Objective The identification of TCM constitution plays an important role in"treating and preventing diseases"of TCM.At present,the identification of damp-heat constitution and balanced constitution is mostly determined by questionnaire,and subjective factors have a great influence.Aiming at the identification of damp-heat constitution and balanced constitution in TCM,this paper utilizes voice signal to automatically realize the constitution identification task,in order to provide assistance for the clinical identification of TCM constitution.Methods Based on deep learning Transformer and transfer learning,a pure attentional mechanism model was designed for the identification of constitution in TCM sound diagnosis.We collected 700 voices from 34 subjects,pre-processed the voice data to obtain the corresponding Mayer spectrum diagram,and used the Transformer model pre-trained based on the public data set to improve the performance of the model for audio classification.Results The accuracy of the experimental results was 83.33%,the AUC was 92.16%,the sensitivity was 80.25%,and the specificity was 87.03%.Compared with the Convolutional Neural Network(CNN),the performance of the deep learning model was better.Conclusion In this paper,the damp-heat constitution and balanced constitution identification model Transformer has achieved better identification effect,indicating that it can improve the efficiency of TCM acoustic diagnosis of constitution identification,and promote the objective and intelligent development of constitution identification.

Objective To explore the value of MRI quantitative parameters and free/total prostate-specific antigen ratio(f/tPSA)for diagnosing prostate imaging reporting and data system(PI-RADS)3-point clinically significant prostate cancer(csPCa).Methods Totally 57 patients with PI-RADS 3-point prostate lesions were retrospectively enrolled,including 18 prostate cancer(PCa)(PCa group)and 39 benign hyperplasia with chronic prostatitis(non-PCa group).The former included 12 cases of csPCa and 6 cases of clinically insignificant PCa(ciPCa).Taken non-PCa and ciPCa into non-csPCa group(n=45),laboratory and MRI parameters(apparent diffusion coefficient[ADC],T1,T2,proton density[PD]values)were compared between PCa and non-PCa groups,also between csPCa and non-csPCa groups.Based on laboratory and MRI parameters being statistically different between groups according to univariate analysis,combined models were established using logistic regression.The efficacy of laboratory,MRI parameters and combined models for differentiating PCa and non-PCa as well as csPCa and non-csPCa were evaluated.Results ADC,T1,T2,PD values in PCa group were all lower those in non-PCa group(all P＜0.05),and f/tPSA,ADC,T1,T2 and PD values in csPCa group were all lower than those in non-csPCa group(all P＜0.05).AUC of ADC,T1,T2 and PD values for differentiating PCa from non-PCa was 0.662,0.755,0.793 and 0.729 respectively,while of ADC-T1-T2-PD combined model was 0.839,higher than that of ADC alone(P＜0.05)but not significantly different with T1,T2 and PD values alone(all P＞0.05).AUC of f/tPSA,ADC,T1,T2 and PD values for differentiating csPCa from non-csPCa was 0.692,0.759,0.741,0.805 and 0.737,respectively,while of ADC-T1-T2-PD combined model was 0.889,higher than that of f/tPSA,ADC and T1 values alone(all P＜0.05)but not significantly different with that of T2 and PD value alone(both P＞0.05).AUC of f/tPSA-ADC-T1-T2-PD combined model was 0.898,higher than that of f/tPSA,ADC,T1 and PD values alone(all P＜0.05)but not significantly different with T2 value and ADC-T1-T2-PD combined model(both P＞0.05).Conclusion MRI quantitative parameters combined with f/tPSA could effectively diagnose PI-RADS 3-point csPCa.

Objective:To conduct a survey on the influence of personality trait on depres-sive symptom and obesity in patients before bariatric and metabolic surgery.Methods:The retros-pective cross-sectional investigation study was conducted. Patients who underwent bariatric and metabolic surgery in The Third Xiangya Hospital of Central South University and The First Affiliated Hospital of Ji′nan University from January 1 to June 1,2024 were recruited. The survey was conducted in electronic format using the general information survey questionnaire, the patient health question-naire-9 (PHQ-9), and the Chinese big five personality inventory brief version (CBF-PI-B). Observa-tion indicators: (1) results of the questionnaire; (2) general data of patient; (3) personality trait scores for patient with different subtypes of obesity; (4) depression symptom scores for patient with different subtypes of obesity; (5) correlation analysis for patient personality trait, depressive symptom and body mass index (BMI). Comparison of measurement data with normal distribution between groups was conducted using the independent t test, and one-way analysis of variance was used for comparison among multiple groups. LSD test was used for pairwise comparison. Comparison of measurement data with skewed distribution among multiple groups was conducted using the Kruskal-Wallis H test, and Dunn Bonferroni test was used for pairwise comparison. The Spearman correlation analysis and Pearson correlation analysis were used for correlation analysis, and the mediation effect analysis was conducted using the Process 4.0 model and the Bootstrap test. Results:(1)Results of the questionnaire. A total of 146 questionnaires were distributed and collected, including 83 questionnaires from The Third Xiangya Hospital of Central South University and 63 questionnaires from The First Affiliated Hospital of Ji′nan University. Of 146 questionnaires, 137 questionnaires were valid, yielding an effective response rate of 93.836%(137/146). (2)General data of patient. Of the 137 patients who completed valid questionnaires, 52 were male with BMI of (41±5)kg/m 2, 85 were female with BMI of (38±6)kg/m 2, showing a significant difference between them ( t=2.586, P<0.05). There were 40 patients aged ≤25 years, with BMI of (42±5)kg/m 2, 28 patients aged 26-30 years, with BMI of (39±5)kg/m 2, 49 patients aged 31-40 years, with BMI of (38±6)kg/m 2, 14 patients aged 41-50 years, with BMI of (38±7)kg/m 2, 6 patients aged >50 years, with BMI of (37±3)kg/m 2. There were significant differences in BMI of patients of different age groups ( F=2.697, P<0.05). (3)Persona-lity trait scores for patient with different subtypes of obesity. Of the 137 patients who completed valid questionnaires, there were 15 patients of mild obesity, with personality trait neuroticism score of 19.0(14.0,24.0), personality trait strictness score of 32.5±5.2, personality trait extroversion score of 30.0(24.0,40.0), 36 patients of moderate obesity, with personality trait neuro-ticism score of 26.5(22.3,28.8), personality trait strictness score of 32.6±5.9, personality trait extro-version score of 34.0(26.3,39.0), 81 patients of severe obesity, with personality trait neuroticism score of 35.0(29.5,41.0), personality trait strictness score of 26.8±7.4, personality trait extroversion score of 28.0(20.5,35.0), 5 patients of extreme obesity, with personality trait neuroticism score of 28.0(26.5,44.0), personality trait strictness score of 19.6±3.4, personality trait extroversion score of 22.0(18.5,25.0). There were significant differences in personality trait neuroticism, strictness and extroversion among patients of different subtypes of obesity ( H=50.316, F=10.774, H=14.446, P<0.05). (4)Depression symptom scores for patient with different subtypes of obesity. Of the 137 pati-ents who completed valid questionnaires, the depressive symptom score were 4.0(2.0,9.0) for 15 pati-ents of mild obesity, 5.0(3.0,7.0) for 36 patients of moderate obesity, 13.0(8.5,17.0) for 81 patients of severe obesity, and 18.0(9.5,22.0) for 5 patients of extreme obesity, respectively, showing a significant difference among them ( H=50.129, P<0.05). (5) Correlation analysis for patient personality trait, depressive symptom and BMI. Results of Spearman correlation analysis showed that personality trait neuroticism were positively correlated with depressive symptoms and BMI ( r=0.780, 0.557, P<0.05), personality trait strictness was negatively correlated with depressive symptoms ( r=-0.523, P<0.05), personality trait extroversion were negatively correlated with depressive symptoms and BMI ( r=-0.448, -0.323, P<0.05), and depressive symptoms was positively correlated with BMI ( r=0.568, P<0.05). Results of Pearson correlation analysis showed that personality trait strictness was negatively correlated with BMI ( r=-0.489, P<0.05). Conclusion:Preoperative personality trait of patients undergoing bariatric and metabolic surgery can influence their depressive symptom and BMI.

Purpose To analyze the expression of SNAP23 in esophageal squamous cell carcinoma(ESCC)and its influence on invasion of ESCC cells.Methods A total of 41 cases of ESCC and paired normal adjacent tissue(NAT)were collected.The expression and localization of SNAP23 were detected by immunohistochemical EnVision method.The differences of SNAP23 expression levels between ESCC tissues and NAT tissues were compared to analyze the relationship between SNAP23 expression and clinicopathological characteristics.The expression level of SNAP23 in human immortalized esophageal epithelial cells SHEE and ESCC cell lines TE-1,TE-13 and KYSE150 were detected by Western blot.Lentiviral vector transfection technique was used to construct stable transfection cell lines with knock-down and overexpression of SNAP23 gene.The effect of SNAP23 on invasion of ESCC cell line TE-13 was evaluated by cell invasion experiment.Results The expression of SNAP23 in ESCC was significantly higher(53.7％,22/41)than that in the NAT group(19.5％,8/41),the difference was statistically significant(x2=10.303,P＜0.01).The expression level of SNAP23 in ESCC tissues was significantly correlated with maximum tumor diameter(x2=4.193,P＜0.05)and invasion depth(x2=7.264,P＜0.05),but was not correlated with patient gender,age,tumor site,tumor type,pathologic grade,vascular embolus,nerve invasion and lymph node metastasis(P＞0.05).Compared with human immortalized esophageal epithelial cells SHEE,SNAP23 was highly expressed in ESCC cell lines(P＜0.000 1).Compared with the sh-NT group,the invasion of ESCC cell line TE-13 was inhibited when SNAP23 expression was knocked down(P＜0.000 1);compared with the Vector group,the invasion of ESCC cell line TE-13 was enhanced after overexpression of SNAP23(P＜0.000 1).Conclusion SNAP23 is highly expressed in ESCC tis-sue and cell lines,and its expression level in ESCC tissues is positively correlated with tumor maximum diameter and invasion depth;SNAP23 promotes the invasion of ESCC cells.

Objective To explore the value of MRI quantitative parameters and free/total prostate-specific antigen ratio(f/tPSA)for diagnosing prostate imaging reporting and data system(PI-RADS)3-point clinically significant prostate cancer(csPCa).Methods Totally 57 patients with PI-RADS 3-point prostate lesions were retrospectively enrolled,including 18 prostate cancer(PCa)(PCa group)and 39 benign hyperplasia with chronic prostatitis(non-PCa group).The former included 12 cases of csPCa and 6 cases of clinically insignificant PCa(ciPCa).Taken non-PCa and ciPCa into non-csPCa group(n=45),laboratory and MRI parameters(apparent diffusion coefficient[ADC],T1,T2,proton density[PD]values)were compared between PCa and non-PCa groups,also between csPCa and non-csPCa groups.Based on laboratory and MRI parameters being statistically different between groups according to univariate analysis,combined models were established using logistic regression.The efficacy of laboratory,MRI parameters and combined models for differentiating PCa and non-PCa as well as csPCa and non-csPCa were evaluated.Results ADC,T1,T2,PD values in PCa group were all lower those in non-PCa group(all P＜0.05),and f/tPSA,ADC,T1,T2 and PD values in csPCa group were all lower than those in non-csPCa group(all P＜0.05).AUC of ADC,T1,T2 and PD values for differentiating PCa from non-PCa was 0.662,0.755,0.793 and 0.729 respectively,while of ADC-T1-T2-PD combined model was 0.839,higher than that of ADC alone(P＜0.05)but not significantly different with T1,T2 and PD values alone(all P＞0.05).AUC of f/tPSA,ADC,T1,T2 and PD values for differentiating csPCa from non-csPCa was 0.692,0.759,0.741,0.805 and 0.737,respectively,while of ADC-T1-T2-PD combined model was 0.889,higher than that of f/tPSA,ADC and T1 values alone(all P＜0.05)but not significantly different with that of T2 and PD value alone(both P＞0.05).AUC of f/tPSA-ADC-T1-T2-PD combined model was 0.898,higher than that of f/tPSA,ADC,T1 and PD values alone(all P＜0.05)but not significantly different with T2 value and ADC-T1-T2-PD combined model(both P＞0.05).Conclusion MRI quantitative parameters combined with f/tPSA could effectively diagnose PI-RADS 3-point csPCa.

At present,malignant tumor diseases occur frequently and increase year by year.Traditional chemoradiotherapy methods are expensive,have serious toxic and side effects,and are easy to reduce patient tolerance.Natural medicines have advantages of multiple targets,high selectivity and low toxicity and side effects in process of anti-tumor,and are one of important sources of anti-tumor drugs.As a polypeptide substance,lactoferrin has a strong anti-tumor effect and plays a huge role in field of nano-drug delivery.Receptors of lactoferrin are widely expressed on surface of various cancer cells.In addition to its strong anti-tumor effect,it is also widely used to modify nanocarriers.In this paper,anti-tumor mechanism of lactoferrin is reviewed,and the latest research progress of using lactoferrin as an anti-cancer drug delivery carrier is also introduced.

Aim To evaluate the tyrosine nitration modification of specific proteins in vascular endothelial cells and its impact on mitochondria-mediated apoptosis.Methods Human umbilical vein endothelial cells were cultured in vitro and divided into three groups:control group(treatment with dimethyl sulfoxide),3-morphansulam(SIN-1)group,and SIN-1+Fe(Ⅲ)5,10,15,20-(tetraphenyl)porphyrin(FeTPP)group.After 24 h,the levels of hexokinase 1(HK1)nitration modification,mitochondrial membrane potential,reactive oxygen species(ROS)production,and endothelial cell proliferation and apoptosis were assessed.A human umbilical vein endothelial cell line knockout of HK1 was constructed using gene editing technology,and its proliferation and apoptosis levels were detected.Results After treatment of hu-man umbilical vein endothelial cells with peroxynitrite generator SIN-1,the level of HK1 protein nitration modification sig-nificantly increased(P＜0.01),reactive oxygen species production significantly increased,mitochondrial membrane poten-tial significantly decreased,endothelial cell proliferation ability significantly decreased,and endothelial cell apoptosis level significantly increased(all P＜0.01).Peroxynitrite decomposition catalyst FeTPP could reverse the above effect(P＜0.01).In addition,HK1 gene knockout also exhibited similar antioxidant effects,with a significant decrease in endothe-lial cell proliferation ability and a significant increase in apoptosis levels(P＜0.01).Conclusion Peroxynitrite can induce an increase in the level of nitration modification of HK1 in vascular endothelial cells,which may be achieved by pro-moting the production of mitochondrial reactive oxygen species,thereby accelerating the process of endothelial cell apoptosis.

Aim To evaluate the tyrosine nitration modification of specific proteins in vascular endothelial cells and its impact on mitochondria-mediated apoptosis.Methods Human umbilical vein endothelial cells were cultured in vitro and divided into three groups:control group(treatment with dimethyl sulfoxide),3-morphansulam(SIN-1)group,and SIN-1+Fe(Ⅲ)5,10,15,20-(tetraphenyl)porphyrin(FeTPP)group.After 24 h,the levels of hexokinase 1(HK1)nitration modification,mitochondrial membrane potential,reactive oxygen species(ROS)production,and endothelial cell proliferation and apoptosis were assessed.A human umbilical vein endothelial cell line knockout of HK1 was constructed using gene editing technology,and its proliferation and apoptosis levels were detected.Results After treatment of hu-man umbilical vein endothelial cells with peroxynitrite generator SIN-1,the level of HK1 protein nitration modification sig-nificantly increased(P＜0.01),reactive oxygen species production significantly increased,mitochondrial membrane poten-tial significantly decreased,endothelial cell proliferation ability significantly decreased,and endothelial cell apoptosis level significantly increased(all P＜0.01).Peroxynitrite decomposition catalyst FeTPP could reverse the above effect(P＜0.01).In addition,HK1 gene knockout also exhibited similar antioxidant effects,with a significant decrease in endothe-lial cell proliferation ability and a significant increase in apoptosis levels(P＜0.01).Conclusion Peroxynitrite can induce an increase in the level of nitration modification of HK1 in vascular endothelial cells,which may be achieved by pro-moting the production of mitochondrial reactive oxygen species,thereby accelerating the process of endothelial cell apoptosis.

A medical image segmentation network (RPR-MLP) based on multi-scale convolution and parallel reverse attention is presented. In the encoder,Res2net modules and tokenized multi-layer perceptron modules are used as the backbone structure to extract multi-scale information and enhance the diversity of semantic features. Meanwhile,the accuracy of semantic information extraction in the decoder is improved through parallel partial decoder. Additionally,reverse attention module re-emphasizes the focus on important regions for further improving the accuracy of segmentation results. The proposed method achieves Dice scores of 0.8967 and 0.8762 on the Kvasir and ISIC 2018 public datasets,respectively,demonstrating its effectiveness and generalization ability in medical image segmentation. Furthermore,when applied to the lung tumor CT image dataset (LungCancer dataset) collected in the study,the proposed network has Dice score,IoU and F1 score of 0.7278,58.83％and 67.85％,respectively,outperforming baseline network (UNeXt) and common CNN (U-Net,AttU-Net,U-Net++and PraNet) by 0.0301-0.0578、3.16％-4.70％,and 6.72％-18.53％,respectively. The study confirms the effectiveness and generalization ability of RPR-MLP network on different datasets,providing important technical support for lung tumor image segmentation.

Objective To explore the functional connectivity(FC)changes of hippocampus and amygdala in type 2 diabetes mellitus(T2DM)patients with erectile dysfunction(DMED),and the central pathological neural mechanisms underlying DMED.Methods 61 T2DM patients who visited Department of Endocrinology,Nanjing First Hospital,Nanjing Medical University from January 2020 to December 2021 were selected and divided into a simple T2DM group(n=30)and a combined DMED group(n=31).Another 47 healthy individuals were selected as control group(NC).The international erectile function scale(IIEF-5)was used to evaluate the erectile function.Resting-state functional magnetic resonance imaging(rs-fMRI)data were acquired from all participants.MRI data were preprocessed by the DPABI software package.Bilateral hippocampus and amygdala were selected as regions of interest(ROI)and the whole brain FC values were calculated.The FC values of brain regions between groups were tested by two-sample t-test with REST software package.Results Left hippocampus as ROI:compared with the NC group,FC values of the left superior temporal gyrus increased in the T2DM group,FC values of the left superior frontal gyrus,left inferior temporal gyrus,left posterior central gyrus and rectus gyrus decreased in the DMED group.Compared with the T2DM group,FC values of the left inferior parietal gyrus,left supramarginal gyrus,left middle occipital gyrus and right posterior central gyrus decreased in the DMED group.Right hippocampus as ROI:compared with the NC group,FC values of the right middle temporal gyrus and right rolandic operculum increased while FC values of the right calcarine fissure decreased in the T2DM group;FC values of bilateral anterior cingulate gyrus,right middle temporal gyrus and left rectus gyrus decreased in the DMED group.Compared with the T2DM group,FC values of the left middle frontal gyrus,left inferior parietal gyrus and right inferior temporal gyrus decreased in the DMED group.Left amygdala as ROI:compared with the NC group,FC values in the left parahippocampal gyrus,left fusiform gyrus and right insula increased in the T2DM group;FC value of the left middle temporal gyrus decreased in the DMED group.Compared with the T2DM group,FC values of the left middle frontal gyrus and left supramarginal gyrus decreased in the DMED group.Right amygdala as ROI:compared with the NC group,FC values of the left insula,right parahippocampal gyrus,right superior temporal gyrus and right supramarginal gyrus increased while FC values in the right caudate decreased in the T2DM group;FC values of the right middle frontal gyrus,left rectus gyrus and left middle occipital gyrus decreased in the DMED group.Compared with the T2DM group,FC values of the left middle frontal gyrus and left inferior parietal gyrus decreased in the DMED group.Conclusions DMED patients have abnormalities in the hippocampus,amygdala and other brain regions,especially the frontal lobe functional cortex,which may be related to changes in their brain function.