Objective:To discuss the effect of berberine hydrochloride(BBR)on autophagy in the HeLa cells infected with herpes simplex virus type 1(HSV-1),and to clarify its related mechanism.Methods:The HeLa cells at logarithmic growth phase were added with 0,10,20,40,80,120,and 160 μmol·L-1 BBR,respectively,and cultured for 24 h.In addition,the HeLa cells were divided into HSV-1 group(the cells were infected with HSV-1),L-BBR group(were infected with HSV-1 and then treated with 20 μmol·L-1 BBR for 24 h),M-BBR group(were infected with HSV-1 and then treated with 40 μmol·L-1 BBR for 24 h),H-BBR group(were infected with HSV-1 and then treated with 80 μmol·L-1 BBR for 24 h),and 740 Y-P group(were infected with HSV-1 and then treated with 80 μmol·L-1 BBR and 10 μmol·L-1 740 Y-P for 24 h)for viral infection and corresponding drug treatment.MTT method was used to detect the activities of microtubule-associated protein 1 light chain 3(LC3)the HeLa cells after treated with different concentrations of BBR;plaque reduction assay was used to detect the proliferation ability of HSV-1 in the HeLa cells in various groups;real-time fluorescence quantitative PCR(RT-qPCR)method was used to detect the mRNA expression levels of virus replication-related genes in the HeLa cells in various groups;immunofluorescence method was used to detect the formation of autophagosomes in the HeLa cells in various groups;flow cytometry was used to detect the apoptotic rate of the HeLa cells in various groups;Western blotting method was used to detect the expression levels of autophagy and the phosphoinositide 3-kinase(PI3K)/protein kinase B(AKT)/mammalian target of rapamycin(mTOR)pathway pathway-related proteins in the HeLa cells in various groups.Results:The MTT method results showed that compared with 0 μmol·L-1 BBR group,the activities of the HeLa cells in 120 and 160 μmol·L-1 BBR groups were significantly decreased(P<0.05),which had certain toxicity to the cells;20,40,and 80 μmol·L-1 BBR were selected for subsequent experiments.The plaque reduction assay results showed that compared with HSV-1 group,the plaque forming units(PFUs)in the HeLa cells in L-BBR group,M-BBR group,and H-BBR group were significantly decreased(P<0.05)in a dose-dependent manner;compared with H-BBR group,the PFUs in the HeLa cells in 740 Y-P group were significantly increased(P<0.05).The RT-qPCR results showed that compared with HSV-1 group,the mRNA expression levels of infected cell protein 0(ICP0),infected cell protein 22(ICP22),infected cell protein 8(ICP8),thymidine kinase(TK),glycoprotein B(gB),and glycoprotein D(gD)in the HeLa cells in L-BBR group,M-BBR group,and H-BBR group were significantly decreased(P<0.05)in a dose-dependent manner;compared with H-BBR group,the expression levels of ICP0,ICP22,ICP8,TK,gB,and gD mRNA in the HeLa cells in 740 Y-P group were significantly increased(P<0.05).The immunofluorescence method results showed that compared with HSV-1 group,the number of LC3 autophagosomes formed in the HeLa cells in L-BBR group,M-BBR group,and H-BBR group was increased;compared with H-BBR group,the number of LC3 autophagosomes formed in the HeLa cells in 740 Y-P group was decreased.The flow cytometry results showed that compared with HSV-1 group,the apoptotic rates of the HeLa cells in L-BBR group,M-BBR group,and H-BBR group were significantly increased(P<0.05)in a dose-dependent manner;compared with H-BBR group,the apoptotic rate of the HeLa cells in 740 Y-P group was significantly decreased(P<0.05).The Western blotting method results showed that compared with HSV-1 group,the expression levels of Beclin-1 and B-cell lymphoma 2(Bcl-2)/adenovirus E1B 19kDa protein interacting protein protein(BNIP)2 proteins and the ratios of LC3-Ⅱ/LC3-Ⅰ in the HeLa cells in L-BBR group,M-BBR group,and H-BBR group were significantly increased(P<0.05)in a dose-dependent manner;compared with H-BBR group,the expression levels of Beclin-1 and BNIP proteins and the LC3-Ⅱ/LC3-Ⅰ ratio in the HeLa cells in 740 Y-P group were significantly decreased(P<0.05);compared with HSV-1 group,the expression levels of cysteine-containing aspartate protein hydrolase 1(Caspase-1),cysteine-containing aspartate protein hydrolase 3(Caspase-3),and Bcl-2 associated X protein(Bax)proteins in the HeLa cells in L-BBR group,M-BBR group,and H-BBR group were significantly increased(P<0.05),and the expression level of Bcl-2 protein was significantly decreased(P<0.05)in a dose-dependent manner;compared with H-BBR group,the expression levels of Caspase-1,Caspase-3,and Bax proteins in the HeLa cells in 740 Y-P group were significantly decreased(P<0.05),and the expression level of Bcl-2 protein was significantly increased(P<0.05);compared with HSV-1 group,the ratios of phosphorylated PI3K(p-PI3K)/PI3K,phosphorylated AKT(p-AKT)/AKT,and phosphorylated mTOR(p-mTOR)/mTOR in the HeLa cells in L-BBR group,M-BBR group,and H-BBR group were significantly decreased(P<0.05)in a dose-dependent manner;compared with H-BBR group,the ratios of p-PI3K/PI3K,p-Akt/Akt,and p-mTOR/mTOR in the HeLa cells in 740 Y-P group were significantly increased(P<0.05).Conclusion:BBR can promote the autophagy process in the HeLa cells infected with HSV-1 by regulating the PI3K/AKT/mTOR pathway,induce autophagy-dependent apoptosis,and significantly inhibit the virus replication.

Peripheral pulmonary lesions(PPL),including peripheral pulmonary nodules,are common lung problems.As the increase of patients with lung nodules,the demand for tissue sampling also increases.Safe and accurate biopsy techniques are very important for patients to identify benign and malignant lesions.Electronic bronchoscopy is one of the biopsy techniques for the diagnosis of PPL in recent decades.Various guiding techniques,such as radial probe endobronchial ultrasound and virtual navigation bronchoscope,have been proved to improve the performance of conventional bronchoscopy.This paper aims to provide an review of the available data on advanced bronchoscopic techniques and explore their application in diagnosing PPL.

Objective To investigate the independent risk factors for postoperative deep vein thrombosis in lung cancer patients and to construct a risk prediction model.Methods Clinical data of 354 inpatients who underwent thoracoscopic surgery for lung cancer in Department of Thoracic Surgery of First Affiliated Hospital of Army Medical University between May 2019 and May 2023 were retrospectively collected and analyzed.LASSO regression was used to screen potential factors,followed by multivariate logistic regression to identify risk factors,and then a nomogram prediction model was constructed.Calibration curves,receiver operating characteristic(ROC)curves,and decision curves were drawn to evaluate the model's calibration,discrimination,sensitivity,specificity,and clinical utility.The net reclassification improvement(NRI)and integrated discrimination improvement(IDI)indices were employed to compare the predictive performance of the constructed model with the Caprini score for outcome events.Results LASSO regression identified 17 potential influencing factors.Multivariate regression analysis showed that D-dimer,central venous catheter(CVC)placement,and lower extremity varicose veins were independent risk factors for postoperative DVT in lung cancer patients(P＜0.05).Calibration curve analysis showed the model had good agreement between the predicted and observed values.ROC curve analysis indicated that the sensitivity and specificity of the model was 0.812 and 0.963,respectively,with an area under the curve(AUC)value of 0.912(95％CI:0.840～0.983).In comparison,the Caprini model had a sensitivity and specificity of 0.625 and 0.860,respectively,with an AUC value of 0.752(95％CI:0.657～0.846).The NRI and IDI for the model group compared to the Caprini model were 0.709 and 0.431,respectively.Decision curve analysis showed that the net benefit of applying the model from this study was higher than that of the Caprini model.Conclusion D-dimer,CVC,and varicose veins of lower extremities are independent risk factors for DVT after thoracoscopic surgery in patients with lung cancer.Our constructed nomogram model can effectively predict the risk of DVT after thoracoscopic surgery in patients with lung cancer.

Objective To analyze the magnetic resonance images (MRI) of patients with spinal epidural lipomatosis (SEL) in high-altitude areas and to determine the optimal cut-off value for diagnosis with epidural fat thickness. Methods This retrospective study included patients who underwent lumbosacral MRI examination for lumbosacral pain in Ping’an District Hospital of Traditional Chinese Medicine, Haidong City, China from January 1, 2021 to December 31, 2022. The epidural fat thickness in vertebral segments T12/L1 to L5/S1 was compared between the SEL group and the non-SEL group. The diagnostic efficacy with different cut-off values at each vertebral segment was evaluated. Between-group comparisons were performed using the t-test, Mann-Whitney U test, chi-square test, or modified chi-square test. The area under the receiver operating characteristic (AUC) was used to evaluate the diagnostic efficiency. The DeLong test was used to compare AUC between the two groups. Results A total of 370 patients were included (60 in the SEL group and 310 in the non-SEL group). There were no significant differences in age, sex, height, body weight, and body mass index between the two groups (all P > 0.05). At different vertebral segments, the epidural fat thickness was significantly higher in the SEL group than in the non-SEL group (all P < 0.05). The cut-off values for SEL diagnosis with epidural fat thickness in segments T12/L1 to L5/S1 were 2.23, 4.25, 4.85, 5.57, 7.21, and 8 mm, respectively. The AUC of MRI SEL diagnosis with epidural fat thickness in segment L5/S1 was the highest (0.945, 95% confidence interval [CI]: 0.916-0.966, P < 0.001). SEL diagnosis with epidural fat thickness > 8 mm in segment L5/S1 was the most accurate, with an AUC of 0.931 (95% CI: 0.901-0.955, P < 0.001), a sensitivity of 95.0%, and a specificity of 91.3%; this AUC was significantly higher than those of diagnosis with other cut-off values (all P < 0.05). Conclusion SEL patients have significantly increased epidural fat in the spinal canal. Epidural fat thickness > 8 mm in segment L5/S1 can be used for diagnosis of SEL with improved efficiency and accuracy.

Pediatric idiopathic nephrotic syndrome (INS) is characterized by massive albuminuria, hypoproteinemia, edema and hyperlipidemia, with a long course and high probability of relapse and prolongation. Long-term complications caused by long-term usage of hormones and immunosuppressants in children with INS seriously affect their physical and mental health and quality of life. Most children with steroid-sensitive nephrotic syndrome can be cured before adulthood, while some of them relapse in adulthood. Long-term prognosis of children with steroid-resistant nephrotic syndrome is poor. There have been few studies in China followed the long-term outcomes and its related factors of children with INS over 10 years. The paper reviewed the literatures on the long-term outcomes of children with INS, including renal survival, growth, mental health, learning and work, marriage and fertility, disease recurrence and long-term related complications, to explore the factors related to the poor long-term outcomes of children with INS and to assist in clinical decision-making and follow-up management.

Objective To investigate the recognition efficiency of AI model based on deep learning for cardiac conduction system(CCS).Methods HE staining sections of cardiac muscle and CCS of 17 cases of non-sudden death were selected,and the gold standard was unanimous recognition by 2 forensic pathologists with more than 20 years of CCS diagnosis experience.Inception V3 algorithm was used to establish AI model and complete CCS identification training and testing.Confusion matrix,accuracy,precision,recall,F1 score,ROC curve and AUC value were used to evaluate the effectiveness of AI model,and accuracy,sensitivity and specificity were used to evaluate the efficiency of manual independent and AI-assisted manual recognition for CCS.Results The accuracy of AI model was 87.3%,the precision was 91.9%,the recall was 81.9%,the F1 score was 86.6%,and the AUC value was 95.3%.The accuracy of AI model was higher than that of senior forensic pathologists.There was no statistical significance in the accuracy of AI-assisted senior forensic pathologists in identifying CCS compared with manual independent detection(P>0.05),while the accuracy of AI-assisted intermediate and junior forensic pathologists in identifying CCS was increased by 8%and 14.33%,respectively,with statistical significance(P<0.05).The accuracy rate of AI-assisted junior forensic pathologists to identify CCS was higher than that of intermediate forensic pathologists in self-diagnosis.Conclusion The AI model could be used for the automatic recognition of CCS,and could improve the diagnostic efficiency of CCS and narrow the gap between the forensic pathologists with low experience and that with high experience.

Objective:To explore and analyze the effect of therapeutic communication system (TCS) intervention mode on Therapeutic effect and quality of life in patients with cardiac valve replacement.Methods:A total of 103 patients with cardiac valve replacement admitted from February 2018 to February 2019 were selected and divided into observation group (51 cases) and control group (52 cases) according to the random number table method. Patients in the control group were treated with staged rehabilitation intervention, while patients in the observation group were treated with staged rehabilitation combined with TCS intervention mode. Patients' prognosis, the score of Short Form 36-item Health Survey (SF-36) before and after intervention, the changes in the score of the Morisky label Scale (MMAS-8) before and after intervention, and perioperative indicators were recorded and compared between the two groups.Results:The quality of life scores of the observation group at 1 month,3 months and 6 months after intervention were (64.42±9.51), (76.23±9.19), (87.24±9.21) points, which were significantly higher than (58.73±9.38), (61.23±9.29), (76.29±9.42) points of the control group ( t values were 3.057, 8.237, 5.964, P<0.05);and also higher than those before intervention (54.29±9.14, 54.45± 9.31), the difference was statistically significant ( F values were 11.358, 7.581, P<0.001); the ICU hospitalization time (43.25±1.72),bed rest time (42.13±8.32) and hospitalization time (16.32±4.20) days in the observation group were significantly lower than (54.34±1.93), (72.33±8.54), (21.24±4.36) days in the control group, and the difference was statistically significant ( t values were 30.766, 18.174, 5.831, P<0.001); the drug compliance (7.21±0.17) was significantly higher than that of the control group (6.01±0.34) ( t value was 22.588, P<0.001). Conclusion:Stage rehabilitation combined with TCS intervention mode can effectively improve the prognosis and perioperative indicators of patients with heart valve, and improve the quality of life of patients, which is worthy of clinical application.