Objective To explore the clinical value of artificial intelligence (AI) quantitative parameters in distinguishing pathological grades of stageⅠ invasive adenocarcinoma (IAC). Methods Clinical data of patients with clinical stageⅠ IAC admitted to Yantaishan Hospital Affiliated to Binzhou Medical University from October 2018 to May 2023 were retrospectively analyzed. Based on the 2021 WHO pathological grading criteria for lung adenocarcinoma, IAC was divided into gradeⅠ, grade Ⅱ, and grade Ⅲ. The differences in parameters among the groups were compared, and logistic regression analysis was used to evaluate the predictive efficacy of AI quantitative parameters for grade Ⅲ IAC patients. Parameters were screened using least absolute shrinkage and selection operator (LASSO) regression analysis. Three machine learning models were constructed based on these parameters to predict grade Ⅲ IAC and were internally validated to assess their efficacy. Nomograms were used for visualization. Results A total of 261 IAC patients were included, including 101 males and 160 females, with an average age of 27-88 (61.96±9.17) years. Six patients had dual primary lesions, and different lesions from the same patient were analyzed as independent samples. There were 48 patients of gradeⅠ IAC, 89 patients of grade Ⅱ IAC, and 130 patients of grade Ⅲ IAC. There were statitical differences in the AI quantitive parameters such as consolidation/tumor ratio (CTR), ect among the three goups. (P<0.05). Univariate analysis showed that the differences in all variables except age were statistically significant (P<0.05) between the group gradeⅠ+grade Ⅱand the group grade Ⅲ . Multivariate analysis suggested that CTR and CT standard deviation were independent risk factors for identifying grade Ⅲ IAC, and the two were negatively correlated. Grade Ⅲ IAC exhibited advanced TNM staging, more pathological high-risk factors, higher lymph node metastasis rate, and higher proportion of advanced structure. CTR was positively correlated with the proportion of advanced structures in all patients. This correlation was also observed in grade Ⅲ but not in gradeⅠand grade ⅡIAC. CTR and CT median value were selected by using LASSO regression. Logistic regression, random forest, and XGBoost models were constructed and validated, among which, the XGBoost model demonstrated the best predictive performance. Conclusion Cautious consideration should be given to grade Ⅲ IAC when CTR is higher than 39.48% and CT standard deviation is less than 122.75 HU. The XGBoost model based on combined CTR and CT median value has good predictive efficacy for grade Ⅲ IAC, aiding clinicians in making personalized clinical decisions.

Objective Network Meta-analysis was used to compare and estimate the therapeutic effect and safety of oral Chinese patent drugs in treatment of diabetic peripheral neuropathy(DPN).Methods PubMed,Cochrane Library,EMbase,Web of Science,China National Knowledge Infrastructure(CNKI),Chinese Citation Database(CCD),China Science Periodical Database(CSPD)and SinoMed was retrieved to collect randomized controlled trials(RCTs),which were related to oral Chinese patent drugs in treatment of DPN.Cochrane Handbook 5.3 was used to assess the quality of the studies,and Stata 15 and ADDIS 1.16.5 were utilized to analyse data.Results 48 RCTs were included,including 4200 patients,involving 11 kinds of Chinese patent drugs.In terms of improving clinical total effective rate,the top three interventions were mecobalamin combined with Tangmaikang granules,Jinlida granules and Naoxintong capsules.The top three interventions for improving toronto clinical scoring system(TCSS)were mecobalamin combined with Mailuoning peroral liquids,Mudan granules and Xuefuzhuyu capsules.In the aspect of improving sensory conduction velocity(SCV)of median nerve,the top three interventions were mecobalamin combined with Tongxinluo capsules,Xuesaitong soft capsules and Fufangxueshuantong capsules.The top three interventions for improving SCV of peroneal nerve were mecobalamin combined with Xuefuzhuyu capsules,Jinlida granules and Mailuoning peroral liquids.In terms of improving motor conduction velocity(MCV)of median nerve,the top three interventions were mecobalamin combined with Tongxinluo capsules,Yindanxinnaotong soft capsules and Tangmaikang granules.The top three interventions for improving MCV of peroneal nerve were mecobalamin combined with Xuesaitong soft capsules,Yindanxinnaotong soft capsules and Tongxinluo capsules.In the terms of improving blood glucose,several studies reported that Tangmaikang granules and Tongmaijiangtang capsules combined with mecobalamin could improve the level of glycated hemoglobin(HbA1c),which was superior to mecobalamin alone.Compared with mecobalamin alone,mecobalamin combined with Chinese patent drugs did not increase the occurrence of adverse reactions.Conclusion Mecobalamin combined with Chinese patent drugs can improve the therapeutic effect,TCSS scores and nerve conduction velocity,and the safety is satisfactory,which can provide some reference for clinical medication.

Objective Network Meta-analysis was used to compare and estimate the therapeutic effect and safety of oral Chinese patent drugs in treatment of diabetic peripheral neuropathy(DPN).Methods PubMed,Cochrane Library,EMbase,Web of Science,China National Knowledge Infrastructure(CNKI),Chinese Citation Database(CCD),China Science Periodical Database(CSPD)and SinoMed was retrieved to collect randomized controlled trials(RCTs),which were related to oral Chinese patent drugs in treatment of DPN.Cochrane Handbook 5.3 was used to assess the quality of the studies,and Stata 15 and ADDIS 1.16.5 were utilized to analyse data.Results 48 RCTs were included,including 4200 patients,involving 11 kinds of Chinese patent drugs.In terms of improving clinical total effective rate,the top three interventions were mecobalamin combined with Tangmaikang granules,Jinlida granules and Naoxintong capsules.The top three interventions for improving toronto clinical scoring system(TCSS)were mecobalamin combined with Mailuoning peroral liquids,Mudan granules and Xuefuzhuyu capsules.In the aspect of improving sensory conduction velocity(SCV)of median nerve,the top three interventions were mecobalamin combined with Tongxinluo capsules,Xuesaitong soft capsules and Fufangxueshuantong capsules.The top three interventions for improving SCV of peroneal nerve were mecobalamin combined with Xuefuzhuyu capsules,Jinlida granules and Mailuoning peroral liquids.In terms of improving motor conduction velocity(MCV)of median nerve,the top three interventions were mecobalamin combined with Tongxinluo capsules,Yindanxinnaotong soft capsules and Tangmaikang granules.The top three interventions for improving MCV of peroneal nerve were mecobalamin combined with Xuesaitong soft capsules,Yindanxinnaotong soft capsules and Tongxinluo capsules.In the terms of improving blood glucose,several studies reported that Tangmaikang granules and Tongmaijiangtang capsules combined with mecobalamin could improve the level of glycated hemoglobin(HbA1c),which was superior to mecobalamin alone.Compared with mecobalamin alone,mecobalamin combined with Chinese patent drugs did not increase the occurrence of adverse reactions.Conclusion Mecobalamin combined with Chinese patent drugs can improve the therapeutic effect,TCSS scores and nerve conduction velocity,and the safety is satisfactory,which can provide some reference for clinical medication.

Objective     To explore the clinical value of artificial intelligence (AI) quantitative parameters of pulmonary ground-glass nodules (GGN) in predicting the degree of infiltration. Methods     A retrospective analysis of 168 consecutive patients with 178 GGNs in our hospital from October 2019 to May 2021 was performed, including 43 males and 125 females, aged 21-78 (55.76±10.88) years. Different lesions of the same patient were analyzed as independent samples. Totally, 178 GGNs were divided into two groups, a non-invasive group (24 adenocarcinoma in situ and 77 minimally invasive adenocarcinoma), and an invasive group (77 invasive adenocarcinoma). We compared the difference of AI quantitative parameters between the two groups, and evaluated predictive valve by receiver operating characteristic curve and binary logistic regression model. Results     (1) Except for the gender (P=0.115), the other parameters, such as maximal diameter [15.10 (11.50, 21.60) mm vs. 8.90 (7.65, 11.15) mm], minimum diameter [10.80 (8.85, 15.20) mm vs. 7.40 (6.10, 8.95) mm], proportion of consolidation/tumor ratio [13.58% (1.61%, 63.76%) vs. 0.00% (0.00%, 0.67%)], mean CT value [–347.00 (–492.00, –101.50) Hu vs. –598.00 (–657.50, –510.00) Hu], CT maximum value [40.00 (–40.00, 94.50) Hu vs. –218.00 (–347.00, –66.50) Hu], CT minimum value [–584.00 (–690.50, –350.00) Hu vs. –753.00 (–786.00, –700.00) Hu], danger rating (proportion of high-risk nodules, 92.2% vs. 66.3%), malignant probability [91.66% (85.62%, 94.92%) vs. 81.81% (59.98%, 90.29%)] and age (59.93±8.53 years vs. 52.04±12.10 years) were statistically significant between the invasive group and the non-invasive group (all P<0.001). (2) The highest predictive value of a single quantitative parameter was the maximal diameter (area under the curve=0.843), the lowest one was the risk classification (area under the curve=0.627), the combination of two among the three parameters (maximal diameter, mean CT value, and consolidation/tumor ratio) improved the predictive value entirely. (3) Logistic regression analysis showed that maximal diameter and mean CT value both were the independent risk factor for predicting invasive adenocarcinoma. (4) When the threshold of v was 1.775%, the diagnostic sensitivity of invasive adenocarcinoma was 0.753 and the specificity was 0.851. Conclusion     AI quantitative parameters can effectively predict the degree of infiltration of GGNs and provide a reliable reference basis for clinicians.

Objective: To investigate the expression levels of long non-coding RNA LincROR in plasma and tissues of ovarian cancer patients and its value in the screening of ovarian cancer. Methods: The plasma samples from 30 healthy women, 56 cases of ovarian cysts, 23 cases of endometriosis, 38 cases of endometrial carcinoma, 35 cases of cervical cancer, 42 cases of ovarian cancer, 21 cases of ovarian cancer after operation and 26 cases of ovarian cancer after chemotherapy were collected, and the expression levels of LincROR in these samples were detected by quantitative PCR. The diagnostic value of LincROR in common clinical gynecological diseases was evaluated combined with clinical data. Results: The expression levels of LincROR in plasma of ovarian cancer patients (2.90± 4.42 ) were significantly higher than that in healthy women (0.23±0.28) and the patients with benign ovarian cysts (0.62±0.55, P ＜ 0.01 ). The results of ROC curve analysis showed that the diagnostic value of plasma LincROR in the screening of breast cancer was better than that of CA125, CA199, CA153, AFP and CEA. The sensitivity and specificity of combined screening of LincROR and CA125 for ovarian cancer were 89.7% and 86.7%, respectively (AUCROC=0.918, 95% CI :0.817-0.973). In addition, the expression levels of plasma LincROR in the postoperative patients were significantly lower than that in the ovarian cancer patients without any treatment (0.50±1.72 vs 2.90±4.42, P ＜0.01). The ROC curve analysis showed that plasma LincROR was more sensitive than CA125 in evaluating the efficacy of chemotherapy for ovarian cancer (AUCROC: 0.866 vs 0.738). Conclusion LincROR is expected to be an ideal biomarker for the screening of ovarian cancer, and has potential clinical value in evaluating the efficacy of chemotherapy for ovarian cancer. Combination of LincROR with CA125 may improve the sensitivity and specificity of the screening of ovarian cancer

Objective: To explore the correlation of non-coding RNA and the tumor-associated antigen midkine (MK) in SKOV3cells and the clinical significance for diagnosis of ovarian cancer. Methods: The Agilent′s gene chips (miRNAs chip and lncRNAs chip) were used to analyze the differential expression of miRNAs and lncRNAs in both MK-overexpressing SKOV3-MK cells and the control SKOV3-Con cells to screen the potential biomarkers in ovarian cancer. The clinical significance of midkine in the serum and tissues samples was analyzed for the patients with ovarian cancer by quantitative PCR combined with clinical data. Results: Compared with control SKOV3-con cells, MK overexpression significantly promoted the expressions of 11 miRNAs and 7 lncRNAs in SKOV3 cells (P＜0.01, ratio＞3 fold), reduced the expressions of 8 miRNAs and 13 lncRNAs (P＜0.01, ratio＜0.3). Results of qPCR showed that the expression level of miR489 was significantly lower in ovarian cancer tissues than that of the contralateral normal ovarian tissues, while HOTAIR was significantly elevated (P＜0.05). The expression level of HOTAIR in the serum of ovarian cancer patients was significantly higher than that in healthy controls group with same age (0.036±0.024 vs 0.019±0.020, P=0.002). ROC curve analysis of HOTAIR showed that the specificity was 66.7%, the sensitivity was 75.6% and the AUC value was 0.749 as a marker for serum detection of ovarian cancer when the cutoff value was 0.017 6. Conclusion Long-chain non-coding RNA HOTAIR may be served as a potential biomarker in serum of ovarian cancer patients.

Objective: To study the clinical efficacy of Sini-Moxibustion in the treatment of cancer-induced fatigue in patients with yang- deficiency gastrointestinal cancer. Methods: A total of 120 patients with gastrointestinal cancer treated in our department from January 2017 to January 2018 were randomly divided into 2 groups: the fire moxibustion group and the conventional group. The conventional group and the fire therapy group were treated with basic treatments such as anti-cancer and nutritional support. The conventional group added Sini-Moxibustion to the basic treatment, and the fire therapy group added"Sini-Moxibustion"therapy for a period of 1 month. Tthe indicators of the 2 groups of patients with Piper fatigue scale and grade, quality of life, symptoms of yang deficiency symptoms, clinical efficacy and blood tests of patients with chemotherapy were evaluated. Results: After the treatment, the degrees of fatigue in the fire moxibustion group was lower than that in the conventional group with statistically significant difference ( χ2 =4.24, P =0.037 ＜ 0.05). The scores of improvement in the quality of life scale and five subscales in the fire moxibustion were higher than those in the conventional group with statistically significant difference (P ＜ 0.01), and the improvement score of the body yang deficiency in the fire moxibustion group was greater than that of the conventional group (P ＜ 0.01). The scores of fatigue, nausea and vomiting, insomnia, anorexia, and diarrhea in the fire moxibustion group were higher than those in the conventional group with statistically significant difference (P ＜ 0.05 or P ＜ 0.01). After treatment, the total effective rate was 76.67％ in the fire moxibustion treatment group, which was higher than the conventional group 91.53％ with statistically significant difference ( χ2 =5.64, P =0.012 ＜ 0.01). Hemoglobin improvement value of 3.92 ± 1.18 in the fire moxibustion group was higher than that of the conventional group 1.02 ± 0.52 with statistically significant difference (t =7.212, P =0.003 ＜ 0.01). Conclusion: Sini-moxibustion can improve the CRF of patients with yangdeficiency gastrointestinal cancer, reduce the symptoms of yang deficiency, improve the quality of life, and increase the hemoglobin content in patients with chemotherapy.

Objective To establish a HPLC method for the determination of related substances in lysine hydrochloride and zinc gluconate oral solution. Methods The HPLC separation was performed at 30 ℃ on an Inertsil Amide column (4.6 mm×250 mm,5 μm) by gradient elution with mobile phase A [phosphatesolution (2.72 g KH2PO4and 0.46 goctane sulfonate,added with 1 000 mL)-acetonitrile (22:78)] and B [phosphate solution-acetonitrile (95:5)] at the flow rate of 1.0 mL·min-1.The clumn temperature was 30 ℃.The determination wavelength was 203 nm. Results The major peaks were well separated from adjacent related substances peaks and resolution were greater than 2.0.The theoretical plate number of major peaks and related substance peaks were greater than 3 000.Excipients and destruction test products did not interfere with the determination. Conclusion This method is practicable,specific and durable for the simultaneous determination of related substances in lysine hydrochloride and zinc gluconate oral solution.

Objective:To investigate the expression of activin A in paraventricular nucleus (PVN)of the WKY rats and its influence in arterial blood pressure,and to clarify the mechanism of activin A in the regulation of arterial blood pressure by PVN.Methods:The WKY rats were selected.The expressions of activin A,ActRⅡA,ActRⅡB,and Smads mRNA in PVN of the WKY rats were measured by RT-PCR.The expression of ActRⅡA protein in PVN was detected by immunohistochemical staining.The microinjection of exogenous activin A into PVN was used to observe the changes of arterial blood pressure.The primary cultured PVN neurons from the WKY rats were divided into control group and activin A group.The mRNA expression levels of ActRⅡA,ActRⅡB,and Smads in the PVN neurons were analyzed by RT-PCR.Results:Activin A,ActRⅡA,ActRⅡB,Smad2 and Smad3 mRNA were expressed in PVN of the WKY rats.The ActRⅡ A protein expression in PVN was further confirmed by immunohistochemical staining.After microinjection of activin A or angiotensin Ⅱ (AgⅡ)into PVN,the mean arterial blood pressure was increased obviously compared with before treatment (P <0.05).Moreover,compared with control group,the expression levels of ActRⅡA and Smad3 mRNA in primary cultured PVN neurons of the rats in vitro were significantly increased (P <0.05).Conclusion:Activin A can regulate the arterial blood pressure in PVN in an autocrine or paracrine manner,which is related to ActRⅡA-Smad3 signal pathway.

Objective To investigate the changes in histological characteristics and collagen content in uterosacral and cardinal ligaments of pefimenopausal women in relation to relaxation of pelvic supports.Methods Twenty-eight subjects undergoing hysterectomies were selected,in which 14 cases were perimenopausal women with relaxation of pelvic support as the relaxation group and 14 women at perimenopansal age with leomyoma,cervical cancer,adenomyosis as the control group.Samples of cardinal ligaments and uterosacral ligaments were obtained at hysterectomies,and the tissues were shced and stained bv Masson's trichrome technique.Histological characteristics of the samples were studied and immunohistochemistry assay was applied to demonstrate the contents of collagen types I andⅢ.Results (1)The collagen in uterosacral ligaments and cardinal ligaments were stained blue by tlle MaSson's trichome technique.In comparison to the control group,the relaxation group had milder positive stains of the collagen and the stains were distributed in unequal intensities.Collagen content was arranged in loose pattern.Focal arrangement of the collagen was dense but fragmented.Collagen fibers were atrophic. (2)In immunohistochemistry assay and image analysis,collagen was positive in light to deep brown areas.In the relaxation group,positive units of collagen types I and III in cardinal ligaments were 13.8±2.1 and 9.6±2.4 respectively.Positive units of coHagen types I and Ⅲ of cardinal ligaments in the control group were 27.4 ±3.5 and 17.7 ±4.0 respectively.Difierences between these two groups were statistically significant (P