Objective To observe the value of fetal MRI in diagnosis of duodenal obstruction(DO).Methods A total of 35 fetuses with suspected DO according to MRI were retrospectively included.The length and the maximum diameter of the dilated duodenum were measured,so as site(categorized in descending order from proximal to distal as descending segment,horizontal segment and ascending duodenum/proximal jejunum)and the degree of obstruction(complete or incomplete)were assessed.Taken findings of labor induction specimen,postnatal neonatal surgery or follow-up data as standards,the positive predictive value(PPV)of MRI for diagnosing fetal DO was calculated,while the correlations of the measured parameters of dilated duodenum and the confirmed obstruction site/degree were analyzed.Results Among 35 fetuses,DO was confirmed in 34 fetuses,yielding an overall PPV of 97.14％(34/35)for MRI.In 34 fetuses with confirmed DO,there were 23 with descending DO(DDO),4 with horizontal DO(HDO)and 7 with ascending DO/proximal jejunum obstruction(ADO/PJO),including 12 with complete DO and 22 with incomplete DO.PPV of MRI for diagnosing DDO,HDO and ADO/PJO was 87.50％(21/24),50.00％(2/4)and 100％(7/7),respectively,for diagnosing complete and incomplete DO was 90.00％(9/10)and 84.00％(21/25),respectively.Both the length and the maximum diameter of fetal proximal dilated duodenum showed on MRI were positively correlated with the actual obstruction site(from proximal to distal)(rs=0.736,P＜0.001;rs=0.424,P=0.011,respectively),but had no significant rank correlation with the degree of obstruction(rs=-0.216,P=0.212;rs=-0.285,P=0.097,respectively).Conclusion Fetal MRI could effectively evaluate the length and the maximum diameter of dilated duodenum hence indicating the level and degree of DO.

Objective:The association between air pollutants and the risk of sudden cardiac death (SCD) remains controversial. This study aimed to investigate the relationship between five air pollutants—PM 2.5, PM 2.5–10, PM 10, NO 2, and NO?—and the risk of SCD. Methods:We analyzed data from 460 862 participants in the UK Biobank cohort, all enrolled between 2006 and 2010, with no baseline SCD. Follow-up continued until the study endpoint. Annual average concentrations of the five pollutants were assessed. Associations between pollutants and SCD were evaluated using Cox proportional hazards models, followed by Mendelian randomization (MR) to assess causality.Results:Over a mean follow-up of 12.4 years, 2 662 SCD cases were recorded. After adjusting for confounders, no significant associations were found between air pollutants and SCD risk: PM 2.5 ( HR 1.03, 95% CI 0.99–1.07, P = 0.14), PM 2.5–10 ( HR 1.04, 95% CI 1.00–1.08, P = 0.08), PM 10 ( HR 1.01, 95% CI 0.99–1.03, P = 0.26), NO? ( HR 1.00, 95% CI 0.99–1.00, P = 0.26), and NO x ( HR 1.00, 95% CI 1.00–1.01, P = 0.19). MR analysis further supported the absence of causal relationships: PM 2.5 ( β = -0.149, P = 0.90), PM 2.5–10 ( β = 0.387, P = 0.62), PM 10 ( β = -0.994, P = 0.62), NO? ( β = –0.005, P = 0.99), and NO 2 ( β = –0.827, P = 0.25). Conclusions:This study found no evidence linking PM 2.5, PM 2.5–10, PM 10, NO?, or NO 2 to an increased risk of SCD. Mendelian randomization confirmed the lack of causal associations between these pollutants and SCD.

This study was aimed at preliminarily investigating the molecular biological functions of the PPE65 protein from Myco-bacterium tuberculosis,and providing foundational data for tuberculosis prevention and control.The basic biological properties of the PPE65 gene-encoded protein were predicted with bioinformatics tools.Sequence information for the Mycobacterium tuberculosis Rv3621c gene and PPE65 protein was retrieved from the NCBI database.The Rv3621c gene was amplified through PCR with the H37Rv genome as a template,then cloned into the pET22b(+)expression vector.The recombinant pET22b(+)-PPE65 plasmid was transformed into Escherichia coli BL21(DE3)competent cells for IPTG-induced expression.Solubility analysis,purification,and identification of the recombinant PPE65 protein were performed.BEAS-2B cells were treated with various concentrations of PPE65 protein for 24 h,and cell proliferation was assessed with CCK-8 assays.PPE65 was found to be composed of 413 amino acids and to have a molecular formula of C????H????N???O???S??,a relative molecular mass of 40 679.88,a theoretical isoelectric point of 4.60,an ali-phatic index of 81.94,and an average hydrophilicity value of 0.319,thus indicating a stable hydrophobic protein lacking signal pep-tides or transmembrane domains.Secondary structure analysis revealed 53.03%α-helix(Hh),2.66%β-sheet(Ee),and 44.31%ran-dom coil(Cc).Bioinformatics predictions identified 38 B-cell epitopes and 22 CTL/Th-cell epitopes.The full-length PPE65 gene(1 308 bp)was confirmed through double restriction enzyme digestion and sequencing,thereby validating the correct construction of the pET22b(+)-PPE65 recombinant plasmid.SDS-PAGE analysis demonstrated that the recombinant protein was found in inclusion bodies,and a single band at 43.7 kDa was observed after purification.Western blotting revealed specific binding to mouse-derived His monoclonal antibodies,thereby confirming successful expression of the PPE65 protein.BEAS-2B cells treated with a PPE65 protein concentration gradient(2.5-20 μg/mL)exhibited a dose-dependent increase in cell number.Compared with those in the PBS control group,TGF-β relative expression levels were significantly higher in all treatment groups(t2.5=4.893,P<0.001,t5.0=4.640,P<0.05,t10=7.535,P<0.05,t20=16.44,P<0.000 1).This study elucidated the structural characteristics of the PPE65 protein,successfully obtained the recombinant protein through prokaryotic expression and purification,and demonstrated its ability to promote BEAS-2B cell proliferation.The underlying mechanism might involve suppression of TGF-β/S mad signaling pathway activation.These findings provide a theoretical basis for understanding the role and regulatory mechanisms of PPE65 during M.tuberculosis infection.

Objective To explore the value of machine learning(ML)models based on ultrasonic texture features(TF)of coronary artery for predicting incomplete Kawasaki disease(IKD)in children.Methods Forty-eight children with IKD and 48 children without KD(non-KD)were enrolled with propensity score matching and divided into training set(n=67,34 cases of IKD and 33 cases of non-KD)and test set(n=29,14 of IKD and 15 of non-KD)at the ratio of 7∶3.Based on clinic-laboratory indicators(C-L)in training set and TF obtained with texture analysis of coronary artery ultrasound images,the optimal C-L-related features and TF were selected.Based on the optimal C-L correlated features,TF and their combinations,6 ML models,including random forest(RF),support vector machine(SVM),logistic regression(LR),gradient boosting decision tree(GBDT),decision tree(DT)and eXtreme gradient boosting(XGBoost)were respectively constructed for predicting IKD in children.The models were then trained in training set and validated in test set,and the best C-L ML,TF ML and C-L-TF ML models were selected.The area under the curve(AUC)of the best ML models were compared,and the clinical value of the best TF ML model was observed with decision curve analysis(DCA).Results Totally 3 optimal C-L related features and 8 optimal TF were selected.Among the constructed C-L ML,TF ML and C-L-TF ML models,C-L-LR model,TF-LR model and C-L-TF-SVM model were the optimal ones,with AUC in training set of 0.891,0.985 and 0.965,while in test set of 0.676,0.971 and 0.948,respectively.No significant difference of AUC was found between TF-LR model and C-L-TF-SVM model in both training set and test set(both P＞0.05),which were both greater than those of C-L-LR model(all P＜0.05).TF-LR model achieved higher clinical benefits in both training set and test set.Conclusion Ultrasound TF-LR model of coronary artery could be used to effectively predict IKD in children.

Objective:To survey the status of radiological diagnostic equipment, protective equipment and articles, personnel allocation, and exposure frequencies in Linyi city, Shandong province, and to provide data support for rational allocation of radiological resources and radiological health management.Methods:In 2023, a questionnaire survey was conducted of radiological diagnostic resources in 353 medical health institutions with radiological diagnostic equipment (excluding simple dental clinics, hereinafter referred to as radiological diagnostic institutions) in Linyi. The survey included the radiological diagnostic equipment (including 16 types of equipment in 7 categories), protective equipment and articles, the number of staff, and the exposure frequencies of X-ray diagnosis. The comparisons were conducted using rank sum test of number of peices of equipment and article and staff number in institutions at different levels in different regions.Results:In 2023, the 353 radiological diagnostic institutions in Linyi were all equipped with radiological diagnostic equipment, summing 1 180 pieces. The median value M ( P25, P75) of the number of peices of radiological diagnostic equipment possessed by each diagnostic institution was 2 (2, 3). The highest proportion of a single piece of equipment was 35.4% for digital radiography (RD) machine and 32.5% for computed tomography (CT) scanner, respectively, followed by image intensifier fluoroscopes 7.9% and flat-panel detector fluoroscopes 7.6%, while computed radiography(CR), 3 kinds of breast X-ray machines, 4 kinds of dental CT machines, and bone densitometers accounted for less than 4.0% each. A total of 223 items of protection equipment (radiation monitoring devices) were equipped, about of 47.0%. The radiological diagnostic institution was each equipped with protective articles. A total of 5 709 protective articles were provided, mainly including lead rubber neck covers, lead rubber hats, and lead rubber aprons (accounting for over 20% each). In 2023, there were a total of 2 677 staff engaged in radiological diagnosis in Linyi, with the majority being male (62.9%). The M ( P25, P75) of staff was 3 (2, 5), including 2 (1, 4) males and 1 (0, 2) females. There were level differences in radiological diagnostic equipment ( χ2=109.04, P<0.05), protective articles ( χ2=83.05, P<0.05), and the number of staff ( χ2=96.90, P<0.05), with tertiary institutions significantly higher than other levels. In 2023, there were 107.8 pieces of radiological diagnostic equipment per million population (38.2 DR units and 35.0 CT scanners per million population) and 244 radiological diagnostic staff per million population (154 males and 90 females per million population) in Linyi. The exposure frequencies of radiological diagnosis in Linyi were 543.7 examinations per thousand population, with CT diagnosis having the highest frequency (342.7 examinations per thousand population), followed by X-ray photography (157.8 examinations per thousand population) during the survey period. Conclusions:In 2023, all the radiological diagnostic institutions in Linyi are equipped with diagnostic equipment and protective articles. The number of CT, DR, breast DR units possessed by every millions of population are higher than the national and Shandong provincial average levels. The overall radiological diagnostic resources are generally good. However, the allocation of radiological diagnostic resources is unbalanced to a certain degree, which currently mainly focuses on the tertiary institutions. At the same time, the bone density meters and breast X-ray machines are insufficient, and further adjustments and optimizations are needed in the future.

Background and Aims:In recent years,with the continuous progress of systemic therapy,hepatic arterial infusion chemotherapy(HAIC)combined with immune checkpoint inhibitors and anti-angiogenic agents has demonstrated significant efficacy in the treatment of advanced hepatocellular carcinoma(HCC).However,direct comparisons between different immunotherapeutic targets,such as PD-1 and PD-L1 inhibitors,in terms of clinical benefit and safety remain limited.This study aimed to compare the efficacy and safety of HAIC plus bevacizumab and sintilimab(HAIC-BP1)versus HAIC plus bevacizumab and atezolizumab(HAIC-BPL)in advanced HCC.Methods:A retrospective analysis was conducted on 88 patients with advanced HCC who received first-line HAIC-BP1or HAIC-BPL at Sun Yat-sen University Cancer Center between January 2020 and December 2022.Progression-free survival(PFS),overall survival(OS),objective response rate(ORR),disease control rate(DCR),and adverse events(AEs)were compared between the two groups.Cox regression analysis was performed to identify prognostic factors affecting PFS.Results:A total of 47 patients were included in the HAIC-BP1 group and 41 patients in the HAIC-BPL group,with no statistically significant differences in baseline characteristics between the two groups(all P>0.05).The ORR(59.6%vs.65.9%)and DCR(72.3%vs.80.5%)did not significantly differ between the HAIC-BP1 group and the HAIC-BPL group(both P>0.05).After a median follow-up of 16.3 months,there were no significant differences in median OS(21.3 months vs.22.4 months)or median PFS(6.7 months vs.6.2 months)between the HAIC-BP1 group and the HAIC-BPL group(both P>0.05).The incidence of AEs was similar,and no treatment-related deaths occurred.Multivariate Cox regression analysis identified tumor diameter>10 cm as an independent adverse prognostic factor for PFS(HR=0.48,95%CI=0.27-0.83,P=0.009).Conclusion:Both HAIC-BP1 and HAIC-BPL demonstrated comparable efficacy and favorable safety profiles as first-line treatment options for advanced HCC.Tumor diameter>10 cm was an independent unfavorable prognostic factor for PFS,underscoring the importance of patient stratification in clinical decision-making.

Objective:To survey the status of radiological diagnostic equipment, protective equipment and articles, personnel allocation, and exposure frequencies in Linyi city, Shandong province, and to provide data support for rational allocation of radiological resources and radiological health management.Methods:In 2023, a questionnaire survey was conducted of radiological diagnostic resources in 353 medical health institutions with radiological diagnostic equipment (excluding simple dental clinics, hereinafter referred to as radiological diagnostic institutions) in Linyi. The survey included the radiological diagnostic equipment (including 16 types of equipment in 7 categories), protective equipment and articles, the number of staff, and the exposure frequencies of X-ray diagnosis. The comparisons were conducted using rank sum test of number of peices of equipment and article and staff number in institutions at different levels in different regions.Results:In 2023, the 353 radiological diagnostic institutions in Linyi were all equipped with radiological diagnostic equipment, summing 1 180 pieces. The median value M ( P25, P75) of the number of peices of radiological diagnostic equipment possessed by each diagnostic institution was 2 (2, 3). The highest proportion of a single piece of equipment was 35.4% for digital radiography (RD) machine and 32.5% for computed tomography (CT) scanner, respectively, followed by image intensifier fluoroscopes 7.9% and flat-panel detector fluoroscopes 7.6%, while computed radiography(CR), 3 kinds of breast X-ray machines, 4 kinds of dental CT machines, and bone densitometers accounted for less than 4.0% each. A total of 223 items of protection equipment (radiation monitoring devices) were equipped, about of 47.0%. The radiological diagnostic institution was each equipped with protective articles. A total of 5 709 protective articles were provided, mainly including lead rubber neck covers, lead rubber hats, and lead rubber aprons (accounting for over 20% each). In 2023, there were a total of 2 677 staff engaged in radiological diagnosis in Linyi, with the majority being male (62.9%). The M ( P25, P75) of staff was 3 (2, 5), including 2 (1, 4) males and 1 (0, 2) females. There were level differences in radiological diagnostic equipment ( χ2=109.04, P<0.05), protective articles ( χ2=83.05, P<0.05), and the number of staff ( χ2=96.90, P<0.05), with tertiary institutions significantly higher than other levels. In 2023, there were 107.8 pieces of radiological diagnostic equipment per million population (38.2 DR units and 35.0 CT scanners per million population) and 244 radiological diagnostic staff per million population (154 males and 90 females per million population) in Linyi. The exposure frequencies of radiological diagnosis in Linyi were 543.7 examinations per thousand population, with CT diagnosis having the highest frequency (342.7 examinations per thousand population), followed by X-ray photography (157.8 examinations per thousand population) during the survey period. Conclusions:In 2023, all the radiological diagnostic institutions in Linyi are equipped with diagnostic equipment and protective articles. The number of CT, DR, breast DR units possessed by every millions of population are higher than the national and Shandong provincial average levels. The overall radiological diagnostic resources are generally good. However, the allocation of radiological diagnostic resources is unbalanced to a certain degree, which currently mainly focuses on the tertiary institutions. At the same time, the bone density meters and breast X-ray machines are insufficient, and further adjustments and optimizations are needed in the future.

[Objective]To explore the effects of exosomal CXCL on the biological behavior of cervical cancer cells and its underlying mechanisms.[Methods]Chemokine CXCL was first screened through bioinformatics databases.The GEPIA database was analyze CXCL expression in cervical cancer tissues and adjacent normal cervical tissues.Western blot was performed to detect CXCL expression levels in cervical cancer cells(Caski)and normal cervical epithelial cells(H8).The successful isolation of exosomes was confirmed by nanoparticle tracking analysis,transmission electron microscopy(TEM)and Western blot.ELISA was employed to detect the expression level of exosomes CXCL was determined by ELISA.After CXCL knockdown via siRNA transfection,cells were divided into three groups:blank control,negative control and experimental groups.Cell proliferation was evaluated using the CCK-8 assay,while cell migration and invasion were assessed by Transwell assays.[Results]Exosomal CXCL expression was significantly upregulated in cervical cancer cells compared with normal cervical epithelial cells(P<0.01),and also markedly elevated in cervical cancer tissues compared with adjacent normal tissues.After low expression of CXCL knockdown significantly reduced CXCL expression in both cancer cells and their derived exosomes(P<0.05).Low expression markedly inhibited the proliferation,invasion and migration abilities[Conclusion]Silencing exosomal CXCL may inhibit the malignant biological behavior of cancer cells.

This study was aimed at preliminarily investigating the molecular biological functions of the PPE65 protein from Myco-bacterium tuberculosis,and providing foundational data for tuberculosis prevention and control.The basic biological properties of the PPE65 gene-encoded protein were predicted with bioinformatics tools.Sequence information for the Mycobacterium tuberculosis Rv3621c gene and PPE65 protein was retrieved from the NCBI database.The Rv3621c gene was amplified through PCR with the H37Rv genome as a template,then cloned into the pET22b(+)expression vector.The recombinant pET22b(+)-PPE65 plasmid was transformed into Escherichia coli BL21(DE3)competent cells for IPTG-induced expression.Solubility analysis,purification,and identification of the recombinant PPE65 protein were performed.BEAS-2B cells were treated with various concentrations of PPE65 protein for 24 h,and cell proliferation was assessed with CCK-8 assays.PPE65 was found to be composed of 413 amino acids and to have a molecular formula of C????H????N???O???S??,a relative molecular mass of 40 679.88,a theoretical isoelectric point of 4.60,an ali-phatic index of 81.94,and an average hydrophilicity value of 0.319,thus indicating a stable hydrophobic protein lacking signal pep-tides or transmembrane domains.Secondary structure analysis revealed 53.03%α-helix(Hh),2.66%β-sheet(Ee),and 44.31%ran-dom coil(Cc).Bioinformatics predictions identified 38 B-cell epitopes and 22 CTL/Th-cell epitopes.The full-length PPE65 gene(1 308 bp)was confirmed through double restriction enzyme digestion and sequencing,thereby validating the correct construction of the pET22b(+)-PPE65 recombinant plasmid.SDS-PAGE analysis demonstrated that the recombinant protein was found in inclusion bodies,and a single band at 43.7 kDa was observed after purification.Western blotting revealed specific binding to mouse-derived His monoclonal antibodies,thereby confirming successful expression of the PPE65 protein.BEAS-2B cells treated with a PPE65 protein concentration gradient(2.5-20 μg/mL)exhibited a dose-dependent increase in cell number.Compared with those in the PBS control group,TGF-β relative expression levels were significantly higher in all treatment groups(t2.5=4.893,P<0.001,t5.0=4.640,P<0.05,t10=7.535,P<0.05,t20=16.44,P<0.000 1).This study elucidated the structural characteristics of the PPE65 protein,successfully obtained the recombinant protein through prokaryotic expression and purification,and demonstrated its ability to promote BEAS-2B cell proliferation.The underlying mechanism might involve suppression of TGF-β/S mad signaling pathway activation.These findings provide a theoretical basis for understanding the role and regulatory mechanisms of PPE65 during M.tuberculosis infection.

Background and Aims:In recent years,with the continuous progress of systemic therapy,hepatic arterial infusion chemotherapy(HAIC)combined with immune checkpoint inhibitors and anti-angiogenic agents has demonstrated significant efficacy in the treatment of advanced hepatocellular carcinoma(HCC).However,direct comparisons between different immunotherapeutic targets,such as PD-1 and PD-L1 inhibitors,in terms of clinical benefit and safety remain limited.This study aimed to compare the efficacy and safety of HAIC plus bevacizumab and sintilimab(HAIC-BP1)versus HAIC plus bevacizumab and atezolizumab(HAIC-BPL)in advanced HCC.Methods:A retrospective analysis was conducted on 88 patients with advanced HCC who received first-line HAIC-BP1or HAIC-BPL at Sun Yat-sen University Cancer Center between January 2020 and December 2022.Progression-free survival(PFS),overall survival(OS),objective response rate(ORR),disease control rate(DCR),and adverse events(AEs)were compared between the two groups.Cox regression analysis was performed to identify prognostic factors affecting PFS.Results:A total of 47 patients were included in the HAIC-BP1 group and 41 patients in the HAIC-BPL group,with no statistically significant differences in baseline characteristics between the two groups(all P>0.05).The ORR(59.6%vs.65.9%)and DCR(72.3%vs.80.5%)did not significantly differ between the HAIC-BP1 group and the HAIC-BPL group(both P>0.05).After a median follow-up of 16.3 months,there were no significant differences in median OS(21.3 months vs.22.4 months)or median PFS(6.7 months vs.6.2 months)between the HAIC-BP1 group and the HAIC-BPL group(both P>0.05).The incidence of AEs was similar,and no treatment-related deaths occurred.Multivariate Cox regression analysis identified tumor diameter>10 cm as an independent adverse prognostic factor for PFS(HR=0.48,95%CI=0.27-0.83,P=0.009).Conclusion:Both HAIC-BP1 and HAIC-BPL demonstrated comparable efficacy and favorable safety profiles as first-line treatment options for advanced HCC.Tumor diameter>10 cm was an independent unfavorable prognostic factor for PFS,underscoring the importance of patient stratification in clinical decision-making.