Objective To explore the correlation between lymph node metastasis and clinicopathological features of lung adenocarcinoma with diameter≤3 cm. Methods The clinicopathologic data of the patients with lung adenocarcinoma≤3 cm in diameter were retrospectively analyzed. The relationship between lymph node metastasis and age, gender, smoking history, pathological subtype, tumor diameter, pleural invasion, vascular invasion and other factors was analyzed. The risk factors of lymph node metastasis were analyzed by univariate and multivariate logistic regression. Results Finally 1 718 patients were collected, including 697 males and 1 021 females with an average age of (58.89±9.85) years. The total lymph node metastasis rate was 12.9%, among whom 452 patients of adenocarcinoma in situ and minimally invasive adenocarcinoma did not have lymph node metastasis, and the lymph node metastasis rate of invasive lung adenocarcinoma was 17.5%. Multivariate analysis showed that tumor diameter, micropapillary subtype, solid subtype, micropapillary component, solid component, vascular invasion and pleural invasion were independent risk factors for lymph node metastasis of invasive lung adenocarcinoma with diameter≤3 cm (P<0.05). While age, lepidic subtype and lepidic component were independent protective factors for lymph node metastasis (P<0.05). Conclusion Clinicopathological features can help predict lymph node metastasis of lung adenocarcinoma with diameter≤3 cm.

Objective To investigate the relationships of the expression of Calponin 1 and tumor ubiquitin-specific protease 1(OTUB1)with clinicopathological features in gastric cancer tissues as well as their prognostic values.Methods A total of 98 patients with gastric cancer were enrolled in this study.The qPCR was used to detect the expression levels of Calponin 1 mRNA and OTUB1 mRNA in gastric cancer tissues;the immunohistochemical staining was performed to detect the protein expres-sion levels of Calponin 1 and OTUB1;the Kaplan-Meier curve was plotted to compare the survival differences among gastric cancer patients with different expression levels of Calponin 1 and OTUB1;the Cox regression model was used to screen the influencing factors of prognosis in gastric cancer.Results Compared with adjacent tissues,the expression levels of Calponin 1 mRNA and OTUB1 mRNA in gastric cancer tissues were significantly higher(P＜0.05).The positive expression rates of Calponin 1 and OTUB1 protein in gastric cancer tissues were 63.27％and 65.31％respectively,which were significantly higher than 6.12％and 8.16％in adjacent tissues(P＜0.001).The expression levels of Calponin 1 and OTUB1 proteins were increased significantly in gastric cancer tissues of cases with stage Ⅲ ofTNM staging and lymph node metastasis(P＜0.05).The 3-year overall survival rate was 45.16％(28/62)in the Calponin 1-positive group,which was significantly lower than 83.33％(30/36)in the Calponin 1-negative group(Log-rank x2=12.990,P＜0.001).The 3-year overall survival rate was 45.31％(29/64)in the OTUB1-positive group,which was significantly lower than 85.29％(29/34)in the OTUB1-negative group(Log-rank x2=14.880,P＜0.001).The results of multivariate Cox regression showed that Calponin 1 positivity,OTUB1 positivity,stage Ⅲ ofTNM staging,and lymph node metastasis were risk factors for death in gastric cancer patients(P＜0.001).Conclusion The expressions of Calponin 1 and OTUB1 are upregulated in gastric cancer tissues and are related to TNM staging and lymph node metastasis.

Objective:To investigate the predictive value of a radiomics model based on biparametric magnetic resonance imaging(bpMRI)for biochemical recurrence(BCR)after radical prostatectomy(RP)in elderly prostate cancer patients(≥60 years old).Methods:A retrospective analysis was conducted on data from 175 patients treated at Beijing Hospital from August 2017 to December 2021.Based on pathological results, image segmentation was performed on preoperative bpMRI T2, diffusion weighted imaging(DWI), and apparent diffusion coefficient(ADC)sequences.Pyradiomics was utilized to extract radiomic features, and Cox regression, Spearman correlation coefficient, and LASSO regression were employed for feature dimensionality reduction, leading to the construction of radiomic labels.Clinical models and image-clinical combined models were developed using multifactorial Cox regression analysis, and the performance of these models in predicting BCR was evaluated using the concordance index(C-index).Results:The 175 patients were randomly divided into a training set(122 cases)and a test set(53 cases)at a ratio of 7∶3, with 24 cases(19.7%, 24/122)and 11 cases(20.8%, 11/53)experiencing BCR, respectively.A total of 5 775 radiomic features were extracted from the three sequences, and after dimensionality reduction, 5 features were selected to construct the radiomic labels.The radiomics model exhibited C-index values of 0.764(95% CI: 0.655-0.872)and 0.769(95% CI: 0.632-0.906)in the training and test sets, respectively.Multifactorial Cox regression analysis revealed serum prostate-specific antigen(PSA)( HR=1.032, 95% CI: 1.010-1.054), postoperative pathology International Society of Urological Pathology(ISUP)grade grouping( HR=1.682, 95% CI: 1.039-2.722), and positive surgical margins( HR=2.513, 95% CI: 1.094-5.774)as independent predictors of BCR.The clinical model exhibited C-index values of 0.751(95% CI: 0.655-0.846)and 0.753(95% CI: 0.630-0.877)in the training and test sets, respectively.Following combined modeling of clinical factors and radiomic labels, the image-clinical combined model demonstrated the highest C-index values, namely 0.782(95% CI: 0.679-0.874)and 0.801(95% CI: 0.677-0.915)in the training and test sets, respectively. Conclusions:The radiomics model based on bpMRI can predict the occurrence of BCR after RP in elderly prostate cancer patients.Combined modeling of clinical factors and radiomic labels can enhance predictive efficiency.

ObjectiveTo systematically sort out the knowledge framework and conceptual logic relationship of "disease-syndrome-treatment-prescription-medicine" in the existing literature on traditional Chinese medicine（TCM） treatment of diabetic peripheral neuropathy（DPN）， to construct of the knowledge map of TCM treatment of DPN， and to promote the explicitation of the implicit knowledge in the literature on the treatment of DPN with TCM. MethodTaking the literature of China National Knowledge Infrastructure about TCM treatment of DPN as the main data source， TCM-related concepts and entities were constructed by manual citation， and the corresponding relationships between the entities were established. Structured data were formed by processing with Python 3.7， and the knowledge graph was constructed based on Neo4j 3.5.34 graph database. ResultThe resulting knowledge graph with TCM diagnosis and treatment logic， defined 12 node labels such as prescriptions， Chinese medicines and syndrome types at the schema layer， as well as 4 types of relationships， such as inclusion， correspondence， selection and composition. It could support the query and discovery of nodes（syndrome elements， syndrome types and treatment methods）， as well as the relationship between each node. ConclusionBased on the literature data， this study constructed a knowledge map for TCM treatment of DPN， which brought together various methods of TCM treatment of DPN， including internal and external treatment. The whole chain knowledge structure of syndrome differentiation and classification for DPN treatment is formed from syndrome element analysis， syndrome type composition to treatment method selection， which can provide new ideas and methods for literature data to serve clinical and scientific research work， as well as reference for visualization of TCM literature knowledge， intellectualization of TCM knowledge services and the standardization of TCM diagnosis and treatment.

Purpose To investigate the effect of autophagy intervention on ferroptosis and drug resistance of colorectal canc-er cells and its molecular mechanism.Methods The human colorectal cancer cell lines HCT-8,COLO205,HCT-116,SW620,and SW480 were cultured.HCT-116 cells with moder-ate expression of LC3 were screened,and the expression differ-ences of LC3,p62,Keap1,Nrf2,GPX4 proteins,Fe2+,GSH,and MDA between them and OXA-resistant HCT-116/OXA cell lines were detected.The expression levels of LC3,p62,Keap1,Nrf2,GPX4,Fe2+,GSH and MDA were assessed in HCT-116/OXA cells through the intervention of autophagy and ferroptosis intervention agent combined with oxaliplatin.The proliferative activity and sensitivity to oxaliplatin in each group were detected by CCK-8 assay.Cell growth and invasion ability of each group were detected by plate cloning and Trans well assay.Results LC3,p62 and GPX4 expression levels of HCT-116 cells in the 5 groups were moderate.Compared with HCT-116 cells,HCT-116/OXA was less sensitive to oxaliplatin,and the proteins of p62,Nrf2 and GPX4 were highly expressed,LC3 and Keap1 were lowly expressed,and the expression of Fe2+,GSH and MDA were increased(P＜0.05).The levels of LC3,Keap1 protein,Fe2+and MDA in Rapa and Rapa+Fer-1 groups were higher than those in Fer-1 and control groups,while p62,Nrf2,GPX4 and GSH levels were lower.The expressions of GPX4 pro-tein and GSH in Rapa+Fer-1 group were lower than those in Rapa group(P＜0.05).In the autophagy inhibitor group,LC3,p62,Nrf2,GPX4 and GSH were highly expressed in the CQ and CQ+Erastin groups compared with the control and Eras-tin groups,while Keap1 protein,Fe2+and MDA were low.The levels of GPX4 protein and GSH in Erastin group were lower than those in the other three groups,and the levels of Fe2+and MDA were higher than those in the other three groups(P＜0.05).The combination of autophagy activator OXA showed that Rapa intervention group had higher chemical sensitivity to OXA,less number of migrating cells and lower cell proliferation activity than the other three groups.The sensitivity of Rapa+Fer-1 group to oxaliplatin was lower than that of Rapa group,but higher than that of Fer-1 group and control group(P＜0.05).There was no significant difference between Fer-1 group and con-trol group(P＜0.05).Compared with the control group,the cell activity,migration capacity and clonogenesis capacity of Erastin,CQ+Erastin and CQ groups were decreased when auto-phagy inhibitor was combined with OXA,and the Erastin group was the lowest,while the CQ+Erastin group was higher than the Erastin group,and lower than the CQ group(P＜0.05).Con-clusion In colorectal cancer,autophagy is involved in the regu-lation of ferroptosis,and intervention in autophagy can regulate ferroptosis in colorectal cancer cells through the p62-Keap1/Nrf2-GPX4 pathway,thereby reversing oxaliplatin resistance.

Objectives:To investigate the relationship between procedure time (PT) and outcome in patients with acute vertebrobasilar artery occlusion (VBAO) underwent endovascular mechanical thrombectomy (EMT), and to evaluate whether symptomatic intracranial hemorrhage (sICH) plays a mediating role in this relationship.Methods:Patients with acute VBAO underwent EMT treatment at 65 comprehensive stroke centers in 15 provinces of China from December 2015 to June 2022 were included retrospectively. PT was defined as the time from puncture to the first successful recanalization or termination of procedure (if recanalization was not successful). The main outcome measure was the functional outcome evaluated using the modified Rankin Scale at 90 days after onset, 0-3 was defined as good outcome and >3 was defined as poor outcome. The secondary outcome measure was sICH. Multivariate logistic regression analysis was used to determine the independent influencing factors of functional outcome and sICH. Mediation analysis was use to determine whether sICH affected the association between PT and functional outcome. Results:A total of 2 353 patients with acute VBAO underwent EMT treatment were enrolled, including 1 764 males (71.1%), aged 64.0±12.2 years. The baseline National Institutes of Health Stroke Scale score was 21.16±10.03 (median 22, interquartile range, 13-28), the baseline posterior circulation Alberta Stroke Project Early CT Score was 8.36±1.56 (median 8, interquartile range 7-10), and the baseline Basal Artery CT Angiography Score was 5.15±2.52 (median 5, interquartile range, 3-7). One hundred and sixty-nine patients (7.2%) had sICH; 1 061 (45.1%) had good outcome, while 1 292 (54.9%) had poor outcome. Multivariate logistic regression analysis showed that a longer PT was significantly independently associated with the poor outcome at 90 days (odds ratio 1.238, 95% confidence interval 1.144-1.340; P<0.001), but not independently associated with sICH. The mediation effect analysis showed that longer PT did not directly increase the risk of sICH ( P=0.077), and the explanation of sICH for the association between PT and poor outcome was limited. This suggested that a longer PT also promote the poor outcome through other pathways, such as ischemic injury. Conclusion:Longer PT is an independent predictor of poor outcome in patients with acute VBAO at 90 days after EMT, and sICH is not the main mediating factor for poor outcome caused by longer PT.

Objective: To investigate the relationship between the expression of p-Stat3 and Survivin in gastric cancer and the clinical characteristics and prognosis of patients, and to establish the prediction model of postoperative survival of patients combined with alanine aminotransferase(ALT) and aspartate aminotransferase(AST). Methods: Data of 133 patients undergoing gastric tumor resection were collected and followed up. The expression of p-STAT3 and Survivin in gastric cancer and precancerous tissues were detected by immunohistochemical method. Kaplan-Meier method was used to draw the survival curve. Logistic regression model combined with receiver operating characteristic curve(ROC) curve was used to describe the predictive value of multi-index combined detection on postoperative survival status of patients. The prediction model of the histogram was established using Survival and RMS packages in R Studio software. Results: The expressions of p-Stat3 and Survivin in gastric cancer tissues were higher than those in precancerous tissues. The expression of p-Stat3 in gastric cancer tissues was positively correlated with the depth of invasion and TNM stage, while the expression of Survivin in gastric cancer tissues was positively correlated with the degree of differentiation and the depth of invasion. The higher the expression levels of p-Stat3 and Survivin, the worse the prognosis. The lower the ALT level, the worse the prognosis. Survivin, ALT and AST were the optimal combination for predicting postoperative survival in patients with gastric cancer. Conclusion The expression of p-Stat3 and Survivin plays an auxiliary role in the diagnosis of gastric cancer. P-Stat3, Survivin and ALT are correlated with the prognosis of patients with gastric cancer and have predictive value. Survivin, ALT and AST combined model has a big value to predict the postoperative survival prognosis of gastric cancer patients, which can provide a reference for clinical practice.