Objective To observe the efficacy of a nomogram based on conventional ultrasonic manifestations for predicting malignant risk of breast non-mass lesions(NML).Methods A total of 120 NML diagnosed with ultrasound in 113 female patients were retrospectively included and divided into malignant group(n=44)and benign group(n=76)based on pathological results.Patients' age,ultrasonic manifestations of NML and ipsilateral axillary lymph node were compared between groups.Then a nomogram was constructed using a multivariable logistic regression model,and its diagnostic performance and accuracy were validated.Results The ratios of patients' aged≥45 years,with abnormal ipsilateral axillary lymph nodes,NML with maximum diameter≥2 cm,posterior echo attenuation,rich blood flow signals,architectural distortion and microcalcification were significantly different between groups(all P＜0.05).Patient's age≥45 years,with abnormal ipsilateral axillary lymph nodes,and NML with rich blood flow signals,architectural distortion and microcalcification were all independent predictive factors for high malignant risk of breast NML(all P＜0.05).The constructed nomogram achieved an area under the receiver operating characteristic curve of 0.901 for predicting malignant risk of breast NML,and its predicting probabilities demonstrated good agreement with the actual probabilities(Hosmer-Lemeshow test P＞0.05).Conclusion The nomogram incorporating patient's age,ultrasonic manifestations of NML and ipsilateral axillary lymph node could effectively quantify malignancy risk of breast NML.

[This corrects the article DOI: 10.1016/j.apsb.2021.10.012.].

Objective To observe the efficacy of a nomogram based on conventional ultrasonic manifestations for predicting malignant risk of breast non-mass lesions(NML).Methods A total of 120 NML diagnosed with ultrasound in 113 female patients were retrospectively included and divided into malignant group(n=44)and benign group(n=76)based on pathological results.Patients' age,ultrasonic manifestations of NML and ipsilateral axillary lymph node were compared between groups.Then a nomogram was constructed using a multivariable logistic regression model,and its diagnostic performance and accuracy were validated.Results The ratios of patients' aged≥45 years,with abnormal ipsilateral axillary lymph nodes,NML with maximum diameter≥2 cm,posterior echo attenuation,rich blood flow signals,architectural distortion and microcalcification were significantly different between groups(all P＜0.05).Patient's age≥45 years,with abnormal ipsilateral axillary lymph nodes,and NML with rich blood flow signals,architectural distortion and microcalcification were all independent predictive factors for high malignant risk of breast NML(all P＜0.05).The constructed nomogram achieved an area under the receiver operating characteristic curve of 0.901 for predicting malignant risk of breast NML,and its predicting probabilities demonstrated good agreement with the actual probabilities(Hosmer-Lemeshow test P＞0.05).Conclusion The nomogram incorporating patient's age,ultrasonic manifestations of NML and ipsilateral axillary lymph node could effectively quantify malignancy risk of breast NML.

Objective To explore the safety and efficacy of sequential tirofiban in patients with small artery occlusion(SAO)cerebral infarction after intravenous thrombolysis.Methods A retrospective collection of 90 cases of small artery occlable cerebral infarction who underwent intravenous thrombolytic treatment within the time window at the Department of Neurology,Heji Hospital,Affiliated to Changzhi Medical College from December 2019 to June 2022.It was divided into observation group(receiving tirofiban,conventional antiplatelet aggregation,lipid regulation and stabilization)and control group(conventional antiplatelet aggregation,lipid regulation and plaque stabilization).Baseline feature differences were balanced by propensity score matchingd.The main evaluation index was the long-term prognosis,the ratio of good prognosis(mRS≤2 points)at 3 months.The secondary outcome was early neurological impairment and clinical outcome.Results At 3 months,the long-term functional outcome of the tirofiban group was better than that of the control group(P>0.05).Compared with the control group,the early neurological function NIHSS score of the tirofiban group was significantly reduced(P<0.05).On the 7th day,the total efficiency of tirofiban treatment was higher than that of the control group(P<0.05).On the 14th day,the data was still significantly higher(P<0.05).Conclusion Sequential tirofiban treatment after thrombolysis is safe and effective for SAO,which may be the remedial treatment of AIS patients after thrombolysis and recanalization.

Objective To investigate the role and mechanism of sine oculis homeobox 1(Six1),a nephrogenic transcription factor,in regulating injury repair after acute kidney injury(AKI).Methods C57BL/6J mice were inflicted with renal ischemia reperfusion(IR)injury to establish AKI model,and then the serum samples and kidney tissues were collected at days 1,2,and 3 after modeling.Serum creatinine(Cr)and blood urea nitrogen(BUN)levels were measured and renal morphology was observed with HE staining.The expression and distribution of nephrogenic molecules(Six1 and Pax2,etc.)and cell proliferation/migration genes(Cyclin A1,MMP9,etc.)were detected with RT-PCR,Western blotting,and immunofluorescence assay and immunohistochemical assay.The expression of apoptosis pathway(Bc12,Caspase3,etc.)and cell proliferation related molecules were evaluated in Six1 overexpression/knockout human epithelial cells(HK2)with CoCl2-induced injury.Additionally,after the adeno-associated viruses carrying Six1 overexpression vector were used to overexpress the molecule in the mice,the expression of Six1 and other related molecules were detected after IR injury modeling.Results After renal IR injury,Six1 was significantly activated in epithelial cells,the expression of nephrogenic and cell proliferation/migration molecules(Pax2,Cyclin A1,MMP9,etc.)was obviously up-regulated(P＜0.05),which was positively correlated with Six1 expression,while the proliferation/migration molecules(Ki67,MMP9)were also localized within the tubular epithelial cells.In cellular models of Six1 overexpression,the expression levels of nephrogenic and cell proliferation/migration molecules(Pax2,Cyclin A1,MMP9,etc.)were also notably up-regulated(P＜0.05).In the mice with renal overexpression of Six1,the nephrogenic molecules as well as anti-apoptotic ones(Six2,Pax2,Bc12,etc.)were up-regulated,while the expression of kidney injury-related molecule(Kim1)in kidneys was reduced in the renal tissues.While,in 2 d after IR injury,the anti-apoptotic gene(Bc12,Stat3)was significantly up-regulated(P＜0.05),and the apoptotic and injury molecules(Kim1,Caspase3)showed remarkable down-regulation(P＜0.05)in the mice with renal Six1 overexpression.Furthermore,CoCl2-inducion significantly decreased the cell proliferation rate in the Six1 knockoutgroup(TCMK1-Six1-/-)(P＜0.05)but increased the rate in the Six1 overexpression group(TCMK1-Six1)when compared to the control cells(P＜0.05).And,the expression of nephrogenic,anti-apoptotic pathways and cell proliferation/migration molecules(Pax2,Bc12,Cyclin A1,MMP9,etc.)were reduced in TCMK1-Six1-/-group,and apoptosis and kidney injury molecules(Caspase3,Kim1)were significantly down-regulated in TCMK1-Six1 group(P＜0.05).Conclusion Activation of Six1 after AKI can promote the proliferation/migration of renal tubular epithelial cells by up-regulating nephrogenic molecules and inducing anti-apoptotic pathway molecules,and then,participate in IR-induced renal injury repair.

Objective:To assess the value of S-Detect and contrast-enhanced ultrasound (CEUS) in the differential diagnosis of Breast Imaging Reporting and Data System(BI-RADS) 4 breast lesions.Methods:A total of 104 breast lesions in 100 patients diagnosed as BI-RADS category 4 by conventional ultrasound were prospectively enrolled, and all of them were received S-Detect and CEUS examination at the same time. Taking pathology as the gold standard, ROC curve was constructed to compare the diagnostic efficacy of conventional ultrasound, S-Detect, CEUS and their combination.Results:Among the 104 BI-RADS category 4 breast lesions, 63 were benign and 41 were malignant. The sensitivities of conventional ultrasound, S-Detect, CEUS and S-Detect combined with CEUS were 73.17%, 87.80%, 87.80%, 90.24%; the specificities were 57.14%, 60.32%, 68.25%, 77.78%; the positive predictive values were 52.63%, 59.02%, 64.29% and 72.55%; the negative predictive values were 76.60%, 88.37%, 89.59% and 92.45%; the accuracies were 63.46%, 71.15%, 75.96% and 82.69%; and the areas under the ROC curve (AUC) were 0.652, 0.741, 0.780 and 0.840. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of S-Detect and CEUS diagnosis were improved compared with conventional ultrasound. The AUC of combined diagnosis was higher than that of S-Detect, CEUS alone, and the differences were statistically significant(all P<0.05). The AUC of CEUS was higher than that of conventional ultrasound, and the difference was statistically significant ( P<0.05). There were no significant differences in AUC between any two of other groups (all P>0.05). Conclusions:The combined application of S-Detect and CEUS could achieve complementary advantages, which is of great significance for the differential diagnosis of benign and malignant in BI-RADS 4 breast lesions.

Fragile X syndrome (FXS) is the leading inherited cause of intellectual disability, resulting from the lack of functional fragile X mental retardation protein (FMRP), an mRNA binding protein mainly serving as a translational regulator. Loss of FMRP leads to dysregulation of target mRNAs. The Drosophila model of FXS show an abnormal circadian rhythm with disruption of the output pathway downstream of the clock network. Yet the FMRP targets involved in circadian regulation have not been identified. Here, we identified collapsing response mediator protein (CRMP) mRNA as a target of FMRP. Knockdown of pan-neuronal CRMP expression ameliorated the circadian defects and abnormal axonal structures of clock neurons (ventral lateral neurons) in dfmr1 mutant flies. Furthermore, specific reduction of CRMP in the downstream output insulin-producing cells attenuated the aberrant circadian behaviors. Molecular analyses revealed that FMRP binds with CRMP mRNA and negatively regulates its translation. Our results indicate that CRMP is an FMRP target and establish an essential role for CRMP in the circadian output in FXS Drosophila.

Objective:To explore the effect of pathway nursing under multidisciplinary collaboration on self-care ability and rehabilitation effect in patients with acute cerebral infarction.Methods:Using the convenient sampling method, a total of 294 patients with acute cerebral infarction who were admitted to the Department of Neurology in the Fengcheng Hospital, Fengxian District, Shanghai from January 2018 to December 2019 were selected as the research objects. A total of 147 patients with acute cerebral infarction admitted from January to December 2019 were included in the experimental group, while 147 patients with acute cerebral infarction admitted from January to December 2018 were included in the control group. The experimental group adopted pathway nursing under multidisciplinary collaboration, while the control group adopted neurology routine nursing. Scores of Exercise of Self-Care Agency (ESCA) , National Institutes of Health Stroke Scale (NIHSS) , Fugl-Meyer Assessment (FMA) , Barthel Index and nursing satisfaction of patients were compared between the two groups. Finally, 147 patients in the experimental group and 145 patients in the control group completed the experiment.Results:The scores of self-concept, self-responsibility, health knowledge level and self-care skills in ESCA of patients in the experimental group at discharge were respectively (25.36±4.86) , (20.43±3.21) , (53.37±5.89) and (40.02±3.78) and the nursing satisfaction score was (97.26±2.52) , which were higher than (21.48±4.33) , (16.24±3.25) , (46.44±5.47) , (30.08±3.81) and (90.65±3.16) in the control group, and the differences were statistically significant ( P<0.01) . The NIHSS score of the experimental group 60 days after discharge was (3.7±2.2) , lower than (6.9±2.3) of the control group. And FMA and Barthel Index scores were respectively (79.3±9.2) and (78.7±14.5) , higher than (65.6±8.4) and (60.3±16.6) of the control group, and the differences were statistically significant ( P<0.01) . Conclusions:The implementation of pathway nursing under multidisciplinary collaboration for patients with acute cerebral infarction can enhance the consciousness of self-management, contribute to the recovery of neurological function and limb motor function and improve the ability of self-care and nursing satisfaction of patients.

Objective To observe the ultrasonographic findings of patients with basal ganglia hemorrhage by transcranial color-code sonography ( TCCS) and contrast-enhanced transcranial color-code sonography (CE-TCCS) ,and to evaluate the clinical value of TCCS and CE-TCCS in assessing the cerebral perfusion with basal ganglia hemorrhage . Methods Eighty-two patients with basal ganglia hemorrhage were selected ,and hematoma was seen in 58 patients (70 .7％ ) . Forty-six cases of bilateral TCCS with clear display of basal ganglia through temporal window were selected . CE-TCCS was used to observe cerebral perfusion of edema zone ,edema zone edge and peripheral brain parenchyma . Results The bilateral rate displayed by TCCS was 79 .3％ . Among 58 cases ,30 cases had ventricular compression ,14 cases had hematoma rupture into ventricle ,8 cases had midline displacement ,and 10 cases had no complication change . The cerebral perfusion in edema areas around hematoma was reduced by CE-TCCS ,but the degree of reduction was different . There were reduced in a step-like manner in the cerebral perfusion from edema zone and edema zone edge to peripheral brain tissue . Conclusions CE-TCCS is a new method for clinical diagnosis and monitoring the progress of treatments of cerebral hematoma .

BACKGROUND: Compared with the traditional organic fluorescent dyes, quantum dots present good biomarker characteristics. Especially, quantum dots for cell labeling and targeted bioimaging present unique optical properties.OBJECTIVE: To investigate the biocompatibility of CdSe/ZnS quantum dots with mononuclear macrophages.METHODS: The macrophages RAW264.7 were inoculated into 96-well plates containing 0, 50, 100 mg/L CdSe/ZnS quantum dots for 1 or 2 hours. Then, the fluorescent signal was detected by flow cytometry. After 0-24 hours of culture,the fluorescence signal intensity of the macrophages cultured with 50 mg/L CdSe/ZnS quantum dots was detected by flow cytometry. After 18 hours of culture, quantitative PCR was used to detect the levels of tumor necrosis factor α and interleukin 1β in macrophages, and macrophage proliferation cell apoptosis were detected by MTT and flow cytometry,respectively.RESULTS AND CONCLUSION: The fluorescence signal intensity was positively correlated with the mass concentration of CdSe/ZnS quantum dots, and the intensity of the fluorescent signal was increased with the labeling time. After labeling using 50 mg/L CdSe/ZnS quantum dots, the fluorescence signal of macrophages increased continuously with time, and reached the peak at 18 hours. Compared with 0 mg/L quantum dot group, 50, 100mg/L quantum dot groups could significantly promote the expression of tumor necrosis factor α and interleukin 1β in macrophages (P < 0.01 or P < 0.05).The level of tumor necrosis factor α in the 100 mg/L quantum dot group was higher than that in the 50 mg/L quantum dot group (P < 0.01). The expression of interleukin-1β showed no difference between 50 and 100 mg/L quantum dot groups.The cell proliferation in the 50 and 100 mg/L CdSe/ZnS quantum dot groups was significantly higher than that in the 0 mg/L quantum dot group (P < 0.05), but there was no difference between the former two groups. In addition, 50 and 100 mg/L CdSe/ZnS quantum dots had no significant effect on apoptosis of macrophages. To conclude, CdSe/ZnS quantum dots could activate macrophages and promote their proliferation and secretion of inflammatory factors, but did not affect their apoptosis.