Objective To evaluate the respective or synergistic value of cytoplasmic tryptophan-tRNA ligase(WARS1/SYWC)and adenosine deaminase(ADA)in diagnosing tuberculous pleural effusion(TPE).Methods A retrospective analysis was conducted on 120 patients with pleural effusion(64 cases of TPE,56 cases of non-TPE)admitted to the First Affiliated Hospital of Jinan University and its affiliated Shunde Hospital from January 2020 to December 2024.Pleural fluid SYWC levels were identified using enzyme-linked immunosorbent assay(ELISA).Univariate and multivariate logistic regression analyses were performed to identify diagnostic predictors,while receiver operating characteristic(ROC)curves were plotted to assess the diagnostic perfor-mance of individual and combined biomarkers.Results Compared to the non-TPE group,TPE group exhibited significantly younger age,lower pleural CEA,less serum CEA,and lower neutrophil-to-lymphocyte ratio(NLR),but significantly higher levels of pleural ADA,total protein,SYWC,and serum CRP(all P<0.05).Univariate analysis identified age,pleural CEA,carbohydrate antigen 199,ADA,SYWC,serum CEA,and NLR as potential predictors.Multivariate analysis confirmed pleural ADA(OR=1.064,95%CI:1.017～1.228)and SYWC(OR=6.695,95%CI:2.794～16.04)as independent diagnostic factors.At optimal cutoffs,SYWC(16.94 μg/L)demonstrated a sensitivity of 71.80%and specificity of 98.21%,while ADA(36.5 U/L)showed a sensitivity of 93.75%and a specificity of 89.29%.Combined detection increased the sensitivity to 95.56%,the specificity to 98.0%,and the accuracy to 97.87%.ROC analysis revealed an AUC of 0.973(95%CI:0.943～1.000)for the combination,outperforming ADA(0.897)and SYWC(0.938)alone.Conclusion The combi-nation of SYWC and ADA notably enhances diagnostic efficacy for TPE,providing high sensitivity and specificity as a reliable tool for clinical differentiation.

BACKGROUND:The therapeutic efficacy of moderate or severe intrauterine adhesions is poor.After synechotomy,the high postoperative recurrence rate severely affects the reproductive health of women of childbearing age,which is an urgent problem to be solved in clinical practice.Perinatal mesenchymal stem cells and their combined hydrogels have unique advantages,and they have received particular attention on the treatment of intrauterine adhesions.OBJECTIVE:To summarize the research progress of perinatal mesenchymal stem cells and their combined hydrogel in the treatment of intrauterine adhesions.METHODS:Search terms were"mesenchymal stem cells,perinatal period,hydrogel,intrauterine adhesions,endometrial injury"in Chinese and English.Relative articles published from 2010 to 2024 were retrieved on PubMed,CNKI,and WanFang databases.As a result,80 articles that met the inclusion criteria were reviewed and analyzed.RESULTS AND CONCLUSION:(1)Similar to other sources of mesenchymal stem cells,perinatal mesenchymal stem cells have a good therapeutic effect on intrauterine adhesions,and can meet the needs of autologous and allogeneic transplantation.(2)The mechanism of perinatal mesenchymal stem cell transplantation from umbilical cord,amniotic membrane,placenta,and umbilical cord blood in the treatment of uterine adhesion involves in regulation of relative signaling pathways such as colonization and differentiation,cellular immunity,paracrine,and promoting endometrial regeneration and angiogenesis,immune regulation,anti-endometrial cell apoptosis,inhibition of epithelial-mesenchymal transition,and anti-fibrosis.(3)Perinatal mesenchymal stem cells combined with hydrogel have a synergistic effect on the treatment of intrauterine adhesions.On the basis of the effect of mesenchymal stem cells,the hydrogel also plays a role in supporting and maintaining the continuous release of mesenchymal stem cells,promoting cell migration and adhesion,which is helpful to better promote endometrial regeneration and anti-fibrosis.It is beneficial to repair the damaged endometrial,improve endometrial receptivity and fertility,and reduce the recurrence rate.(4)A few of clinical trials have initially verified the effectiveness and safety of umbilical cord mesenchymal stem cells or hydrogels in the treatment of intrauterine adhesions.Further studies are still needed on the interaction between perinatal mesenchymal stem cells and polymer biomaterials such as hydrogels,and other effects and molecular mechanism of combined treatment of intrauterine adhesions.

Objective To observe the value of MRI radiomics model for predicting postoperative prognosis of moderate carpal tunnel syndrome(CTS).Methods A total of 126 patients with moderate CTS who underwent endoscopic release and fat-suppressed proton density weighted imaging(PDWI)before operation were retrospectively enrolled.The patients were divided into good prognosis group(n=80)and poor prognosis group(n=46)based on postoperative functional evaluation,also randomly divided into training set and validation set at a ratio of 7∶3.Volume of interest(VOI)of the median nerve was obtained through delineating ROI of the affected wrist on fat suppressed PDWI.Radiomics features were extracted,and those associated with postoperative prognosis of CTS were screened in training set.Clinical prediction model,radiomics model and combined model of these two were established,and the predictive efficacy of the models were evaluated and compared according to the area under the curve(AUC)of receiver operating characteristic(ROC)curve.Results Patients in poor prognosis group were older than in good prognosis group(P＜0.05).A clinical model was constructed based on age.The radiomics model was constructed based on 6 radiomics features associated with postoperative prognosis of CTS,with predictive efficacy(AUC=0.872)higher than that of clinical model(AUC=0.604,P＜0.05)but not significantly different with that of the combined model(AUC=0.905,P＞0.05).Conclusion MRI radiomics model could be used to effectively predict postoperative prognosis of moderate CTS.

Objective To evaluate the respective or synergistic value of cytoplasmic tryptophan-tRNA ligase(WARS1/SYWC)and adenosine deaminase(ADA)in diagnosing tuberculous pleural effusion(TPE).Methods A retrospective analysis was conducted on 120 patients with pleural effusion(64 cases of TPE,56 cases of non-TPE)admitted to the First Affiliated Hospital of Jinan University and its affiliated Shunde Hospital from January 2020 to December 2024.Pleural fluid SYWC levels were identified using enzyme-linked immunosorbent assay(ELISA).Univariate and multivariate logistic regression analyses were performed to identify diagnostic predictors,while receiver operating characteristic(ROC)curves were plotted to assess the diagnostic perfor-mance of individual and combined biomarkers.Results Compared to the non-TPE group,TPE group exhibited significantly younger age,lower pleural CEA,less serum CEA,and lower neutrophil-to-lymphocyte ratio(NLR),but significantly higher levels of pleural ADA,total protein,SYWC,and serum CRP(all P<0.05).Univariate analysis identified age,pleural CEA,carbohydrate antigen 199,ADA,SYWC,serum CEA,and NLR as potential predictors.Multivariate analysis confirmed pleural ADA(OR=1.064,95%CI:1.017～1.228)and SYWC(OR=6.695,95%CI:2.794～16.04)as independent diagnostic factors.At optimal cutoffs,SYWC(16.94 μg/L)demonstrated a sensitivity of 71.80%and specificity of 98.21%,while ADA(36.5 U/L)showed a sensitivity of 93.75%and a specificity of 89.29%.Combined detection increased the sensitivity to 95.56%,the specificity to 98.0%,and the accuracy to 97.87%.ROC analysis revealed an AUC of 0.973(95%CI:0.943～1.000)for the combination,outperforming ADA(0.897)and SYWC(0.938)alone.Conclusion The combi-nation of SYWC and ADA notably enhances diagnostic efficacy for TPE,providing high sensitivity and specificity as a reliable tool for clinical differentiation.

BACKGROUND:The therapeutic efficacy of moderate or severe intrauterine adhesions is poor.After synechotomy,the high postoperative recurrence rate severely affects the reproductive health of women of childbearing age,which is an urgent problem to be solved in clinical practice.Perinatal mesenchymal stem cells and their combined hydrogels have unique advantages,and they have received particular attention on the treatment of intrauterine adhesions.OBJECTIVE:To summarize the research progress of perinatal mesenchymal stem cells and their combined hydrogel in the treatment of intrauterine adhesions.METHODS:Search terms were"mesenchymal stem cells,perinatal period,hydrogel,intrauterine adhesions,endometrial injury"in Chinese and English.Relative articles published from 2010 to 2024 were retrieved on PubMed,CNKI,and WanFang databases.As a result,80 articles that met the inclusion criteria were reviewed and analyzed.RESULTS AND CONCLUSION:(1)Similar to other sources of mesenchymal stem cells,perinatal mesenchymal stem cells have a good therapeutic effect on intrauterine adhesions,and can meet the needs of autologous and allogeneic transplantation.(2)The mechanism of perinatal mesenchymal stem cell transplantation from umbilical cord,amniotic membrane,placenta,and umbilical cord blood in the treatment of uterine adhesion involves in regulation of relative signaling pathways such as colonization and differentiation,cellular immunity,paracrine,and promoting endometrial regeneration and angiogenesis,immune regulation,anti-endometrial cell apoptosis,inhibition of epithelial-mesenchymal transition,and anti-fibrosis.(3)Perinatal mesenchymal stem cells combined with hydrogel have a synergistic effect on the treatment of intrauterine adhesions.On the basis of the effect of mesenchymal stem cells,the hydrogel also plays a role in supporting and maintaining the continuous release of mesenchymal stem cells,promoting cell migration and adhesion,which is helpful to better promote endometrial regeneration and anti-fibrosis.It is beneficial to repair the damaged endometrial,improve endometrial receptivity and fertility,and reduce the recurrence rate.(4)A few of clinical trials have initially verified the effectiveness and safety of umbilical cord mesenchymal stem cells or hydrogels in the treatment of intrauterine adhesions.Further studies are still needed on the interaction between perinatal mesenchymal stem cells and polymer biomaterials such as hydrogels,and other effects and molecular mechanism of combined treatment of intrauterine adhesions.

Objective To observe the value of MRI radiomics model for predicting postoperative prognosis of moderate carpal tunnel syndrome(CTS).Methods A total of 126 patients with moderate CTS who underwent endoscopic release and fat-suppressed proton density weighted imaging(PDWI)before operation were retrospectively enrolled.The patients were divided into good prognosis group(n=80)and poor prognosis group(n=46)based on postoperative functional evaluation,also randomly divided into training set and validation set at a ratio of 7∶3.Volume of interest(VOI)of the median nerve was obtained through delineating ROI of the affected wrist on fat suppressed PDWI.Radiomics features were extracted,and those associated with postoperative prognosis of CTS were screened in training set.Clinical prediction model,radiomics model and combined model of these two were established,and the predictive efficacy of the models were evaluated and compared according to the area under the curve(AUC)of receiver operating characteristic(ROC)curve.Results Patients in poor prognosis group were older than in good prognosis group(P＜0.05).A clinical model was constructed based on age.The radiomics model was constructed based on 6 radiomics features associated with postoperative prognosis of CTS,with predictive efficacy(AUC=0.872)higher than that of clinical model(AUC=0.604,P＜0.05)but not significantly different with that of the combined model(AUC=0.905,P＞0.05).Conclusion MRI radiomics model could be used to effectively predict postoperative prognosis of moderate CTS.

AIM:To investigate the therapeutic effect of enteric-coated sustained-release new dosage form of tadalafil on mice with renal fibrosis caused by unilateral ureteral obstruction(UUO).METHODS:Eight-week-old male C57BL/6J mice were divided into four groups randomly:sham group,UUO group,UUO+new dosage form of tadalafil(1 mg/kg)group and UUO+original patented drug of tadalafil(5 mg/kg)group.Surgery was performed to create a mouse UUO model,and therapeutic drugs were administered intragastrically for 7 d after modeling.A fully automated biochemi-cal analyzer was used to detect serum creatinine(SCr)levels of each group.Through renal histopathological staining(HE staining,Masson trichrome staining,and immunohistochemistry staining)and Western blot,we assessed the therapeutic effect of enteric-coated sustained-release new dosage forms of tadalafil on kidney fibrosis in mice,as well as its effect on the expression and distribution of fibronectin(FN)and α-smooth muscle actin(α-SMA).RESULTS:Compared with sham group,the SCr levels were significantly increased in mice with renal fibrosis,and renal tubules were dilated and in-filtrated with inflammation.Moreover,the expressions of FN and α-SMA were increased significantly(P<0.05).New dosage form and the original patented drug tadalafil both significantly reduced SCr levels in mice with renal fibrosis,im-proved the renal tissue structure on the affected side,reduced collagen fiber deposition,and inhibited FN and α-SMA ex-pression(P<0.05).CONCLUSION:Enteric-coated sustained-release new dosage form of tadalafil reduces the deposit of extracellular matrix in kidney interstitial tissue and attenuates fibrosis and renal function damage caused by ureteral ob-struction.New dosage form of tadalafil has significant advantages over the original patented drug because the low dose and high effectiveness.

Objective:To investigate the phenotypic characteristics of dendritic cell (DC) in the peripheral blood of patients with chronic antibody-mediated rejection (CAMR) after kidney transplantation,revealing the potential role of DCs in the occurrence and development of CAMR.Methods:Case-control study. A total of 25 kidney transplant recipients who underwent kidney transplantation or were under long-term follow-up at West China Hospital of Sichuan University from October 1st, 2020, to July 31st, 2021, were recruited in this case-control study, comprising 15 cases of patients with CAMR and 10 cases of patients with stable renal function. Flow cytometry was used to analyze DC subsets in peripheral blood mononuclear cells (PBMC) of patients. Correlation analysis was conducted to explore the relationship between DC subsets and renal function indicators. Iterative cluster analysis was performed based on the absolute counts of DC, ILT3+ mDC, ILT3+ pDC,ILT4+ mDC and ILT4+ pDC in the CAMR group.Results:Compared with the stable renal function group, the percentages and absolute count of pDC, pDC/mDC ratio, and absolute count of ILT3+ pDC were decreased while percentages of ILT3+ mDC were increased in CAMR group . DC percentage was negatively correlated with Scr (r=-0.467, P=0.019) and CysC (r=-0.502, P=0.011) and positively correlated with eGFR (r=0.436, P=0.029). ILT4+ pDC percentage was positively correlated with CysC (r=0.433, P=0.031), and absolute count of DCs was negatively correlated with CysC (r=-0.425, P=0.034). Iterative cluster analysis defined two patient clusters with significant statistic differences of Scr, eGFR, and CysC detection results in the CAMR group.Conclusion:The distribution of DC subsets and the expression of ILT3 and ILT4 in the blood of post-transplant patients could provide new biomarkers for early identification of CAMR risk and optimization of immunosuppressive therapy strategies. Particularly, changes of pDC and the expression levels of ILT3, ILT4 can serve as valuable indicators for assessing post-transplant immune status and renal function prognosis.

Objective:To investigate the phenotypic characteristics of dendritic cell (DC) in the peripheral blood of patients with chronic antibody-mediated rejection (CAMR) after kidney transplantation,revealing the potential role of DCs in the occurrence and development of CAMR.Methods:Case-control study. A total of 25 kidney transplant recipients who underwent kidney transplantation or were under long-term follow-up at West China Hospital of Sichuan University from October 1st, 2020, to July 31st, 2021, were recruited in this case-control study, comprising 15 cases of patients with CAMR and 10 cases of patients with stable renal function. Flow cytometry was used to analyze DC subsets in peripheral blood mononuclear cells (PBMC) of patients. Correlation analysis was conducted to explore the relationship between DC subsets and renal function indicators. Iterative cluster analysis was performed based on the absolute counts of DC, ILT3+ mDC, ILT3+ pDC,ILT4+ mDC and ILT4+ pDC in the CAMR group.Results:Compared with the stable renal function group, the percentages and absolute count of pDC, pDC/mDC ratio, and absolute count of ILT3+ pDC were decreased while percentages of ILT3+ mDC were increased in CAMR group . DC percentage was negatively correlated with Scr (r=-0.467, P=0.019) and CysC (r=-0.502, P=0.011) and positively correlated with eGFR (r=0.436, P=0.029). ILT4+ pDC percentage was positively correlated with CysC (r=0.433, P=0.031), and absolute count of DCs was negatively correlated with CysC (r=-0.425, P=0.034). Iterative cluster analysis defined two patient clusters with significant statistic differences of Scr, eGFR, and CysC detection results in the CAMR group.Conclusion:The distribution of DC subsets and the expression of ILT3 and ILT4 in the blood of post-transplant patients could provide new biomarkers for early identification of CAMR risk and optimization of immunosuppressive therapy strategies. Particularly, changes of pDC and the expression levels of ILT3, ILT4 can serve as valuable indicators for assessing post-transplant immune status and renal function prognosis.

Objective:To investigate the relationship of oxidative stress levels in serum and follicular fluid of polycystic ovary syndrome (PCOS) patients with the quality of oocytes and embryos.Methods:A prospective follow-up study was conducted to analyze 67 patients with PCOS (PCOS group) and 66 infertility patients with simple fallopian tube factors (control group) who underwent in vitro fertilization in Center for Reproductive Medicine, Zhejiang Provincial People's Hospital from January 2019 to October 2020. Serum and follicular fluid from the follicles with a diameter of more than 18 mm were collected on the oocyte retrieval day. Colorimetric method was used to detect the levels of total antioxidant activity (TAC), superoxide dismutase (SOD), and malondialdehyde (MDA), and the differences of those oxidative stress indicators between the two groups were compared and the correlation of those parameters with oocyte quality, embryo development and clinical outcomes were analyzed. Results:The serum SOD level of the PCOS group [(22.11±3.70) U/mL] was significantly lower than that of control group [(25.70±3.32) U/mL, P<0.001]. The follicular fluid TAC level [(0.62±0.05) mmol/L], MDA level [(16.64±3.85) nmol/mL] and serum MDA level [(18.20±4.68) nmol/mL] of the PCOS group were significantly higher than those of control group [(0.53±0.04) mmol/L, P<0.001; (13.74±2.28) nmol/mL, P<0.001; (15.37±5.34) nmol/mL, P=0.008]. The good-quality embryo rate [34.1% (341/1 000)], the implantation rate [49.5% (54/109)], the clinical pregnancy rate [60.9% (39/64)] and the live birth rate [50.0% (32/64)] in the PCOS group were statistically different from those in control group [41.7% (306/733), P=0.013; 58.7% (54/92), P=0.023; 70.3% (45/64), P=0.006;59.4% (38/64), P=0.007]. There was a negative correlation between the TAC level in follicular fluid and the rate of good-quality embryo ( β=-1.83, P=0.012). There was no significant correlation between oxidative stress indicators and clinical outcomes. Conclusion:The TAC level of follicular fluid in PCOS patients is elevated, and increased TAC level in follicular fluid may be one of the risk factors for poor embryo quality.