ObjectiveTo study the effect and mechanism of fibrinogen （Fib） overexpression on mitochondrial quality control system in the rat model of coronary heart disease with the syndrome of blood stasis. MethodsForty male SD rats were randomly assigned into normal， model， Fib， and empty vector （AAV） groups， with 10 rats in each group. The model， Fib， and AAV groups were fed with a high-fat diet adaptively and administrated with 3×10⁶ U·kg^-1 vitamin D3 powder by gavage after 7 days and 2×10⁶ U·kg^-1 vitamin D3 solution after 14 days. After being fed with a high-fat diet for 7 weeks， rats in each group received subcutaneous injection of isoproterenol （5 mg·kg^-1） for 3 days. During the modeling period， rats in the normal group were fed with ordinary feed without any special treatment. The changes in blood lipid and hemorheological indexes of rats in each group were measured. The aorta tissue was stained with hematoxylin-eosin （HE）， and the standard lead Ⅱ electrocardiograms （ECGs） of rats in each group were recorded. Enzyme-linked immunosorbent assay （ELISA） and real-time PCR were employed to verify the overexpression levels of Fib in the liver and plasma. Western blotting was employed to determine the protein levels of mitofusin 2 （Mfn2）， optic atrophy protein 1 （OPA1）， dynamin-related protein 1 （Drp1）， phosphorylated adenosine monophosphate-activated protein kinase （p-AMPK）/adenosine monophosphate-activated protein kinase （AMPK）， peroxisome proliferator-activated receptor γ-coactivator-1α （PGC-1α）， PTEN-induced putative kinase 1， and Parkin. Real-time PCR was employed to determine the mRNA levels of AMPK and PGC-1α in the myocardial tissue. The changes in levels of adenosine triphosphate （ATP） and adenosine monophosphate （AMP） in the myocardial tissue were determined by ELISA. ResultsCompared with the normal group， the other three groups showed elevated levels of total cholesterol and low-density lipoprotein cholesterol （P<0.01） and no significant changes in levels of triglyceride and high-density lipoprotein cholesterol. Compared with the model group， the Fib and AAV groups showed risen levels of total cholesterol （P<0.05， P<0.01）. Compared with the normal group， the model and Fib groups presented increases in low shear viscosity and middle shear viscosity （P<0.05， P<0.01）， and the Fib group showcased an increase in high shear viscosity （P<0.01）. Compared with the model group， the Fib group showed increases in low shear viscosity， middle shear viscosity， and high shear viscosity （P<0.05， P<0.01）. Compared with the Fib group， the AAV group demonstrated decreases in low shear viscosity， middle shear viscosity， and high shear viscosity （P<0.05， P<0.01）. The normal group had an complete aortic structure with well arrangement of elastic fibers. In the model group， the vascular wall became thickened and the intima was rough with inflammatory infiltration. In the Fib group， the intima calcification formed a cavity structure and the intima was abnormally proliferated， while in the AAV group， the intima smooth muscle was slightly proliferated with local calcification. The ECG of the normal group indicated sinus rhythm， and that of the model group presented ST segment oblique elevation （>0.1 mV）. The ECG of the Fib group presented characteristic ST segment arch back elevation with T-wave towering， and that of the AAV group presented ST segment oblique elevation. Compared with the normal group， the model and Fib groups showed elevations in levels of liver Fib， plasma Fib， and liver Fibα mRNA （P<0.01）， and the AAV group had risen levels of Fib and Fibα mRNA （P<0.01）. Compared with the model group， the Fib group presented risen levels of liver Fib and Fibα mRNA （P<0.01）. Compared with the Fib group， the AAV group presented decreases in levels of liver Fib， plasma Fib， and liver Fibα mRNA （P<0.01）. Compared with the normal group， the other three groups had down-regulated protein and mRNA levels of Mfn2， OPA1， PINK1， Parkin， p-AMPK/AMPK， and PGC-1α （P<0.05， P<0.01） and up-regulated protein levels of Drp1 （P<0.01）. Compared with those in the model group， the mRNA and protein levels of Mfn2， OPA1， PINK1， Parkin， p-AMPK/AMPK， and PGC-1α were all down-regulated （P<0.05， P<0.01） and the protein level of Drp1 was up-regulated （P<0.01） in the Fib group. Compared with the Fib group， the AAV group showed differences in protein levels of OPA1， PGC-1α， Parkin， and Drp1 （P<0.05， P<0.01） and an increasing trend in the mRNA levels of AMPK and PGC-1α with no significant difference. Compared with the normal group， the other three groups had elevated levels of ATP in the myocardial tissue （P<0.01）. Compared with the model group， the Fib group showed elevated levels of ATP and AMP （P<0.01）. Compared with the Fib group， the AAV group exhibited lowered levels of ATP and AMP （P<0.01）. ConclusionFib can achieve the overexpression effect in the rat model of coronary heart disease with the syndrome of blood stasis. At the same time， the overexpression of Fib can induce the damage of the mitochondrial quality control system in the myocardial tissue， inhibit mitochondrial dynamics and mitochondrial biosynthesis， and down-regulate mitochondrial autophagy， thereby aggravating myocardial injury in the rat model.

To summarize the nursing experience of a patient with relapsed/refractory diffuse large B-cell lymphoma who suffered from cytokine release syndrome after chimeric antigen receptor T-cell therapy.The main nursing experiences include:implementing emergency care for distributive shock caused by cytokine storm;carrying out the nursing of lung ventilation protection strategies;strengthening detailed skin care;prevention,control and care of hospital-acquired infections in an immunosuppressed state.After active treatment,the patient was transferred to the general ward 9 days later and discharged 27 days later.

ObjectiveTo analyze the metabolomic characteristics of platelets in fibrinogen（FIB） overexpression rats of coronary heart disease with blood stasis syndrome（CHD-BSS）， explore potential biomarkers， and investigate the mechanism of FIB overexpression on CHD-BSS. MethodsSD rats were randomly divided into BSS group and BSS+FIB overexpression group（BSS+FIB group）， with 10 rats in each group. Both the BSS+FIB group and the BSS group were fed a high-fat diet combined with oral administration of vitamin D₃ and subcutaneous injection of isoproterenol， but rats in the BSS+FIB group were overexpressed with FIB during the initial modeling stage by transfection with adeno-associated virus（AAV）. The overexpression level of FIB in rat liver and plasma samples was detected by enzyme-linked immunosorbent assay（ELISA） and real-time fluorescence quantitative polymerase chain reaction（Real time PCR）， as well as the expression level of liver FIB A（FGA） mRNA. The characteristics of metabolites in rat platelet samples were analyzed by ultra-high performance liquid chromatography-quadrupole-electrostatic field orbital trap high-resolution mass spectrometry（UPLC-Q-Exactive Orbitrap-MS）， and the differential metabolites between groups were screened by principal component analysis（PCA） and orthogonal partial least squares-discriminant analysis（OPLS-DA）， and the enriched pathways were analyzed. The accuracy of potential biomarkers in the diagnosis of CHD-BSS was evaluated by receiver operating characteristic（ROC） curve. The expression of autophagy related proteins phosphorylated adenosine monophosphate（AMP） activated protein kinase（p-AMPK）/AMPK， phosphorylated mammalian target of rapamycin（p-mTOR）/mTOR， microtubule-associated protein 1 light chain 3（LC3） Ⅱ/Ⅰ and p62 in platelets were detected by Western blot. ResultsCompared with the BSS group， the expression levels of FIB in liver and plasma samples of the BSS+FIB group were significantly increased（P<0.05， P<0.01）， and the expression level of FIB mRNA in the liver was remarkably increased（P<0.01）， indicating successful overexpression of FIB. Platelet metabolomics results showed significant differences in metabolic profiles between the BSS+FIB group and the BSS group， and a total of 25 significantly enriched metabolic pathways and 8 metabolites involved in these metabolic pathways， among which uric acid， guanosine and ribose 1-phosphate levels were up-regulated， while adenosine diphosphate（ADP）， AMP， guanosine diphosphate（GDP）， adenylosuccinate and norepinephrine levels were down-regulated. The diagnostic ability analysis of differential metabolites showed that all 8 differential metabolites had good diagnostic ability， with an area under the curve（AUC）>0.85. Western blot results showed that compared with the BSS group， the expression levels of p-mTOR/mTOR and p62 proteins in platelets of the BSS+FIB group was significantly reduced（P<0.01）， while the expression levels of p-AMPK/AMPK and LC3Ⅱ/Ⅰ proteins were increased， but the difference was not statistically significant. ConclusionOverexpression of FIB can change the metabolic characteristics of CHD-BSS rat model， involving multiple aspects such as vascular endothelial injury， platelet activation and myocardial function damage. Among them， overexpression of FIB may enhance the occurrence of platelet autophagy， thereby inducing platelet activation and promoting thrombus formation.

Objective To investigate the value of predicting microsatellite instability(MSI)status in endometrial cancer based on whole-tumor apparent diffusion coefficient(ADC)histogram.Methods The data of 131 endometrial cancer patients who underwent preoperative MRI examination and were confirmed by pathology were retrospectively analyzed.According to the pathological immu-nohistochemical results,they were divided into microsatellite stability(MSS)group(103 cases)and MSI group(28 cases).The whole-tumor volume of interest(VOI)was outlined using ITK-SNAP software,and ADC histogram analysis was performed using uAI Research Portal software.The t-test or Mann-Whitney U-test were used to compare the differences between the two groups,and multifactorial logistic regression analysis was used to screen independent predictors for the above parameters with differences.The area under the curve(AUC),sensitivity and specificity were calculated using the receiver operating characteristic(ROC)curve.Results The ADC histogram parameters that were statistically significant between groups were ADC10th,ADC90th,ADCmaximum,ADCmedian,ADCmean,ADCrange,ADCinterquartile range,ADCuniformity,ADCvariance,ADCenergy,ADCentropy,ADCtotal energy,ADCroot mean square,ADCmean absolute deviation,ADCrobust mean absolute deviation,all the above parameters were significantly smaller in the MSI group than in the MSS group.Further multifactorial logistic regression analysis results showed that ADCmedian[odds ratio(OR)=1.019,P=0.020]and ADCroot mean square(OR=0.977,P=0.005)were independent predictors of the MSI status in endometrial cancer.The results of ROC curve showed that the AUC of ADCmedian and ADCroot mean square for predicting MSI status were 0.699 and 0.731,respectively,and the AUC of combining the two parameters to predict MSI status was 0.760,with a sensitivity of 57.14%and a specificity of 86.41%.Conclusion The parameters of ADCmedian and ADCroot mean square based on whole-tumor ADC histogram can be used to predict the MSI status of endometrial cancer,and the combined use of these two parameters helps to improve the efficacy of predicting MSI.

Objective To investigate the value of predicting microsatellite instability(MSI)status in endometrial cancer based on whole-tumor apparent diffusion coefficient(ADC)histogram.Methods The data of 131 endometrial cancer patients who underwent preoperative MRI examination and were confirmed by pathology were retrospectively analyzed.According to the pathological immu-nohistochemical results,they were divided into microsatellite stability(MSS)group(103 cases)and MSI group(28 cases).The whole-tumor volume of interest(VOI)was outlined using ITK-SNAP software,and ADC histogram analysis was performed using uAI Research Portal software.The t-test or Mann-Whitney U-test were used to compare the differences between the two groups,and multifactorial logistic regression analysis was used to screen independent predictors for the above parameters with differences.The area under the curve(AUC),sensitivity and specificity were calculated using the receiver operating characteristic(ROC)curve.Results The ADC histogram parameters that were statistically significant between groups were ADC10th,ADC90th,ADCmaximum,ADCmedian,ADCmean,ADCrange,ADCinterquartile range,ADCuniformity,ADCvariance,ADCenergy,ADCentropy,ADCtotal energy,ADCroot mean square,ADCmean absolute deviation,ADCrobust mean absolute deviation,all the above parameters were significantly smaller in the MSI group than in the MSS group.Further multifactorial logistic regression analysis results showed that ADCmedian[odds ratio(OR)=1.019,P=0.020]and ADCroot mean square(OR=0.977,P=0.005)were independent predictors of the MSI status in endometrial cancer.The results of ROC curve showed that the AUC of ADCmedian and ADCroot mean square for predicting MSI status were 0.699 and 0.731,respectively,and the AUC of combining the two parameters to predict MSI status was 0.760,with a sensitivity of 57.14%and a specificity of 86.41%.Conclusion The parameters of ADCmedian and ADCroot mean square based on whole-tumor ADC histogram can be used to predict the MSI status of endometrial cancer,and the combined use of these two parameters helps to improve the efficacy of predicting MSI.

To summarize the nursing experience of a patient with relapsed/refractory diffuse large B-cell lymphoma who suffered from cytokine release syndrome after chimeric antigen receptor T-cell therapy.The main nursing experiences include:implementing emergency care for distributive shock caused by cytokine storm;carrying out the nursing of lung ventilation protection strategies;strengthening detailed skin care;prevention,control and care of hospital-acquired infections in an immunosuppressed state.After active treatment,the patient was transferred to the general ward 9 days later and discharged 27 days later.

Objective To evaluate the performance of magnetic resonance imaging(MRI)multi-sequence feature imputation and fusion mutual model based on sequence deletion in differentiating high-grade glioma(HGG)from low-grade glioma(LGG).Methods We retrospectively collected multi-sequence MR images from 305 glioma patients,including 189 HGG patients and 116 LGG patients.The region of interest(ROI)of T1-weighted images(T1WI),T2-weighted images(T2WI),T2 fluid attenuated inversion recovery(T2_FLAIR)and post-contrast enhancement T1WI(CE_T1WI)were delineated to extract the radiomics features.A mutual-aid model of MRI multi-sequence feature imputation and fusion based on sequence deletion was used for imputation and fusion of the feature matrix with missing data.The discriminative ability of the model was evaluated using 5-fold cross-validation method and by assessing the accuracy,balanced accuracy,area under the ROC curve(AUC),specificity,and sensitivity.The proposed model was quantitatively compared with other non-holonomic multimodal classification models for discriminating HGG and LGG.Class separability experiments were performed on the latent features learned by the proposed feature imputation and fusion methods to observe the classification effect of the samples in two-dimensional plane.Convergence experiments were used to verify the feasibility of the model.Results For differentiation of HGG from LGG with a missing rate of 10%,the proposed model achieved accuracy,balanced accuracy,AUC,specificity,and sensitivity of 0.777,0.768,0.826,0.754 and 0.780,respectively.The fused latent features showed excellent performance in the class separability experiment,and the algorithm could be iterated to convergence with superior classification performance over other methods at the missing rates of 30%and 50%.Conclusion The proposed model has excellent performance in classification task of HGG and LGG and outperforms other non-holonomic multimodal classification models,demonstrating its potential for efficient processing of non-holonomic multimodal data.

As an emerging discipline that combines traditional diagnostic methods with modern scientific technology,micro syndrome differentiation has good prospects for development,but there are some controversies in the research process.Based on ancient and modern literature,this article reviewed the origin and flow of research on micro syndrome differentiation,and summarized the problems to be improved in the process of research on micro syndrome differentiation from three aspects:application of disease type,guiding ideology and micro indicators.Based on this,the article further expounded the new thinking on"near-micro"syndrome differentiation from three aspects:connotation,scope of application,and links to traditional identification and micro-identification,and pointed out that the modern medical detection basis should be incorporated into the field of TCM syndrome differentiation,and at the same time,it should be based on the overall thinking mode of TCM,which would provide a new idea for the development of modern TCM diagnosis technology.

Objective To compare the effects of three kinds of artificial hydronephrosis in percutaneous nephrolithotomy.Methods A total of 120 patients who underwent single-tract percutaneous nephrolithotomy in the Eighth Hospital of Wuhan from May 2020 to April 2022 were selected and divided equally into three groups according to different methods of artificial hydronephrosis.Patients in group A were received preoperative indwelling ureteral catheter and injection of normal saline through ureteral catheter to dilate renal pelvis and form artificial hydronephrosis.Patients in Group B were placed with double J catheters before surgery,and the bladder was filled with physiological saline through the catheter.The renal pelvis was dilated through the double J catheters,resulting in artificial hydronephrosis.Patients in Group C were received intravenous injection of furosemide and stimulated diuretic method to actively dilate renal pelvis to form hydronephrosis.The one-time puncture success rate,channel establishment time,overall operation time,stone clearance rate and incidence of surgical complications of percutaneous nephrolithotomy after hydronephrosis were compared among the three groups.Results The operation was successfully completed in the three groups.There was no significant difference in the one-time puncture success rate and channel establishment time between group A and group B(P>0.05),which were all higher than group C(P<0.05).The overall operation time of group B was shorter than that of group A and group C(P<0.05).There were no significant differences in stone clearance rate and surgical complications among the three groups(P>0.05).Conclusion Preoperative indwelling of double J tubes to create artificial kidney hydronephrosis has advantages such as high success rate of one-time puncture,short channel establishment time,and surgical time.

Objective To examine the precise function of influenza A virus target genes(IATGs)in malignancy. Methods Using multi-omics data from the TCGA and TCPA datasets,33 tumor types were evaluated for IATGs.IATG expression in cancer cells was analyzed using transcriptome analysis.Copy number variation(CNV)was assessed using GISTICS 2.0.Spearman's analysis was used to correlate mRNA expression with methylation levels.GSEA was used for the enrichment analysis.Pearson's correlation analysis was used to examine the association between IATG mRNA expression and IC50.The ImmuCellAI algorithm was used to calculate the infiltration scores of 24 immune cell types. Results In 13 solid tumors,IATG mRNA levels were atypically expressed.Except for UCS,UVM,KICH,PCPG,THCA,CHOL,LAMI,and MESO,most cancers contained somatic IATG mutations.The main types of CNVs in IATGs are heterozygous amplifications and deletions.In most tumors,IATG mRNA expression is adversely associated with methylation.RT-PCR demonstrated that EGFR,ANXA5,CACNA1C,CD209,UVRAG were upregulated and CLEC4M was downregulated in KIRC cell lines,consistent with the TCGA and GTEx data. Conclusion Genomic changes and clinical characteristics of IATGs were identified,which may offer fresh perspectives linking the influenza A virus to cancer.