ObjectiveTo investigate pulmonary function levels and associated influencing factors among rural elderly in Guangzhou， to identify high-risk populations for poor pulmonary function， and to reveal the relationship between the influencing factors of pulmonary function. MethodsWe recruited 1 500 residents aged 60 to 94 years from rural area of Conghua District， Guangzhou City using convenience sampling in 2023. Data on demographics， body measurements， medical history and lifestyle were collected via face-to-face questionnaires and physical examination. Meanwhile， expiratory function parameters including forced expiratory volume in one second （FEV1）， forced vital capacity （FVC）， FEV1/FVC， and the prevalence of airflow obstruction （AFO） were assessed using a portable spirometer. Age and sex distribution of pulmonary function in older adults at 5-year intervals was reported， and risk factors of AFO using multifactorial logistic regression models were analyzed. Furthermore， path analysis was further employed to explore the role of lifestyle in the association between other influencing factors and lung function. ResultsAmong the 1 500 participants， the median age was 71 years （67-75）， and 44.2% were male. Subjects identified as AFOs were generally older， more likely male， less educated， and had lower rates of moderate to vigorous physical activity （＜1 time/week） and lower lean body mass. Mean FEV1/FVC ratio was （82.0±16.4） %. FEV1/FVC was （79.80±17.58） % in men and （83.66±15.22） % in women. Older age， lower education， male sex and leanness were negatively associated with all pulmonary function outcomes （all P values＜0.05）. Path analysis identified that age， gender， marital status， occupation and income may influence pulmonary function indirectly through lifestyle. ConclusionRural elderly in Guangzhou exhibited lower pulmonary function levels， and male sex， non-married status， advanced age， lower education， smoking habits， insufficient engagement in moderate to vigorous physical activity， and lean body type were all associated with worse pulmonary function.

Objective To investigate the differences of type 2 innate lymphocytes (ILC2) and interlukin 9 (IL-9) between chronic lymphocytic leukemia (CLL) patients and healthy controls, and to understand the effects of ILC2 on the function of regulatory T cells (Tregs), CD8⁺ T cells and CLL cells through IL-9. Methods Flow cytometry was used to detect the levels of ILC2 and Tregs in the peripheral blood of 45 newly diagnosed CLL patients and 24 healthy controls, and the expressions of granzyme B and perforin in CD8⁺ T cells in the peripheral blood of 28 patients and 15 healthy controls; ELISA was used to detect the level of IL-9 in the serum. ILC2 of patients and healthy controls was sorted by immunomagnetic beads and cultured separately, and the level of IL-9 in the culture supernatant was measured by ELISA. ILC2 sorted from CLL patients and healthy control-derived peripheral blood mononuclear cells(PBMCs) were co-cultured with the B cell leukemia MEC-1 cells, one group was supplemented with IL-9 antibody and the other group was not. After 72 hours of culture, the ratio of Tregs, programmed death 1 (PD-1), T cell immunoglobulin and immunoreceptor tyrosine-based inhibitory motif domain (TIGIT), cytotoxic T lymphocyte antigen 4 (CTLA-4) on Tregs, granzyme B and perforin in CD8⁺ T cells were measured by flow cytometry, IL-9 level of the culture supernatant was measured by ELISA, the apoptosis of MEC-1 cells was measured by Annexin V-PI. Results Compared with the healthy control group, the levels of ILC2, Tregs and IL-9 in the CLL group increased significantly. The levels of granzyme B and perforin in CD8⁺ T cells were positively correlated in the peripheral blood of CLL patients. Compared with the healthy control group, IL-9 levels in the supernatant of sorted ILC2 from CLL patients increased. In the anti-IL9 antibody group, the level of PD-1 and TIGIT on Tregs decreased, and the level of granzyme B in CD8⁺ T cells increased significantly. The level of IL-9 in the anti-IL9 antibody group decreased statistically. And MEC-1 cells showed increased early apoptotic rate in the anti-IL9 antibody group statistically. Conclusion In CLL, ILC2 affects CD8⁺ T cells and Tregs through IL-9, which weakens the anti-tumor effect of CD8⁺ T cells, enhances the immunosuppressive effect of Tregs, and plays a role in the occurrence and development of CLL disease.
Humans ; Leukemia, Lymphocytic, Chronic, B-Cell/immunology* ; CD8-Positive T-Lymphocytes/immunology* ; T-Lymphocytes, Regulatory/immunology* ; Middle Aged ; Male ; Female ; Interleukin-9/blood* ; Aged ; Granzymes/metabolism* ; Perforin/metabolism* ; Immunity, Innate ; Adult ; Lymphocytes/immunology*

OBJECTIVES: We propose a segmented backprojection tensor degradation feature encoding (SBP-MAC) model for motion artifact correction in dental cone beam computed tomography (CBCT) to improve the quality of the reconstructed images. METHODS: The proposed motion artifact correction model consists of a generator and a degradation encoder. The segmented limited-angle reconstructed sub-images are stacked into the tensors and used as the model input. A degradation encoder is used to extract spatially varying motion information in the tensor, and the generator's skip connection features are adaptively modulated to guide the model for correcting artifacts caused by different motion waveforms. The artifact consistency loss function was designed to simplify the learning task of the generator. RESULTS: The proposed model could effectively remove motion artifacts and improve the quality of the reconstructed images. For simulated data, the proposed model increased the peak signal-to-noise ratio by 8.28%, increased the structural similarity index measurement by 2.29%, and decreased the root mean square error by 23.84%. For real clinical data, the proposed model achieved the highest expert score of 4.4221 (against a 5-point scale), which was significantly higher than those of all the other comparison methods. CONCLUSIONS The SBP-MAC model can effectively extract spatially varying motion information in the tensors and achieve adaptive artifact correction from the tensor domain to the image domain to improve the quality of reconstructed dental CBCT images.
Cone-Beam Computed Tomography/methods* ; Artifacts ; Humans ; Motion ; Image Processing, Computer-Assisted/methods* ; Signal-To-Noise Ratio ; Algorithms

Objective To propose a low-dose CT reconstruction algorithm across different scanners based on federated feature learning(FedCT)to improve the generalization of deep learning models for multiple CT scanners and protect data privacy.Methods In the proposed FedCT framework,each client is assigned an inverse Radon transform-based reconstruction model to serve as a local network model that participates in federated learning.A projection-domain specific learning strategy is adopted to preserve the geometry specificity in the local projection domain.Federated feature learning is introduced in the model,which utilizes conditional parameters to mark the local data and feed the conditional parameters into the network for encoding to enhance the generalization of the model in the image domain.Results In the cross-client,multi-scanner,and multi-protocol low-dose CT reconstruction experiments,FedCT achieved the highest PSNR(+2.8048,+2.7301,and +2.7263 compared to the second best federated learning method),the highest SSIM(+0.0009,+0.0165,and +0.0131 in the same comparison),and the lowest RMSE(-0.6687,-1.5956,and-0.9962).In the ablation experiment,compared with the general federated learning strategy,the model with projection-specific learning strategy showed an average improvement by 1.18 on Q1 of the PSNR and an average decrease by 1.36 on Q3 of the RMSE on the test set.The introduction of federated feature learning in FedCT further improved the Q1 of the PSNR on the test set by 3.56 and reduced the Q3 of the RMSE by 1.80.Conclusion FedCT provides an effective solution for collaborative construction of CT reconstruction models,which can enhance model generalization and further improve the reconstruction performance on global data while protecting data privacy.

Objective To propose a CT truncated data reconstruction model(DDTrans)based on projection and image dual-domain Transformer coupled feature learning for reducing truncation artifacts and image structure distortion caused by insufficient field of view(FOV)in CT scanning.Methods Transformer was adopted to build projection domain and image domain restoration models,and the long-range dependency modeling capability of the Transformer attention module was used to capture global structural features to restore the projection data information and enhance the reconstructed images.We constructed a differentiable Radon back-projection operator layer between the projection domain and image domain networks to enable end-to-end training of DDTrans.Projection consistency loss was introduced to constrain the image forward-projection results to further improve the accuracy of image reconstruction.Results The experimental results with Mayo simulation data showed that for both partial truncation and interior scanning data,the proposed DDTrans method showed better performance than the comparison algorithms in removing truncation artifacts at the edges and restoring the external information of the FOV.Conclusion The DDTrans method can effectively remove CT truncation artifacts to ensure accurate reconstruction of the data within the FOV and achieve approximate reconstruction of data outside the FOV.

Objective To investigate the effect of nuclear factor of activated T cells 2(NFATc2)on the proliferation and apoptosis of human ovarian cancer cells and its possible mechanism.Methods The human epithelial ovarian cancer cell line A2780 was selected,and the A2780 cell lines with over expression(over ex-pression group)and low expression[transfection of small interfering RNA(siRNA),NFATc2 siRNA group]of NFATc2 were constructed,respectively.The control group without any treatment was established.Thiazole blue(MTT)and flow cytometry were used to detect the cell proliferation and apoptosis levels,respectively.The expression levels of apoptosis related proteins and CXC chemokine motif ligand 8(CXCL8)were detected by Western blot.Normal A2780 cells(the blank group),A2780 cells transfected with blank vectors(the con-trol group)and A2780 cells with low expression of NFATc2(the NFATc2 siRNA group)were used to estab-lish ovarian cancer model with subcutaneous xenograft.The tumor volume and mass were measured,and the expression level of CXCL8 in tumor tissue was detected by Western blot.Results Compared with the control group,the cell proliferation rate in the NFATc2 siRNA group was decreased,the cellular apoptosis rate was increased,the cleaved caspase-3 expression level was increased,the Bcl-2/Bax ratio was decreased,the CXCL8 expression was decreased,and the differences were statistically significant(P＜0.01).The cell lines in the o-ver expression group showed the opposite effect.The tumor mass and volume of nude mice,and the expression level of CXCL8 in the NFATc2 siRNA group were lower than those in the blank group and the control group(P＜0.01).Conclusion Down-regulation of NFATc2 could reduce the cell proliferation,increase the expres-sion of apoptosis related proteins by inhibiting CXCL8 expression in A2780 cells,thus promote the apoptosis of ovarian cancer cells.

OBJECTIVE Investigating the clinical characteristics,risk factors,treatment strategies and prognosis of head and neck extramedullary plasmacytoma(HNEMP).METHODS To analyze indicators affecting survival and prognosis,retrospective study was conducted on the clinical data of 38 newly diagnosed and untreated patients with HNEMP who were admitted to Beijing Tongren Hospital from September 2008 to January 2022.RESULTS Among 38 patients,5 cases(13.2%)displayed a manifestation as cranial-nasal-orbital communication,and 8 cases(21.1%)involved a tumor with diameter≥5 cm.There were 17 patients(44.7%)who underwent surgical resection along,13 patients(34.2%)who received postoperative radiotherapy,8 cases(21.1%)who accepted chemotherapy,and 5 cases(13.2%)who experienced combined radiochemotherapy.Following treatment evaluation,32 cases achieved CR,3 cases showed PR,1 case demonstrated SD and 2 cases experienced PD.The median follow-up time was 86 months,with 5-year PFS and OS rates of 92.1%and 94.7%,respectively.Of note,the patients with cranial-nasal-orbital communication exhibited significantly unfavorable 5-year PFS and OS rates of 40%and 60%,respectively,with median PFS of 13 months,whereas the patients in other groups achieved 100%of 5-year PFS and OS rates.Additionally,tumor diameter≥5 cm and the involvement of cranial-nasal-orbital communication were adverse prognostic factors for both PFS and OS.CONCLUSION HNEMP is a rare disease and the primary treatment approach is surgery combined with radiotherapy.The prognosis for HNEMP tends to be relatively favorable,with the involvement of cranial-nasal-orbital communication and high tumor burden as the adverse prognostic indicators.

Objective:To compare the quality of sleep and rehabilitation after routine surgery versus day surgery in pediatric patients with snoring.Methods:This was a prospective study.Seventy pediatric patients with snoring, aged 4-6 yr, of American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, undergoing adenoidectomy and/or tonsillectomy in the Guangzhou Women and Children′s Medical Center from March to June 2023, were divided into routine surgery group (group R) and day surgery group (group D), with 35 cases in each group. A sleep-detecting bracelet was used to monitor the sleep status. The proportion of deep sleep, light sleep and rapid eye movement, sleep continuity score and the maximum and minimum heart rate were recorded on the night before surgery, the first and second night after surgery. Rehabilitation was assessed using Quality of Recovery-15 at 1 day before surgery and 24 and 48 h and 28 days after surgery.Results:Compared with group R, the maximum heart rate at the night before surgery was significantly decreased, the proportion of light sleep on the second night after surgery was increased, the proportion of rapid eye movement sleep on the second night after surgery was decreased, the scores for items on " getting support from hospital doctors and nurses", " feeling comfortable and in control", and " having a feeling of general well-being" and the total score of Quality of Recovery-15 were significantly decreased at 24 and 48 h after operation, and the score for items on " feeling rested" and " have had a good sleep" at 48 h after surgery was decreased in group D ( P<0.05). Conclusions:Pediatric patients with snoring have poor quality of early sleep and rehabilitation after day surgery compared with routine surgery.

Objective To compare the size discrepancy between ultrasonic and pathological measurement of solitary cN0M0 papillary thyroid microcarcinoma(PTMC),and to explore their correlation with lymph node metastasis.Methods From April 2021 to January 2022,234 patients with solitary cN0M0 PTMC who received thyroid lobectomy or total thyroidectomy in the Department of Thyroid and Breast Surgery of Nanjing University of Chinese Medicine,Affiliated Hospital of Integrated Traditional Chinese and Western Medicine were analyzed retrospectively.The size discrepancy between ultrasonic and pathological measurement were compared,and the risk factors of central lymph node metastasis were analyzed.Results The mean of maximum diameter of PTMC measured by ultrasound was 6.8(range 5.6 to 8.4)mm,which was significantly bigger than that measured by pathology 5.0(range 4.0 to 7.0)mm(P=0.000).Of them,37.2%of the tumor size measured by ultrasound is consistent with pathology,61.1%of the tumor size measured by ultrasound is bigger than that measured by pathology,and only 1.7%of the tumor size measured by ultrasound is smaller than that measured by pathology.There was a linear correlation between the diameter measured by ultrasound and pathology.And the regression equation can be expressed as:pathological diameter=0.799×ultrasonic diameter-0.221.In addition,28.6%patients had central lymph node metastasis.Multivariate Logistic regression analysis showed that the diameter measured by pathology is a risk factor for central lymph node metastasis in patients(OR=17.845,95%CI:2.507-127.025,P=0.004),and the cutoff value is 5.5 mm which corresponded to the diameter measured by ultrasound as 7.2 mm.Conclusions The sizes of solitary cN0M0 PTMC measured by ultrasound and pathology are different but also correlated.PMTC with pathological diameter>5.5 mm with its corresponding ultrasonic diameter as 7.2 mm indicated an increased risk of central lymph node metastasis.

Objective To propose a low-dose CT reconstruction algorithm across different scanners based on federated feature learning(FedCT)to improve the generalization of deep learning models for multiple CT scanners and protect data privacy.Methods In the proposed FedCT framework,each client is assigned an inverse Radon transform-based reconstruction model to serve as a local network model that participates in federated learning.A projection-domain specific learning strategy is adopted to preserve the geometry specificity in the local projection domain.Federated feature learning is introduced in the model,which utilizes conditional parameters to mark the local data and feed the conditional parameters into the network for encoding to enhance the generalization of the model in the image domain.Results In the cross-client,multi-scanner,and multi-protocol low-dose CT reconstruction experiments,FedCT achieved the highest PSNR(+2.8048,+2.7301,and +2.7263 compared to the second best federated learning method),the highest SSIM(+0.0009,+0.0165,and +0.0131 in the same comparison),and the lowest RMSE(-0.6687,-1.5956,and-0.9962).In the ablation experiment,compared with the general federated learning strategy,the model with projection-specific learning strategy showed an average improvement by 1.18 on Q1 of the PSNR and an average decrease by 1.36 on Q3 of the RMSE on the test set.The introduction of federated feature learning in FedCT further improved the Q1 of the PSNR on the test set by 3.56 and reduced the Q3 of the RMSE by 1.80.Conclusion FedCT provides an effective solution for collaborative construction of CT reconstruction models,which can enhance model generalization and further improve the reconstruction performance on global data while protecting data privacy.