Objective To construct an intelligent segmentation and T-stage diagnostic model for esophageal cancer based on the DAEUnet and ConvNeXt networks using transfer learning.Methods Dicom raw data from 126 patients diagnosed with esophageal cancer between January 2018 and April 2022 were collected,including 100 cases from Department of Thoracic Surgery at the First Affiliated Hospital of Army Medical University and 26 cases from the Department of Thoracic Surgery at Shanxi Cancer Hospital.After data augmentation,a total of 60 275 images were obtained.The DAEUnet esophageal cancer intelligent segmentation network was built,and on this basis,3 classification networks,ConvNeXt,Swin Transformer,and ResNet were constructed for T-stage diagnosis of esophageal cancer.Results The Dice similarity coefficient(DSC)for esophageal cancer intelligent segmentation using the DAEUnet network was 0.82,and the DSC value of the esophagus,aorta,normal esophagus,mediastinal lymph nodes,and heart was 72.4％,87.5％,79.3％,60.5％ and 96.8％,respectively.Among the 3 T-stage diagnosis models for esophageal cancer,the ConvNeXt model performed the best,with a precision value for T1～T4 stages of 0.65,0.727,0.889 and 0.92,respectively,and an AUC value of 0.892,which were superior to the ResNet and Swin Transformer networks.Conclusion The proposed DAEUnet and ConvNeXt-based intelligent segmentation and T-stage diagnosis model for esophageal cancer improves T-stage accuracy and treatment efficiency.

OBJECTIVES: To investigate the synergistic mechanism of the traditional Chinese medicine Rosa laevigata Michx. (RLM) for treatment of pulmonary arterial hypertension (PAH). METHODS: Network pharmacological analysis was carried out to screen the active ingredients of RLM and PAH disease targets and construct the "component-target-disease" interaction network, followed by gene enrichment analysis and molecular docking studies. In the cell experiments, primary cultures of rat pulmonary arterial smooth muscle cells were exposed to hypoxia for 24 h and treated with solvent or 100, 200 and 300 mg/mL RLM, and the changes in cell proliferation were detected using Western blotting for PCNA and immunofluorescence staining. In the animal experiment, male SD rats were randomized into 5 control group, monocrotaline (MCT) solvent group, and MCT with RLM (100, 200 and 300 mg/mL) treatment groups. HE staining and immunofluorescence staining were used to observe histopathological changes in the pulmonary blood vessels of the rats. RESULTS: Seven core active ingredients (including β-sitosterol and kaempferol) in RLM and 39 key disease targets were identified, and molecular docking showed that SRC was a high-affinity target. KEGG enrichment analysis showed that the differential genes were significantly enriched in calcium signaling and PI3K-AKT pathways. In rat pulmonary arterial smooth muscle cells, hypoxic exposure significantly up-regulated cellular expression of PCNA and phosphorylation levels of Src and AKT1, which were obviously lowered by RLM treatment. In RLM-treated rat models, the mean pulmonary artery pressure and right ventricular hypertrophy index (Fulton index) were significantly reduced, the tricuspid annular plane systolic excursion (TAPSE) was improved, and pulmonary vascular wall thickening and fibrosis were obviously ameliorated. CONCLUSIONS RLM inhibits pulmonary arterial smooth muscle cell proliferation in rat models of hypertension possibly by regulating the Src-AKT1 axis, suggesting the potential of RLM as a new natural drug for treatment of pulmonary hypertension.
Animals ; Cell Proliferation/drug effects* ; Proto-Oncogene Proteins c-akt/metabolism* ; Rats, Sprague-Dawley ; Pulmonary Artery/cytology* ; Male ; Rats ; Myocytes, Smooth Muscle/cytology* ; Hypertension, Pulmonary/pathology* ; Drugs, Chinese Herbal/pharmacology* ; Signal Transduction/drug effects* ; Muscle, Smooth, Vascular/cytology* ; src-Family Kinases/metabolism* ; Cells, Cultured

Objective To explore the electroencephalography(EEG)characteristics of patients with knee osteoarthritis(KOA)which are different from those of healthy subjects during dynamic balance tests,and study the connection and influence between brain activity and KOA.Methods Fifteen patients with KOA and 17 healthy subjects performed the timed up and go test(TUGT)and five times sit-to-stand test(5STS).The EEG characteristics of the 4 frequency bands,namely δ(0.5-4 Hz),θ(4-8 Hz),α(8-14 Hz)and β(14-30 Hz)of 9 electrodes including CZ,C3,C4 in the central region,PZ,P3,P4 in the parietal lobe,and OZ,O1,O2 in the occipital lobe of the cerebral cortex of the subjects were recorded.Time and frequency domain analysis were conducted.Results During 5STS,the time-domain amplitudes of electrodes C4,P3,and P4 in the δ band,electrodes C4,P3,and P4 in the θ band,and electrodes P3 and P4 in the β band of KOA patients were significantly higher than those of healthy subjects(P<0.05);the power of EEG signals of electrodes P3,P4,and O2 in the β band was significantly higher than that of healthy subjects.During TUGT,except that the time-domain amplitude of electrode PZ in the θ band of KOA patients was significantly lower than that of healthy subjects(P<0.05),there was no significant difference in all electrodes in other frequency bands;the power of EEG signals of electrodes C3,CZ,C4,PZ,P4,O1,OZ,O2 in the δ band and electrodes CZ,P3,PZ,and OZ in the α band and electrodes CZ,P4,OZ,and O2 in the β band was significantly lower than that of healthy subjects(P<0.05).Conclusions Compared with healthy subjects,the activity in the parietal lobe area of the brain of KOA patients during 5STS was stronger,while the brain activity in the central region,parietal lobe,and occipital lobe areas of KOA patients during TUGT was weaker than that of healthy subjects.This study may provide some references for clinicians in the prevention and treatment of KOA.

Objective To explore the electroencephalography(EEG)characteristics of patients with knee osteoarthritis(KOA)which are different from those of healthy subjects during dynamic balance tests,and study the connection and influence between brain activity and KOA.Methods Fifteen patients with KOA and 17 healthy subjects performed the timed up and go test(TUGT)and five times sit-to-stand test(5STS).The EEG characteristics of the 4 frequency bands,namely δ(0.5-4 Hz),θ(4-8 Hz),α(8-14 Hz)and β(14-30 Hz)of 9 electrodes including CZ,C3,C4 in the central region,PZ,P3,P4 in the parietal lobe,and OZ,O1,O2 in the occipital lobe of the cerebral cortex of the subjects were recorded.Time and frequency domain analysis were conducted.Results During 5STS,the time-domain amplitudes of electrodes C4,P3,and P4 in the δ band,electrodes C4,P3,and P4 in the θ band,and electrodes P3 and P4 in the β band of KOA patients were significantly higher than those of healthy subjects(P<0.05);the power of EEG signals of electrodes P3,P4,and O2 in the β band was significantly higher than that of healthy subjects.During TUGT,except that the time-domain amplitude of electrode PZ in the θ band of KOA patients was significantly lower than that of healthy subjects(P<0.05),there was no significant difference in all electrodes in other frequency bands;the power of EEG signals of electrodes C3,CZ,C4,PZ,P4,O1,OZ,O2 in the δ band and electrodes CZ,P3,PZ,and OZ in the α band and electrodes CZ,P4,OZ,and O2 in the β band was significantly lower than that of healthy subjects(P<0.05).Conclusions Compared with healthy subjects,the activity in the parietal lobe area of the brain of KOA patients during 5STS was stronger,while the brain activity in the central region,parietal lobe,and occipital lobe areas of KOA patients during TUGT was weaker than that of healthy subjects.This study may provide some references for clinicians in the prevention and treatment of KOA.

Objective: Investigate osteogenic differentiation of canine periodontal ligament stem cells ( cPDLSCs) via over-expression ephrinB2 in cPDLSCs． Methods : cPDLSCs were isolated from the premolars and molars of Beagle．After transfected with EfnB2-GFP-Bsd and GFP-Bsd empty Vector，cPDLSCs were induced to osteogenic differentiation．Western blot was used to invest the expression of ephrinB2 protein．The effect of osteogenic differentiation of EfnB2-cPDLSCs and Vector-cPDLSCs were analyzed by RT-PCR , CCK-8，Alizarin-red S staining and ALP. Results: There was no significant difference in cell proliferation between EfnB2-cPDLSCs and Vector-cPDLSCs．While EfnB2-cPDLSCs displayed an enhanced ALP activity and more prominent mineralized nodules compared with Vector-cPDLSCs．The odonto-/ osteogenic genes in EfnB2-cPDLSCs were also highly enhanced． Conclusion The results of our study indicated that ephrinB2 gene-transfected cPDLSCs showed enhanced osteogenic differentiation.

Patient satisfaction is one of the core indicators to measure the service quality of medical institutions. To this end, a multi-campus public hospital in Shanghai constructed a management system of patient satisfaction evaluation. Since 2021, its call center has conducted a full coverage satisfaction assessment for discharged patients from its three campuses and collected dissatisfaction information feedback. The hospital organized relevant clinical departments and functional departments to fully communicate with the dissatisfied patients according to the feedback information, followed by a joint rectification. The hospital regularly conducts in-depth analysis of all complaints for timely discovery of common problems in different campuses for continuous improvement. This practice can provide reference for multi-campus hospitals to promote homogeneous management, to improve management efficiency, service quality and patient satisfaction.

Objective:The clinical manifestations, types of gene mutations, therapeutic effects and prognostic characteristics of 15 children with cblC type methylmalonic acidemia (MMA) and hydrocephalus were analyzed to improve the clinical understanding of the disease, so as to provide a basis for the treatment of the disease.Methods:From April 2015 to January 2019, 15 patients with MMA and hydrocephalus in Department of Pediatric Surgery, Peking University First Hospital were enrolled, and all gene detection showed clbC type.All the 15 patients underwent ventriculoperitoneal shunt.After surgery, the clinical manifestations and imaging findings were applied as the basis to adjust the pressure of the diverter valve appropriately.Clinical data and gene mutation characteristics of 15 children with cblC type and hydrocephalus were retrospectively analyzed, and the therapeutic effects and prognosis were summarized and analyzed as well.Results:There were 8 males (53.3%) and 7 females (46.7%), aged from 2 to 33 months.All the cases were followed up from 11 to 55 months, without death case and serious postoperative complications of hydroce-phalus.The head circumference of 3 cases (20.0%) was in the normal range, 1 case (6.7%) was greater than the normal range, and 11 cases (73.3%) were less than the normal range.Four patients (26.7%) were transferred to the pediatric intensive care unit after surgery.c.609G>A mutation was the most common in this study, with 7 cases (46.7%) of c. 609G>A homozygous mutation, and 5 cases (33.3%) of c. 609G>A heterozygous mutation.Clinical symptoms of intracranial hypertension were relieved or disappeared.The head circumference progressive enlargement was stopped.The anterior fontanelle tension greatly decreased, all " setting-sun" sign of eyes disappeared, and vision loss and hearing loss were better compared with the pre-operation.Four cases (26.7%) displayed normal intelligence and exercise, and 11 cases (73.3%) were left with mild to severe psychomotor retardation.During the follow-up pe-riod, the head CT showed that the ventricle was remarkably narrowed, and interstitial brain edema obviously improved.Conclusions:Ventriculoperitoneal shunt in the treatment of cblC type MMA with hydrocephalus has positive effects.The head circumference of most cblC type MMA with hydrocephalus is less than the normal range.c.609 G>A is the most common mutation in cblC type MMA with hydrocephalus.Perioperative " metabolic crisis" can result in serious complications.

Objective To systematically evaluate the efficacy and safety of 125I seed implantation on the treatment of refractory thyroid carcinoma.Methods A total of 14 patients with refractory thyroid carcinoma received CT and ultrasound image-guided 125I seed implantation in our hospital from Apr.2003 to Oct.2016.The radioactive activity ranged from 0.3 to 0.8 mCi,and the prescribed doses were 80 to 120 Gy.11 patients were diagnosed as differentiated thyroid carcinoma and 3 patients were medullary thyroid carcinoma.The local control rate,pain relief and complications were observed.Results The patients were followed up from 12 to 96 months.Two months after treatment,complete remission happened in three patients,partial remission in nine,and disease stability in two,no patients with progression.The half year,one year,two year local control rate was 100％,92％ and 42％,respectively.Seven patients were evaluated using number rating scales and obtained a score of 4.14±1.68 before therapy.Two months after treatment,the score was reduced to 2.00±1.15 (P＜0.000).No usual complications occurred during or after treatment except for I acute skin radio reaction in 4 cases.Conclusion 125I seed interstitial implantation for refractory thyroid carcinoma under guidance of ultrasound or CT is efficient and safe.

Objective To establish a high-performance induction culture system for Raw264.7 cells to differentiate into osteoclasts(OC)invitro by improving the cell culture program.Methods The Raw264.7 cells were cultured withα-MEM medium containing 50 μg · L-1 M-CSF, 100 μg · L-1 RANKL, and 1 × 10-8 mol · L-1 1α,25-(OH)2 D3 in 5% CO2 for 12 d at 37℃. The cells were digested transiently every time before the medium was changed after every three days. The morphologic changes of the Raw264.7 cells were observed by inverted microscope.The maturation and phagotrophic function of OC were identified by HE,TRAP,FITC-phalloidin staining and immunofluorescence.Results The cells remained to grow in single layers all the time in most areas of the well during the whole induction by the improved culture program. The observation results of inverted microscope and HE staining showed that the growth area of the polykaryotic OC reached to 70% of the well on day 1 2. FITC-phalloidin staining showed that in the maturation of the OC, the cluster-shaped podosomes in the pseudopodia gradually transformed into rings,which finally fused to form a large belt surrounding the periphery of the cytoplasm. The calcitionin receptor (CTR) expressed by OC was markedly enhanced compared with the precursor cells by immunofluroescence staining,and a large number of red granules appeared in the cytoplasm of OC with TRAP staining on day 1 2. These results comfirmed that the obtained OC were maturated and owned phagotrophic function. Conclusion A high-performance induction culture system for Raw264. 7 cells to differentiate into OC in vitro induced by combination of 50μg · L-1 M-CSF, 100 μg · L-1 RANKL,and 1 × 10-8 mol·L-1 1α,25-(OH)2 D3 is established by improving the cell culture program.

Objective To probe the relationship between the expression of TL1A and the level of IFN-γ secreted by T cells in the acute stage of Guillain-Barre syndrome (GBS). Methods ① Six-week female Bal b/c mice were immunized by purified recombinant human soluble TNF-like molecular 1A (rhsTL1A) protein. The polyclonal antibody against rhsTL1A was identified by immunofluorescence using human umbilical vein epithelial cells (HUVEC). ② To detect the biologic activity of rhsTL1A, the peripheral blood mononuclear cells (PBMC) from the healthy donors were separated by Ficoll gradient centrifugation and were seeded on 96-well plates with medium containing 2 μg/ml PHA (control group), 2 μg/ml PHA + 25 ng/ml rhsTL1 A, 2 μg/ml PHA + 100 ng/ml rhsTL1A and 2 μg/ml PHA + 400 ng/ml rhsTLlA respectively. T cell proliferation assay was carried out using ~3H-TdR. ③ IFN-γ productions in the sera of the children with GBS in the acute stage were detected by ELISA. ④ The ratio of CD_3~+ TL1A~+ T cells to CD_3~+ T cells in the peripheral blood of the children with GBS in acute stage was detected with flow, cytometry. ⑤PBMC from the children in acute GBS were separated and cultured in the environment adding 2 μg/ml PHA and 400 ng/ml rhsTL1A in vitro. Then, the IFN-γ in the supernatant was determined by ELISA kit after 72 hours. Results ① hTL1A A expressed by eukaryotic HUVECs was recognized by rhsTL1 A polyclonal antiserum. ② The result of T cell proliferation assay showed that SI of 25 ng/ml rhTL1A, 100 ng/ml rhTL1A A and 400 ng/ml rhTL1A group was increased compared with control group. The SI of 2 μg/ml PHA +400 ng/ml rhsTL1 A group was the highest (2. 65) among them. ③ IFN-γ productions in the sera of the children with GBS in the acute stage ((102. 25±22. 17) pg/ml) were increased significantly compared with healthy control ((28.75 ± 1.31) pg/ml, t = 3. 309, P < 0. 05). ④ The ratio of CD_3~+ TL1A~+ T cells to CD_3~+ T cells in the peripheral blood of the children with GBS in acute stage (18.22%± 1.83%) was enhanced significantly compared with healthy control (5. 17% ±0. 48%, t = 6. 884, P < 0. 01). ⑤ PBMC both in healthy control and the acute GBS secreted more IFN-γ markedly ((43.56± 4.41) pg/ml and (180.64 ± 38.39) pg/ml) after being incubated in 2 μg/ml PHA and 400 ng/ml rhsTL1A (t =4. 523 and 2. 600, P <0. 01 and 0. 05 respectively). Moreover, PBMC in acute GBS secreted more IFN-γ, than that of the healthy group markedly (t = 3. 545, P < 0. 05). Conclusions ① The mouse antiserum recognizing rhsTL1A is successfully obtained. ② In this study, 400 ng/ml rhsTL1A promotes the proliferation of T cells activated by 2 μg/ml PHA, indicating that rhsTL1A has biological activity. ③ The expression of hTL1A of activated T cells in the peripheral blood of the children with acute GBS is up-regulated. These TL1A proteins promote the secretion of IFN-γ through binding to their receptors DR_3.