OBJECTIVES: We propose a multi-scale jaw cyst segmentation model, AConvLSTM U-Net, which is based on bidirectional dense connections and attention mechanisms to achieve accurate automatic segmentation of mandibular cyst images. METHODS: A dataset consisting of 2592 jaw cyst images was used. AConvLSTM U-Net designs a MBC on the encoding path to enhance feature extraction capabilities. A DPD was used to connect the encoder and decoder, and a bidirectional ConvLSTM was introduced in the jump connection to obtain rich semantic information. A decoding block based on scSE was then used on the decoding path to enhance the focus on important information. Finally, a DS was designed, and the model was optimized by integrating a joint loss function to further improve the segmentation accuracy. RESULTS: The experiment with AConvLSTM U-Net for jaw cyst lesion segmentation showed a MCC of 93.8443%, a DSC of 93.9067%, and a JSC of 88.5133%, outperforming all the other comparison segmentation models. CONCLUSIONS The proposed algorithm shows a high accuracy and robustness on the jaw cyst dataset, demonstrating its superior performance over many existing methods for automatic segmentation of jaw cyst images and its potential to assist clinical diagnosis.
Humans ; Jaw Cysts/diagnostic imaging* ; Algorithms ; Image Processing, Computer-Assisted/methods* ; Neural Networks, Computer

OBJECTIVE To explore the characteristics and influential factors of pharmaceutical clinic service demands， providing evidence for optimizing pharmaceutical service models and facilitating pharmaceutical service models of pharmacist role transformation. METHODS A cross-sectional survey design was adopted， and 410 outpatient participants were selected from Fudan University Shanghai Cancer Center through convenience sampling for questionnaire administration from February to May 2025. Kano model was applied to analyze the demand attributes of 25 pharmaceutical services， while questionnaires were used to assess patients’ awareness and demand status. Subgroup analyses were conducted based on key demographic variables such as gender， age， educational attainment， and economic burdens， to SACA- systematically examine the differences in Kano attribute classification among patients in each subgroup. RESULTS The awareness rate of pharmaceutical outpatient services among patients was only 14.63%， yet those who were aware demonstrated a significantly higher demand rate for such services compared to those who were unaware （P＜0.001）. The demand for pharmaceutical clinic services exhibited a hierarchical characteristic： twelve items were identified as attractive attributes （e. g.， providing suggestions for more affordable treatment options， offering online consultation services， etc.）， five items as expected attributes （e.g.， having a good attitude and being able to patiently answer your questions， etc.）， three items as must-have attributes （e.g.， providing guidance on medication dosage and usage， providing guidance on medication precautions， etc.）， five items as indifferent attributes （e.g.， providing treatment plan recommendations based on the patient’s condition）. There were zero items classified as reverse attribute. Subgroup analysis revealed that female patients showed greater concern for “neat and clean attire of medical staff” than male patients （P＜0.001）； patients under 60 years of age demonstrated stronger demand for “providing treatment plan recommendations based on patients’ conditions” compared to patients aged 60 or above （P＝0.016）； those with below high school education placed greater emphasis on “providing guidance on medication precautions” compared to those with a high school education or above （P＝0.011）； patients with lower economic burdens exhibited stronger preferences for “neat and clean attire of medical staff ” （P＝0.002）. CONCLUSIONS The public awareness rate of pharmaceutical clinic services is considerably low； however， those who are aware of such services demonstrate significantly higher demand. The medication safety-related services and convenience-oriented demands should be prioritized in the development of pharmaceutical clinics. Moreover， the study also revealed that factors such as gender， age， educational level， and economic burdens exert significant influences on patients’ service demands.

Objective:To investigate the role of microglial polarization modulated by triggering receptor expressed on myeloid cells 2/insulin-like growth factor-1(TREM2/IGF-1) in hypertensive model mice exposed to diesel exhaust particulate matter (DPM), with a focus on its implications for anxious- and depressive-like behaviors.Methods:SPF-grade male C57BL/6J mice were divided into the control group, the hypertension group, the DPM group, and the hypertension+ DPM group according to the principle of weight-matching, with 10 mice in each group. The hypertension model was established by intraperitoneal injection of angiotensin Ⅱ (AngⅡ) in hypertension group and hypertension+ DPM group, and mice in the control group and DPM group were intraperitoneally injected with an equivalent amount of 0.9% NaCl solution.DPM suspension was instilled into the nasal cavity of the mice in DPM group and hypertension+ DPM group(1 μg/μL, 10 μL, once a day for 56 days).Behavioral tests, including the sucrose preference test, tail suspension test, elevated plus maze test, and open field test, were conducted to evaluate anxious- and depressive-like behaviors.TREM2-overexpressing BV2 cell model was established through plasmid transfection technology.Western blot was applied to measure the protein expression of IL-1β, IL-6, TNF-α, iNOS, Arg-1, TREM2 and IGF-1.SPSS 23.0 software was used for statistical analysis, one-way ANOVA was used for comparison among multiple groups, and LSD- t test was used for post-hoc testing. Results:(1)There were statistically significant differences in the sucrose preference rate, immobility time in the tail suspension test, percentage of time and number of entries into the open arms in the elevated plus maze, as well as the total distance, percentage of time spent in the central area in the open field test among the four groups of mice( F=22.82, 21.60, 36.17, 20.99, 5.85, 13.24, all P<0.01).The sucrose preference rate, percentage of time spent in the open arms, percentage of number of entries into the open arms, total distance and percentage of time spent in the central area of the DPM group and the hypertension group were lower than those of the control group( P<0.05), while the immobility time of the two group was higher than that of the control group( P<0.05). The sucrose preference rate((55.62±4.46)%) and percentage of time spent in the open arms((4.17±0.62)%) of the hypertension+ DPM group were lower than those of the DPM group((60.78±3.21)%, (6.44±0.89)%) and the hypertension group((66.26±4.25)%, (6.53±1.29)%)(all P<0.05), while the immobility time((155.42±12.50)s) was higher than that of the DPM group((129.03±5.43)s) and the hypertension group((129.28±10.55)s)(both P<0.05).(2)Western blot analysis revealed statistically significant differences in protein expression of IL-1β, IL-6, TNF-α, iNOS, Arg-1, and TREM2/IGF-1 in the medial prefrontal cortex(mPFC) among the four experimental groups( F=12.23, 10.51, 33.89, 145.40, 11.85, 15.56, 33.11, all P<0.05).The hypertension+ DPM group demonstrated significantly higher protein expression of IL-1β and IL-6 compared to the hypertension group (all P<0.05). Relative to the hypertension+ DPM group, TNF-α and iNOS protein expression was elevated in both the hypertension group and DPM group, whereas Arg-1 protein expression was lower in the hypertension group(all P<0.05). Additionally, TREM2 and IGF-1 protein expression in the hypertension and DPM groups were lower than those in the control group but higher than those in the hypertension+ DPM group(all P<0.05).(3)The protein expressions of IL-1β, IL-6 and TNF-α in BV2 cells of the DPM+ AngⅡ-TREM2 overexpression group were lower than those of the DPM+ AngⅡ group. The expression of iNOS was lower than that in the DPM+ AngⅡ group, while the expression of Arg-1 was higher than that in the DPM+ AngⅡ group(all P<0.05). Conclusion:DPM exposure aggravates anxious- and depressive-like behaviors in hypertensive model mice, with TREM2/IGF-1-regulated microglial polarization playing a significant role in this process.

Objective:To investigate the role of microglial polarization modulated by triggering receptor expressed on myeloid cells 2/insulin-like growth factor-1(TREM2/IGF-1) in hypertensive model mice exposed to diesel exhaust particulate matter (DPM), with a focus on its implications for anxious- and depressive-like behaviors.Methods:SPF-grade male C57BL/6J mice were divided into the control group, the hypertension group, the DPM group, and the hypertension+ DPM group according to the principle of weight-matching, with 10 mice in each group. The hypertension model was established by intraperitoneal injection of angiotensin Ⅱ (AngⅡ) in hypertension group and hypertension+ DPM group, and mice in the control group and DPM group were intraperitoneally injected with an equivalent amount of 0.9% NaCl solution.DPM suspension was instilled into the nasal cavity of the mice in DPM group and hypertension+ DPM group(1 μg/μL, 10 μL, once a day for 56 days).Behavioral tests, including the sucrose preference test, tail suspension test, elevated plus maze test, and open field test, were conducted to evaluate anxious- and depressive-like behaviors.TREM2-overexpressing BV2 cell model was established through plasmid transfection technology.Western blot was applied to measure the protein expression of IL-1β, IL-6, TNF-α, iNOS, Arg-1, TREM2 and IGF-1.SPSS 23.0 software was used for statistical analysis, one-way ANOVA was used for comparison among multiple groups, and LSD- t test was used for post-hoc testing. Results:(1)There were statistically significant differences in the sucrose preference rate, immobility time in the tail suspension test, percentage of time and number of entries into the open arms in the elevated plus maze, as well as the total distance, percentage of time spent in the central area in the open field test among the four groups of mice( F=22.82, 21.60, 36.17, 20.99, 5.85, 13.24, all P<0.01).The sucrose preference rate, percentage of time spent in the open arms, percentage of number of entries into the open arms, total distance and percentage of time spent in the central area of the DPM group and the hypertension group were lower than those of the control group( P<0.05), while the immobility time of the two group was higher than that of the control group( P<0.05). The sucrose preference rate((55.62±4.46)%) and percentage of time spent in the open arms((4.17±0.62)%) of the hypertension+ DPM group were lower than those of the DPM group((60.78±3.21)%, (6.44±0.89)%) and the hypertension group((66.26±4.25)%, (6.53±1.29)%)(all P<0.05), while the immobility time((155.42±12.50)s) was higher than that of the DPM group((129.03±5.43)s) and the hypertension group((129.28±10.55)s)(both P<0.05).(2)Western blot analysis revealed statistically significant differences in protein expression of IL-1β, IL-6, TNF-α, iNOS, Arg-1, and TREM2/IGF-1 in the medial prefrontal cortex(mPFC) among the four experimental groups( F=12.23, 10.51, 33.89, 145.40, 11.85, 15.56, 33.11, all P<0.05).The hypertension+ DPM group demonstrated significantly higher protein expression of IL-1β and IL-6 compared to the hypertension group (all P<0.05). Relative to the hypertension+ DPM group, TNF-α and iNOS protein expression was elevated in both the hypertension group and DPM group, whereas Arg-1 protein expression was lower in the hypertension group(all P<0.05). Additionally, TREM2 and IGF-1 protein expression in the hypertension and DPM groups were lower than those in the control group but higher than those in the hypertension+ DPM group(all P<0.05).(3)The protein expressions of IL-1β, IL-6 and TNF-α in BV2 cells of the DPM+ AngⅡ-TREM2 overexpression group were lower than those of the DPM+ AngⅡ group. The expression of iNOS was lower than that in the DPM+ AngⅡ group, while the expression of Arg-1 was higher than that in the DPM+ AngⅡ group(all P<0.05). Conclusion:DPM exposure aggravates anxious- and depressive-like behaviors in hypertensive model mice, with TREM2/IGF-1-regulated microglial polarization playing a significant role in this process.

A 36-year-old healthy male served as an allogeneic hematopoietic stem cell donor was given recombinant human granulocyte colony-stimulating factor injection (rhG-CSF) 300 μg by subcutaneous injection once daily for 5 consecutive days. On day 4 of stem cell mobilization, peripheral stem cell collection was performed and rhG-CSF 250 μg was given in addition. The donor experienced dry cough, dyspnea, and difficulty breathing on the next day. Chest CT scan showed diffuse patchy and nodular shadows in both lungs, and relevant tests excluded bacterial/viral infection of the lungs and heart failure. It was considered to be acute lung injury caused by rhG-CSF. After giving glucocorticoids and symptomatic treatments, the symptoms gradually subsided, and the peripheral blood stem cell collection was successful. In the continuing treatment of glucocorticoids, the symptoms of the donor were further improved, and chest CT scan showed marked improvement. At a 3 years of follow-up, the donor' work and life were normal, and no lung discomfort symptoms recurred.

A 36-year-old healthy male served as an allogeneic hematopoietic stem cell donor was given recombinant human granulocyte colony-stimulating factor injection (rhG-CSF) 300 μg by subcutaneous injection once daily for 5 consecutive days. On day 4 of stem cell mobilization, peripheral stem cell collection was performed and rhG-CSF 250 μg was given in addition. The donor experienced dry cough, dyspnea, and difficulty breathing on the next day. Chest CT scan showed diffuse patchy and nodular shadows in both lungs, and relevant tests excluded bacterial/viral infection of the lungs and heart failure. It was considered to be acute lung injury caused by rhG-CSF. After giving glucocorticoids and symptomatic treatments, the symptoms gradually subsided, and the peripheral blood stem cell collection was successful. In the continuing treatment of glucocorticoids, the symptoms of the donor were further improved, and chest CT scan showed marked improvement. At a 3 years of follow-up, the donor' work and life were normal, and no lung discomfort symptoms recurred.

The incidence of hematologic malignancies is increasing, and although new drugs and treatments have made great progress, relapse and drug resistance are still urgent problems to be solved. Exosomes are tiny membrane vesicles secreted in cells that carry lipid bilayer membrane structures including mRNA, microRNA and proteins. It carries and transmits important signaling molecules, forming an entirely new intercellular information transfer system that exhibits a wide range of biological properties and functions in organisms. Tumor cell exosomes are confirmed to contribute to cancer cell proliferation, angiogenesis, invasiveness, distant metastasis and drug resistance. Multiple studies have shown that exosomes from some malignant hematological tumor cells are closely related to tumor resistance. This review summarizes the research progress of exosomes in the mechanism of drug resistance of hematologic malignancies, in order to provide a theoretical basis for the clinical treatment of hematologic malignancies.

Objective To determine the effect of rapamycin(Rapa) on JAK2, ABCA3, and the immune checkpoint PD-1/PD-L1 in exosomes derived from JAK2 V617F positive HEL cells. Methods Human erythroleukemia HEL cells (JAK2 V617F mutation-positive) were cultured in vitro, and rapamycin was added at concentrations of 10, 50, and 100 nmol/L. The control group was established and cell proliferation inhibition rate was detected by CCK-8. Based on the inhibition rate of cell proliferation, cells intervened with 10 and 50 nmol/L Rapa were selected. Exosomes were extracted using a kit and identified by Western blot and flow cytometry. JAK2, ABCA3, and PD-1/PD-L1 mRNA changes in exosomes were detected by fluorescent quantitative PCR. The expression of exosome PD-1/PD-L1 protein was determined by flow cytometry. Results The exosomes extracted with the exosome kit all expressed characteristic CD9, CD63, and CD81 proteins, which were consistent with the general characteristics of exosomes. JAK2 mRNA can be detected in exosomes from HEL cells; Rapa reduced exosome production by HEL cells, and dose-dependently decreased gene expression of JAK2, ABCA3, and PD-L1 in exosomes. In addition, Rapa inhibited exosomal PD-L1 protein expression and had no significant effect on PD-1 protein expression. Conclusion HEL cells may transmit JAK2 mutant gene signals via exosomes. Rapa can reduce the production of exosomes and inhibits JAK2 mutated signals delivered by exosomes and suppresses PD-L1 protein expression.

This review summarized the researches about physical activity levels, measurement methods, influencing factors and interventions for children and adolescents with intellectual disability. The physical activity levels of children and adolescents with intellectual disability were low, and their health status was not optimistic. The joint efforts of individuals, families and the society were needed to improve their levels of physical activity. The effectiveness of existing physical activity intervention methods should be further discussed. Therefore, focusing on the health demands of children and adolescents with intellectual disability, more researches are needed about in-depth analysis of the dose-effect relationship between physical activity and health indicators, and exploring of effective intervention for physical activity in the future.

Objective     To analyze the risk factors of atrial fibrillation (AF) after radical esophagectomy, providing the basis for prevention and treatment of AF after radical esophagectomy. Methods     We conducted a retrospective analysis of 335 patients' clinical data, who accepted laparoscopic combined thoracic or open radical esophagectomy in the same treatment group at Department of Thoracic Surgery of Shengjing Hospital of China Medical University between January 2014 and August 2016. There were 262 males and 73 females at age of 65.1 (43-78) years. Results     There were 48 of 335 patients with AF within 1 week after surgery. By univariate analysis: age, gender, history of peripheral vascular disease and cardiac stents or angina pectoris, preoperative brain natriuretic peptide (BNP), preoperative left ventricular diastolic dysfunction, operation pattern, intraoperative blood transfusion and lymph nodes and pericardial adhesion were possible risk factors. By multivariate analysis: age, gender, history of cardiac stents or angina pectoris, preoperative BNP, operation pattern, intraoperative blood transfusion and lymph nodes and pericardial adhesion were risk factors. Conclusion     The risk factors of AF after radical esophagectomy are age, gender, history of cardiac stents or angina pectoris, preoperative BNP, operation pattern, intraoperative blood transfusion and lymph nodes and pericardial adhesion. Perioperative positive intervention to above factors may reduce the incidence of postoperative AF.