Objective To investigate the effect of asperuloside(ASP)on the malignant progression and chemotherapy resistance of hepatocellular carcinoma(HCC)cells by regulating the supersonic hedgehog(SHH)/glioma-associated oncogene homolog 1(GLI1)signaling pathway.Methods The expression of SHH and GLI1 protein in human hepatocellular carcinoma cell line(SMMC-7721)/adriamycin(ADM)and SMMC-7721 cell line were detected by Western blot(WB).The HCC drug-resistant cell line SMMC-7721/ADM were divided into Control group,ADM group,L-ASP group(1 mmol/L ASP),M-ASP group(2 mmol/L ASP),H-ASP group(3 mmol/L ASP),ASP+PM group(1 μmol/L SHH/GLI1 signaling pathway activator PM).Ex-cept for Control group,5 μg/mL ADM was added to each group.The effect of ASP on the proliferation of SMMC-7721/ADM cells was detected by cell counting kit-8(CCK8)assay and plate cloning assay.The effect of ASP on the invasion and migration of SMMC-7721/ADM cells were detected by Transwell assay.The effect of ASP on the apoptosis of SMMC-7721/ADM cells was detected by flow cytometry.The expression of SHH,GLI1,proliferating cell nuclear antigen(PCNA),matrix metalloproteinase-9(MMP-9)and B cell lymphoma-2 associated X protein(Bax)in SMMC-7721/ADM cells were detected by WB.Animal experiments verified the effect of ASP on the growth of HCC xenografts and the expression of SHH/GLI1 signaling pathway proteins.Results The expression of SHH and GLI1 in SMMC-7721/ADM cells were higher than those in SMMC-7721 cells(P＜0.05).L-ASP group,M-ASP group and H-ASP group decreased the proliferation,migration and in-vasion of SMMC-7721/ADM cells in a dose-dependent manner,decreased the expression of SHH,GLI1,PCNA and MMP-9,and promoted cell apoptosis and Bax expression(P＜0.05).SHH/GLI1 signaling pathway acti-vator PM could reverse the inhibitory effect of H-ASP treatment on malignant progression and chemotherapy resistance of SMMC-7721/ADM cells(P＜0.05).ASP could inhibit the growth of HCC transplanted tumor and the expression of SHH and GLI1(P＜0.05).Conclusion ASP can inhibit the malignant progression of HCC cells and enhance the sensitivity of chemotherapy,which may be achieved by inhibiting the SHH/GLI1 signaling pathway.

Objective:To investigate the predictive value of the triglyceride-high-density lipoprotein cholesterol-glucose-body mass index (TyHGB) and triglyceride-glucose-body mass index (TyG-BMI) in early pregnancy for gestational diabetes mellitus (GDM) and pregnancy outcomes.Methods:A retrospective analysis was conducted, a total of 600 pregnant women who underwent prenatal examinations at North China Medical and Health Group Xingtai General Hospital from August 2020 to August 2023 were collected. Participants were divided into GDM group (76 cases) and non-GDM group (524 cases) based on GDM occurrence, and further categorized into adverse pregnancy group (101 cases) and favorable pregnancy group (499 cases) based on outcomes. Multivariate Logistic regression was used to identify risk factors for GDM and adverse pregnancy. The predictive performance of TyHGB and TyG-BMI was evaluated using receiver operating characteristic (ROC) curves.Results:After adjusting for confounders, TyHGB and TyG-BMI were independent risk factors for GDM ( OR = 1.569, 95% CI 1.259 -1.955; OR = 1.109, 95% CI 1.029 - 1.038) and adverse pregnancy ( OR = 1.438, 95% CI 1.193 - 1.734; OR = 1.021, 95% CI 1.014 - 1.029). The area under the curve (AUC) for TyHGB and TyG-BMI alone in predicting GDM was 0.677 and 0.731, respectively. Combined prediction of GDM yielded an AUC of 0.793, with sensitivity of 72.37% and specificity of 65.81%. For adverse pregnancy, the AUC of TyHGB and TyG-BMI alone were 0.666 and 0.692, respectively, while their combination achieved AUC of 0.746, with specificity of 69.34% and sensitivity of 65.35%. Conclusions:TyHGB and TyG-BMI in early pregnancy are risk factors for GDM and adverse pregnancy outcomes. Their combination can enhance predictive efficacy for both conditions.

Objective:To investigate the predictive value of the triglyceride-high-density lipoprotein cholesterol-glucose-body mass index (TyHGB) and triglyceride-glucose-body mass index (TyG-BMI) in early pregnancy for gestational diabetes mellitus (GDM) and pregnancy outcomes.Methods:A retrospective analysis was conducted, a total of 600 pregnant women who underwent prenatal examinations at North China Medical and Health Group Xingtai General Hospital from August 2020 to August 2023 were collected. Participants were divided into GDM group (76 cases) and non-GDM group (524 cases) based on GDM occurrence, and further categorized into adverse pregnancy group (101 cases) and favorable pregnancy group (499 cases) based on outcomes. Multivariate Logistic regression was used to identify risk factors for GDM and adverse pregnancy. The predictive performance of TyHGB and TyG-BMI was evaluated using receiver operating characteristic (ROC) curves.Results:After adjusting for confounders, TyHGB and TyG-BMI were independent risk factors for GDM ( OR = 1.569, 95% CI 1.259 -1.955; OR = 1.109, 95% CI 1.029 - 1.038) and adverse pregnancy ( OR = 1.438, 95% CI 1.193 - 1.734; OR = 1.021, 95% CI 1.014 - 1.029). The area under the curve (AUC) for TyHGB and TyG-BMI alone in predicting GDM was 0.677 and 0.731, respectively. Combined prediction of GDM yielded an AUC of 0.793, with sensitivity of 72.37% and specificity of 65.81%. For adverse pregnancy, the AUC of TyHGB and TyG-BMI alone were 0.666 and 0.692, respectively, while their combination achieved AUC of 0.746, with specificity of 69.34% and sensitivity of 65.35%. Conclusions:TyHGB and TyG-BMI in early pregnancy are risk factors for GDM and adverse pregnancy outcomes. Their combination can enhance predictive efficacy for both conditions.

Background: and Purpose CGG repeat expansion in the 5' untranslated region (5'UTR) of the Notch 2 N-terminal-like C gene (NOTCH2NLC) has been associated with neuronal intranuclear inclusion disease (NIID) and oculopharyngodistal myopathy type 3 (OPDM3). Few OPDM3 patients have been reported. This report describes two OPDM3 patients with novel imaging findings who presented the typical features of NIID, and reviews all OPDM3 cases available in the literature. Methods: The available clinical, imaging, and pathological information was reviewed and investigated. CGG repeat expansion in the 5'UTR of NOTCH2NLC was tested using the repeatprimed polymerase chain reaction (PCR), followed by the fluorescence amplicon-length PCR to determine the number of CGG repeats. Results: Our two OPDM3 patients and most patients reported in the literature developed the typical clinical characteristics of NIID, including leukoencephalopathy, peripheral neuropathy, cognitive deterioration, pigmentary retinopathy, ataxia, tremor, acute encephalitis-like episodes, pigmentary retinopathy, miosis, and sensorineural hearing loss. In addition to typical imaging findings of NIID, our two patients exhibited diffusion weighted imaging (DWI) hyperintensities in the middle cerebellar peduncles, which have not been described previously. Muscle biopsies revealed rimmed vacuoles and p62-positive intranuclear inclusions in the myofibers in both patients. The skin biopsy performed in one patient detected typical eosinophilic intranuclear inclusions. Genetic analysis identified CGG repeat expansion in NOTCH2NLC as the causative mutation in the two patients. Conclusions Our two patients with OPDM3 had clinical characteristics of NIID and exhibited DWI abnormality in the cerebellum. Our results indicate that OPDM3 is within the spectrum of NIID and that DWI hyperintensities in the cerebellum are helpful for diagnosing NIID or OPDM3.

Background: and Purpose CGG repeat expansion in the 5' untranslated region (5'UTR) of the Notch 2 N-terminal-like C gene (NOTCH2NLC) has been associated with neuronal intranuclear inclusion disease (NIID) and oculopharyngodistal myopathy type 3 (OPDM3). Few OPDM3 patients have been reported. This report describes two OPDM3 patients with novel imaging findings who presented the typical features of NIID, and reviews all OPDM3 cases available in the literature. Methods: The available clinical, imaging, and pathological information was reviewed and investigated. CGG repeat expansion in the 5'UTR of NOTCH2NLC was tested using the repeatprimed polymerase chain reaction (PCR), followed by the fluorescence amplicon-length PCR to determine the number of CGG repeats. Results: Our two OPDM3 patients and most patients reported in the literature developed the typical clinical characteristics of NIID, including leukoencephalopathy, peripheral neuropathy, cognitive deterioration, pigmentary retinopathy, ataxia, tremor, acute encephalitis-like episodes, pigmentary retinopathy, miosis, and sensorineural hearing loss. In addition to typical imaging findings of NIID, our two patients exhibited diffusion weighted imaging (DWI) hyperintensities in the middle cerebellar peduncles, which have not been described previously. Muscle biopsies revealed rimmed vacuoles and p62-positive intranuclear inclusions in the myofibers in both patients. The skin biopsy performed in one patient detected typical eosinophilic intranuclear inclusions. Genetic analysis identified CGG repeat expansion in NOTCH2NLC as the causative mutation in the two patients. Conclusions Our two patients with OPDM3 had clinical characteristics of NIID and exhibited DWI abnormality in the cerebellum. Our results indicate that OPDM3 is within the spectrum of NIID and that DWI hyperintensities in the cerebellum are helpful for diagnosing NIID or OPDM3.

Background: and Purpose CGG repeat expansion in the 5' untranslated region (5'UTR) of the Notch 2 N-terminal-like C gene (NOTCH2NLC) has been associated with neuronal intranuclear inclusion disease (NIID) and oculopharyngodistal myopathy type 3 (OPDM3). Few OPDM3 patients have been reported. This report describes two OPDM3 patients with novel imaging findings who presented the typical features of NIID, and reviews all OPDM3 cases available in the literature. Methods: The available clinical, imaging, and pathological information was reviewed and investigated. CGG repeat expansion in the 5'UTR of NOTCH2NLC was tested using the repeatprimed polymerase chain reaction (PCR), followed by the fluorescence amplicon-length PCR to determine the number of CGG repeats. Results: Our two OPDM3 patients and most patients reported in the literature developed the typical clinical characteristics of NIID, including leukoencephalopathy, peripheral neuropathy, cognitive deterioration, pigmentary retinopathy, ataxia, tremor, acute encephalitis-like episodes, pigmentary retinopathy, miosis, and sensorineural hearing loss. In addition to typical imaging findings of NIID, our two patients exhibited diffusion weighted imaging (DWI) hyperintensities in the middle cerebellar peduncles, which have not been described previously. Muscle biopsies revealed rimmed vacuoles and p62-positive intranuclear inclusions in the myofibers in both patients. The skin biopsy performed in one patient detected typical eosinophilic intranuclear inclusions. Genetic analysis identified CGG repeat expansion in NOTCH2NLC as the causative mutation in the two patients. Conclusions Our two patients with OPDM3 had clinical characteristics of NIID and exhibited DWI abnormality in the cerebellum. Our results indicate that OPDM3 is within the spectrum of NIID and that DWI hyperintensities in the cerebellum are helpful for diagnosing NIID or OPDM3.

Objective:To explore a better virtual reality (VR) aviation rescue training mode and equipment platform by comparing the application of VR gloves and handle.Methods:A control study was used. Forty undergraduate students were enrolled by using cluster sampling method in this study. They were averagely divided into VR glove group and the VR handle group. Both groups were respectively trained with VR glove and VR handle based on an aviation rescue script of the craniocerebral trauma in traffic accident and the training effect was analyzed by comparing the assessments between VR training and reality simulation. The assessment were conducted both by VR and actual operation trainings and the content included operation, evaluation judgment, and total training time consumed. After the training was completed, the students of 2 groups were investigated by questionnaire.Results:In the VR assessment, the training time for the VR handle group [(26.94±2.00) min] was lower than that of the VR glove group [(31.23±2.23) min], and the difference was significant ( t=6.42, P<0.001). In the reality simulation assessment, the operation score of the VR glove group [(37.80±7.08) points] was higher than that of the VR handle group [(30.40±6.07) points], with a significant difference ( t=3.55, P<0.001). There was no significant difference between the scores of VR assessment and reality simulation assessment in the VR glove group. The reality simulation operation score of the VR handle group [(30.40±6.07) points] was lower than the VR operation score [(36.20±8.15) points], and the difference was significant ( t=2.55, P=0.015). The reality simulation operation time [(30.25±1.66) min] was higher than the VR operation time [(26.94±2.00) min], and the difference was significant ( t=5.59, P<0.001).The scores of assessing operation diversity and the integration with reality in VR glove group were higher than that in VR handle group ( Z=-4.00, -2.00, P<0.001,=0.045), but the scores of positioning accuracy and button functions were lower ( Z=-2.30, t=5.70, P=0.022,<0.001). Conclusions:VR technology has some advantages in helicopter aviation rescue training, has a broad prospect. As the VR human-machine data exchange equipment, both gloves and handles could bring good training effect even they have their own disadvantages. It is still necessary to improve VR software and equipment, and promote the quality of air rescue training in multiple aspects.

Objective:To explore a better virtual reality (VR) aviation rescue training mode and equipment platform by comparing the application of VR gloves and handle.Methods:A control study was used. Forty undergraduate students were enrolled by using cluster sampling method in this study. They were averagely divided into VR glove group and the VR handle group. Both groups were respectively trained with VR glove and VR handle based on an aviation rescue script of the craniocerebral trauma in traffic accident and the training effect was analyzed by comparing the assessments between VR training and reality simulation. The assessment were conducted both by VR and actual operation trainings and the content included operation, evaluation judgment, and total training time consumed. After the training was completed, the students of 2 groups were investigated by questionnaire.Results:In the VR assessment, the training time for the VR handle group [(26.94±2.00) min] was lower than that of the VR glove group [(31.23±2.23) min], and the difference was significant ( t=6.42, P<0.001). In the reality simulation assessment, the operation score of the VR glove group [(37.80±7.08) points] was higher than that of the VR handle group [(30.40±6.07) points], with a significant difference ( t=3.55, P<0.001). There was no significant difference between the scores of VR assessment and reality simulation assessment in the VR glove group. The reality simulation operation score of the VR handle group [(30.40±6.07) points] was lower than the VR operation score [(36.20±8.15) points], and the difference was significant ( t=2.55, P=0.015). The reality simulation operation time [(30.25±1.66) min] was higher than the VR operation time [(26.94±2.00) min], and the difference was significant ( t=5.59, P<0.001).The scores of assessing operation diversity and the integration with reality in VR glove group were higher than that in VR handle group ( Z=-4.00, -2.00, P<0.001,=0.045), but the scores of positioning accuracy and button functions were lower ( Z=-2.30, t=5.70, P=0.022,<0.001). Conclusions:VR technology has some advantages in helicopter aviation rescue training, has a broad prospect. As the VR human-machine data exchange equipment, both gloves and handles could bring good training effect even they have their own disadvantages. It is still necessary to improve VR software and equipment, and promote the quality of air rescue training in multiple aspects.

Objective To evaluate the effect of double filtration plasmapheresis(DFPP)on patients with hyperlipidemic acute pancreatitis(HL-AP).Methods The clinical data of the patients with hyperlipidemic severe acute pancreatitis(HL-SAP)or moderately severe acute pancreatitis(HL-MSAP)from January 2019 to May 2022 were collected.The patients were divided into two groups,the control group received conventional treatment,DFPP group received DFPP treatment on the basis of conventional treatment.Results Compared with the control group,the following parameters changed significantly in DFPP group,triglyceride(TG),alanine aminotransferase(ALT)and aspartate aminotransferase(AST)decreased on day 1 and 2,estimated glomerular filtration rate(eGFR)increased on day 1,2,3 and 5,leukocyte and neutrophil counts decreased on day 1 and 2,hemoglobin(HGB)decreased on day 1,2,and 3,C-reactive protein(CRP)decreased on day 1,2,3,5,and 7.And the patients in DFPP group receiving mechanical ventilation decreased compared with that in control group.Conclusion Compared with conventional treatment,DFPP can reduce plasma TG faster,improve lung,liver and kidney function,reduce inflammatory markers,and facilitate early fluid recovery.

PurposePulmonary tuberculosis (PTB) in the patients with AIDS often manifest as an atypical clinical manifestations, less positive rate in lab and various imaging features. This paper aims to compare the clinical and imaging manifestations of PTB in patients with AIDS and in patients with normal immunity may help us to improve the understanding of PTB in AIDS.Materials and MethodsThe clinical manifestations, the lab results and chest imaging data of 142 conifrmed PTB in patients with AIDS (observation group) and 150 conifrmed PTB in patients with normal immunity (control group) were retrospectively analyzed, the imaging review included the site, shape, density, property and the enhancement patterns of the enlarged lymph node in mediastinum and the status of pleura.ResultsThe incidences of fever, dyspnea, asthenia, anorexia, loss of weight, diarrhea, blurred vision, urinary irritation, oral leukoplakia, pruritus, rash, other pulmonary infections and extrapulmonary tuberculosis in observation group were signiifcantly higher than those in control group (χ2=4.173-68.542,P<0.05,P<0.01,P<0.001). The positive rates of tuberculosis in cough, hemoptysis, putum smear and sputum culture in observation group were signiifcantly lower than those in control group (χ2=30.376, 9.254 and 16.200, P<0.05). Imaging manifestations: observation group of type I, type II, type IV and type V patients were more than those in the control group (χ2=5.977, 8.621, 18.769 and 20.864, P<0.05). The lesions located at middle and lower lobes and involved more than three lobes in observation group than in control group at the same time (χ2=18.692 and 5.860,P<0.05, P<0.001), military nodules, enlarged lymph nodes in mediastinum and pleural effusion appeared more commonly in observation group than in control group (χ2=13.404, 34.704 and 19.469,P<0.001), while calcification, fibrosis and cavity were less in observation group compared to control group (χ2=6.539, 4.658 and 7.280,P<0.05,P<0.01,P<0.001). ConclusionPTB should be considered when AIDS patients present multiple symptoms in whole body, with pulmonary lesions located at middle and lower lobes & involved more than three lobes, military nodules, mediastinal enlarged lymph nodes and pleural effusion.