ObjectiveTo establish a method for the identification of Haliotidis Concha and its counterfeits， and to improve its quality evaluation method. MethodsA total of 17 batches of Haliotis discus hannai， 4 batches of H. ruber， 3 batches of H. laevigata， 3 batches of H. ovina， 3 batches of H. diversicolor， 3 batches of H. asinina， 3 batches of H. iris were collected. Ultra-high performance liquid chromatography-quadrupole/electrostatic field orbitrap high-resolution mass spectrometry（UPLC-Q-Exactive-Orbitrap-MS/MS） was used to analyze the hydrolysates of different original Haliotidis Concha and its counterfeits， and the potential characteristic ions of each species were screened by Venn diagram. UPLC-triple quadrupole tandem mass spectrometry（UPLC-QqQ-MS/MS） was used to validate the characteristic ions， and the specific detection method of the characteristic ions was established. ResultsA total of 1 182， 167， 47， 89， 104， 203， 424 potential characteristic ions were screened from H. discus hannai， H. ruber， H. laevigata， H. ovina， H. diversicolor， H. asinina and H. iris， respectively. And 9 characteristic ions were selected. The precision， stability and repeatability of the 9 characteristic ions in the established identification method met the requirements. Different original Haliotidis Concha and its counterfeits could detect their own characteristic ions， including m/z 631.83-886.48（double charge） and m/z 631.83-443.74（double charge） of H. discus hannai， m/z 699.28-232.11（double charge） and m/z 699.28-544.27（double charge） of H. ruber， m/z 535.76-752.37（double charge） and m/z 535.76-548.28（double charge） of H. laevigata， m/z 708.35-442.28（double charge） and m/z 708.35-215.14（double charge） of H. ovina， m/z 561.33-614.86（triple charge）， m/z 561.33-468.28（triple charge）， m/z 608.29-618.32（double charge） and m/z 608.29-390.21（double charge） of H. diversicolor， m/z 769.85-274.10（double charge）， m/z 769.85-532.75（double charge）， m/z 827.43-646.36（single charge）， m/z 827.43-257.12（single charge） of H. asinina， and m/z 468.24-576.29（double charge） and m/z 468.24-505.26（double charge） of H. iris. ConclusionIn this study， a total of 9 characteristic ions are screened from 6 kinds of original Haliotidis Concha and its counterfeits， and a specific identification method is established， which is helpful to solve the limitations of the existing quality evaluation methods of Haliotidis Concha， and provide a basis for the production， circulation and medication quality.

ObjectiveTo establish a method for the identification of Haliotidis Concha and its counterfeits， and to improve its quality evaluation method. MethodsA total of 17 batches of Haliotis discus hannai， 4 batches of H. ruber， 3 batches of H. laevigata， 3 batches of H. ovina， 3 batches of H. diversicolor， 3 batches of H. asinina， 3 batches of H. iris were collected. Ultra-high performance liquid chromatography-quadrupole/electrostatic field orbitrap high-resolution mass spectrometry（UPLC-Q-Exactive-Orbitrap-MS/MS） was used to analyze the hydrolysates of different original Haliotidis Concha and its counterfeits， and the potential characteristic ions of each species were screened by Venn diagram. UPLC-triple quadrupole tandem mass spectrometry（UPLC-QqQ-MS/MS） was used to validate the characteristic ions， and the specific detection method of the characteristic ions was established. ResultsA total of 1 182， 167， 47， 89， 104， 203， 424 potential characteristic ions were screened from H. discus hannai， H. ruber， H. laevigata， H. ovina， H. diversicolor， H. asinina and H. iris， respectively. And 9 characteristic ions were selected. The precision， stability and repeatability of the 9 characteristic ions in the established identification method met the requirements. Different original Haliotidis Concha and its counterfeits could detect their own characteristic ions， including m/z 631.83-886.48（double charge） and m/z 631.83-443.74（double charge） of H. discus hannai， m/z 699.28-232.11（double charge） and m/z 699.28-544.27（double charge） of H. ruber， m/z 535.76-752.37（double charge） and m/z 535.76-548.28（double charge） of H. laevigata， m/z 708.35-442.28（double charge） and m/z 708.35-215.14（double charge） of H. ovina， m/z 561.33-614.86（triple charge）， m/z 561.33-468.28（triple charge）， m/z 608.29-618.32（double charge） and m/z 608.29-390.21（double charge） of H. diversicolor， m/z 769.85-274.10（double charge）， m/z 769.85-532.75（double charge）， m/z 827.43-646.36（single charge）， m/z 827.43-257.12（single charge） of H. asinina， and m/z 468.24-576.29（double charge） and m/z 468.24-505.26（double charge） of H. iris. ConclusionIn this study， a total of 9 characteristic ions are screened from 6 kinds of original Haliotidis Concha and its counterfeits， and a specific identification method is established， which is helpful to solve the limitations of the existing quality evaluation methods of Haliotidis Concha， and provide a basis for the production， circulation and medication quality.

Objective To observe the effects of applying incremental positive end expiratory pressure(PEEP)lung recruitment method in lung protective ventilation strategy during anesthesia for laparoscopic colorectal cancer surgery on the respiratory mechanics and postoperative pulmonary complications.Methods The patients who underwent laparoscopic colorectal cancer surgery from June to December 2023 were randomly divided into two groups with 30 cases each group:the incremental PEEP lung recruitment combined with lung protective ventilation method group(RM group)and the lung protective ventilation method group(control group,C group).Both groups underwent lung protective ventilation.The RM group underwent the first lung recruitment immediately after the placement of Trendlenburg position,and then the lung recruitment was performed with the incremental PEEP method hourly thereafter.In the C group,no lung recruitment was performed throughout the procedure.The data of respiratory mechanics and oxygenation were recorded at 5 min before tracheal intubation(T0),immediately after tracheal intubation(T1),after the first pulmonary recruitment(after positioning in the C group)(T2),after the second pulmonary recruitment(60 min after positioning in the C group)(T3),after stopping the pneumoperitoneum(T4),and 30 min after extubation(T5),respectively.Postoperative pulmonary complications(PCC)were compared between the two groups.Results In terms of respiratory mechanics:the differences in peak airway pressure(Ppeak),airway plateau pressure(Pplat),driving pressure(△P),and pulmonary dynamic compliance(Cdyn)at the time point of T1 between the two groups were not significant(P＞0.05);the Ppeak,Pplat,and △P at the time points of T2 and T3 in the RM group were smaller than those in the C group(P＜0.05),and the Cdyn was larger than that in the C group(P＜0.05);the Ppeak at the time point of T4 in the RM group was smaller than that in the C group(P＜0.05),while the Pplat,△P,and Cdyn were not significant(P＞0.05).In terms of oxygenation:the differences in arterial partial pressure of oxygen(PaO2)and partial pressure of CO2(PaCO2)at the time point of T0 in the two groups were not significant(P＞0.05);the PaO2 at the time points of T3,T4,and T5 in the RM group was higher than that in the C group(P＜0.05),and the PaCO2 at the time points of T4 and T5 was lower than that in the C group(P＜0.05).In terms of postoperative pulmonary complications,the incidences of pulmonary atelectasis(5 cases vs.12 cases,P=0.045)and PPC(9 cases vs.18 cases,P=0.020)were lower in the RM group than those in the C group,while the difference of incidence of pulmonary infection and pleural effusion between the two groups was not significant(P＞0.05).There was no occurrence of respiratory failure in both groups.Conclusion Application of incremental PEEP lung recruitment in lung protective ventilation strategy can improve lung respiratory mechanics and reduce incidence of postoperative pulmonary complications in patients undergoing laparoscopic colorectal cancer surgery.

Objective:To develop a deep learning model based on super-resolution endorectal ultrasound（ERUS）images for the preoperative prediction of perineural invasion（PNI）in patients with rectal cancer，thereby providing a reference for risk stratification and individualized treatment planning.Methods:A retrospective analysis was conducted on 382 patients with rectal cancer who underwent total mesorectal excision at Fujian Medical University Union Hospital between June 2019 and February 2024. Patients were randomly divided into a training set（ n=305）and a test set（ n=77）at a ratio of 8∶2，and further grouped into PNI-negative group and PNI-positive group subgroups based on pathological results. Super-resolution ultrasound images were generated from original ERUS images using a generative adversarial network（GAN）. Deep convolutional neural networks were developed based on features from intratumoral and peritumoral regions to identify the optimal region of interest（ROI）. The dSR5_ResNet18 and dSR5_ResNet50 models were constructed using the super-resolution images with a 5-pixel peritumoral extension. Representative clinical features were selected for subgroup analysis based on sample size and intergroup statistical differences between PNI-positive and PNI-negative patients. Forest plots were used to evaluate model applicability and robustness across subgroups. Results:The dSR5_ResNet18 model，built using super-resolution images of the tumor combined with a 5-pixel peritumoral region，achieved the best predictive performance，with an AUC of 0.867（95% CI=0.782 - 0.952）in the test set. Decision curve analysis demonstrated that the dSR5_ResNet18 model provided the greatest net clinical benefit. Forest plot analysis indicated strong generalizability of the models across subgroups such as pathological N stage，maximum lesion length，and lymph node enlargement，though relatively weaker performance was observed in the carcinoembryonic antigen（CEA）subgroup. Among all models，dSR5_ResNet18 exhibited the most consistent performance across subgroups，with the narrowest confidence intervals and highest robustness. Conclusions:The deep learning model incorporating ERUS-based super-resolution reconstruction demonstrated excellent performance in the preoperative prediction of PNI in rectal cancer. It offers significant advantages in image quality and generalizability，and may serve as a valuable tool to assist clinicians in formulating personalized treatment strategies.

Hyoid-related carotid artery diseases represent rare clinical entities,encompassing conditions such as carotid atherosclerotic plaque formation,mural thrombosis,carotid artery dissec-tion,carotid stenosis or occlusion,and carotid pseudoaneurysm.Unstable plaques and thrombi may dislodge under external force,leading to middle cerebral artery stenosis or embolism,triggering ische-mic cerebrovascular events.This study reported a related case and explored its clinical characteris-tics,pathogenic mechanisms,and potential risk factors through a review of relevant literature.

Objective To observe the effects of applying incremental positive end expiratory pressure(PEEP)lung recruitment method in lung protective ventilation strategy during anesthesia for laparoscopic colorectal cancer surgery on the respiratory mechanics and postoperative pulmonary complications.Methods The patients who underwent laparoscopic colorectal cancer surgery from June to December 2023 were randomly divided into two groups with 30 cases each group:the incremental PEEP lung recruitment combined with lung protective ventilation method group(RM group)and the lung protective ventilation method group(control group,C group).Both groups underwent lung protective ventilation.The RM group underwent the first lung recruitment immediately after the placement of Trendlenburg position,and then the lung recruitment was performed with the incremental PEEP method hourly thereafter.In the C group,no lung recruitment was performed throughout the procedure.The data of respiratory mechanics and oxygenation were recorded at 5 min before tracheal intubation(T0),immediately after tracheal intubation(T1),after the first pulmonary recruitment(after positioning in the C group)(T2),after the second pulmonary recruitment(60 min after positioning in the C group)(T3),after stopping the pneumoperitoneum(T4),and 30 min after extubation(T5),respectively.Postoperative pulmonary complications(PCC)were compared between the two groups.Results In terms of respiratory mechanics:the differences in peak airway pressure(Ppeak),airway plateau pressure(Pplat),driving pressure(△P),and pulmonary dynamic compliance(Cdyn)at the time point of T1 between the two groups were not significant(P＞0.05);the Ppeak,Pplat,and △P at the time points of T2 and T3 in the RM group were smaller than those in the C group(P＜0.05),and the Cdyn was larger than that in the C group(P＜0.05);the Ppeak at the time point of T4 in the RM group was smaller than that in the C group(P＜0.05),while the Pplat,△P,and Cdyn were not significant(P＞0.05).In terms of oxygenation:the differences in arterial partial pressure of oxygen(PaO2)and partial pressure of CO2(PaCO2)at the time point of T0 in the two groups were not significant(P＞0.05);the PaO2 at the time points of T3,T4,and T5 in the RM group was higher than that in the C group(P＜0.05),and the PaCO2 at the time points of T4 and T5 was lower than that in the C group(P＜0.05).In terms of postoperative pulmonary complications,the incidences of pulmonary atelectasis(5 cases vs.12 cases,P=0.045)and PPC(9 cases vs.18 cases,P=0.020)were lower in the RM group than those in the C group,while the difference of incidence of pulmonary infection and pleural effusion between the two groups was not significant(P＞0.05).There was no occurrence of respiratory failure in both groups.Conclusion Application of incremental PEEP lung recruitment in lung protective ventilation strategy can improve lung respiratory mechanics and reduce incidence of postoperative pulmonary complications in patients undergoing laparoscopic colorectal cancer surgery.

Objective:To develop a deep learning model based on super-resolution endorectal ultrasound（ERUS）images for the preoperative prediction of perineural invasion（PNI）in patients with rectal cancer，thereby providing a reference for risk stratification and individualized treatment planning.Methods:A retrospective analysis was conducted on 382 patients with rectal cancer who underwent total mesorectal excision at Fujian Medical University Union Hospital between June 2019 and February 2024. Patients were randomly divided into a training set（ n=305）and a test set（ n=77）at a ratio of 8∶2，and further grouped into PNI-negative group and PNI-positive group subgroups based on pathological results. Super-resolution ultrasound images were generated from original ERUS images using a generative adversarial network（GAN）. Deep convolutional neural networks were developed based on features from intratumoral and peritumoral regions to identify the optimal region of interest（ROI）. The dSR5_ResNet18 and dSR5_ResNet50 models were constructed using the super-resolution images with a 5-pixel peritumoral extension. Representative clinical features were selected for subgroup analysis based on sample size and intergroup statistical differences between PNI-positive and PNI-negative patients. Forest plots were used to evaluate model applicability and robustness across subgroups. Results:The dSR5_ResNet18 model，built using super-resolution images of the tumor combined with a 5-pixel peritumoral region，achieved the best predictive performance，with an AUC of 0.867（95% CI=0.782 - 0.952）in the test set. Decision curve analysis demonstrated that the dSR5_ResNet18 model provided the greatest net clinical benefit. Forest plot analysis indicated strong generalizability of the models across subgroups such as pathological N stage，maximum lesion length，and lymph node enlargement，though relatively weaker performance was observed in the carcinoembryonic antigen（CEA）subgroup. Among all models，dSR5_ResNet18 exhibited the most consistent performance across subgroups，with the narrowest confidence intervals and highest robustness. Conclusions:The deep learning model incorporating ERUS-based super-resolution reconstruction demonstrated excellent performance in the preoperative prediction of PNI in rectal cancer. It offers significant advantages in image quality and generalizability，and may serve as a valuable tool to assist clinicians in formulating personalized treatment strategies.

ObjectiveTo investigate the cost-effectiveness ratio of Gd-EOB-DTPA contrast-enhanced magnetic resonance imaging (EMRI) versus ultrasound in liver cancer screening for the high-risk population. MethodsThe TreeAge Pro 2011 software was used to establish a decision-tree model. A mathematical model was used to simulate the costs and benefits of EMRI or ultrasound screening every 6 months in patients with liver cirrhosis, and the cost-effectiveness ratios under different screening models were calculated. ResultsThe EMRI group had a mean cost of liver cancer screening of 2050.2 RMB each person each time and mean benefits of 0.11 YLG, while the ultrasound group had a mean cost of 262.6 RMB and mean benefits of 0.02 YLG. When the incidence rate of liver cancer was 17.8%, the EMRI group had a similar cost-effectiveness ratio as the ultrasound group, and the cost of 1 YLG was 11445 RMB; EMRI tended to have a lower cost and a better effect in screening with the increase in the incidence rate of liver cancer. The cost-effectiveness ratio of EMRI gradually decreased with the reduction in its price, and its effect in screening gradually increased with the reduction in price. ConclusionThe cost-effectiveness of liver cancer screening is closely related to the incidence rate of liver cancer and the price of screening. EMRI has a good cost-effectiveness ratio in screening when the risk of liver cancer is higher than 17.8%.

Decision on mode of delivery (MOD) is a process involved by both clients and health care providers, based on specific clinical situations and women′s values. To help each woman obtain the best MOD is crucial for obstetric health professionals to provide women-centered high quality of care. There is a steep upward trend in cesarean sections in China due to the introduced advanced technologies, overused antenatal monitoring methods, flexible indications for cesarean sections, delayed childbearing ages and people′s misconceptions, etc.. Recently the conditional and comprehensive two-child policy have been implemented in China, which might initiate changes in fertility and birth intentions of many families, and in subsequent decisions on MOD. This review illustrates the pros and cons of MOD, decision process on MOD, influencing factors and strategies to promote decision on MOD, in order for the obstetric professionals to provide evidence-based best care for women and their families in the process of decision-making.

To establish vascular endothelial growth factor (VEGF) and interleukin-8 (IL-8) as secretary biomarkers for cell growth on topographic substrates, we have evaluated the secretion and expression of these 2 factors by SH-SY5Y human neuroblastoma cells on poly-L-lactide (PLLA) micropillar arrayed topographic substrates. We fabricated topographic substrates with UV lithography, silicon etching and polydimethylsiloxane-based replica molding, and interfaced SH-SY5Y human neuroblastoma cells with both the topographic substrates and PLLA flat substrates. Cell morphology and spreading were examined with scanning electron microscopy. The secretion and mRNA expression of VEGF and IL-8 were evaluated with enzyme linked immunosorbent assay (ELISA) and real time qPCR, respectively, 24 hours after cell plating. We successfully achieved 4 topographic substrates with a nominal pillar diameter of 2 microm and 4 microm, and a nominal pillar spacing of 2 microm and 7 microm. We found that the secretion and mRNA expression of VEGF and/or IL-8 by SH-SY5Y cells on 2-2 microm (pillar diameter-spacing), 4-2 microm and 4-7 microm topographic substrates were upregulated in comparison to those by cells on PLLA flat substrate, 24 hours after cell plating. Furthermore, both cytokines were even more substantially upregulated on the 2-7 microm substrate than on the other 3 topographic substrates. Compared to those on PLLA flat substrate, cells on topographic substrates showed significant changes in morphology (spreading area, perimeter and roundness), and the increase in the secretion and mRNA expression of VEGF and IL-8 was accompanied with a decrease in cell spreading areas. These results provided evidence that pillar arrayed topography was an important microenvironmental factor in affecting VEGF and IL-8 expression or secretion, and VEGF and IL-8 might serve as important secretary biomarkers for growth on topographic substrates by SH-SY5Y cells.
Biomarkers ; Cell Line ; Cell Proliferation ; Cellular Microenvironment ; Humans ; Interleukin-8 ; genetics ; secretion ; Neuroblastoma ; secretion ; Polyesters ; chemistry ; RNA, Messenger ; genetics ; Vascular Endothelial Growth Factor A ; genetics ; secretion