIE.It suggested that they may have the same pathophysiology development in HIE.