ObjectiveTo analyze the risk factors for long-term cardiovascular events in patients undergoing long-term peritoneal dialysis （PD）， and to construct and validate a visual nomogram prediction model based on multiple parameters. MethodsA prospective cohort study was conducted， consecutively enrolling 248 maintenance PD patients （dialysis duration ≥ 3 months）. Demographic characteristics， clinical indicators， laboratory parameters， and echocardiographic indices （including left ventricular ejection fraction ［LVEF］， ratio of early diastolic mitral inflow velocity to early diastolic mitral annular velocity （E/e’）， etc.） were collected. The composite endpoint was defined as the occurrence of cardiovascular events or cardiovascular death， with non-cardiovascular death as the competing risk and loss to follow-up or the end of follow-up as censoring events. Fine-Gray competing risks model was used to screen independent predictors， based on which a nomogram model was constructed. Internal validation was performed using the Bootstrap method （1 000 resamplings）， and the concordance index （C-index） and time-dependent receiver operating characteristic （time-dependent ROC） curve were calculated to evaluate the model performance. ResultsWith a median follow-up of 29 months （interquartile range： 24–35 months）， 88 patients （35.48%） reached the composite endpoint， including 80 cases of cardiovascular events and 8 cases of cardiovascular death， and 4 patients died of non-cardiovascular causes. Multivariate Fine-Gray analysis revealed that age， diabetes mellitus， hemoglobin （HGB） level and E/e' ratio were independent influencing factors of the composite endpoint. Specifically， each 1-year increase in age was associated with a 3.0% increase in the risk of the composite endpoint （HR=1.030， P=0.006）； patients with diabetes mellitus had a 167.9% higher risk compared with non-diabetic patients （HR=2.679， P=0.007）； each 1g/L increase in HGB level contributed to a 1.5% reduction in the risk （HR=0.985， P=0.003）； and each 0.1 increase in E/e' ratio led to a 7.2% increase in the risk （HR=1.072， P=0.045）. The nomogram model had a C-index of 0.76 （95% CI： 0.698–0.820）， and the AUC of the time-dependent ROC curve reached 0.849 at 23 months of follow-up. ConclusionIncreased age， complicated with diabetes mellitus， decreased HGB， and elevated E/e' ratio are independent risk factors of long-term occurrence of cardiovascular events and cardiovascular death in patients undergoing long-term PD. The nomogram model constructed based on the above variables has good predictive value and clinical applicability， which can provide a reference for cardiovascular risk stratification and individualized intervention in long-term PD patients.

OBJECTIVE To predict and verify the mechanism of Jiawei qifang weitong granule in ameliorating precancerous lesions of gastric cancer （PLGC）. METHODS Transcriptomic data of PLGC-related were obtained from the GEO database to screen differentially expressed genes and conduct functional enrichment analysis. Targets related to gastric mucosal injury repair were screened via the GeneCards database. The active ingredient targets of Jiawei qifang weitong granule were predicted using the TCMSP and other databases. The intersection of differentially expressed genes， gastric mucosal repair targets and active ingredient targets was extracted. A protein-protein interaction network was constructed based on the STRING database， and the top 6 hub target genes with the highest connectivity were screened. A PLGC rat model was established by combining 1-methyl-3-nitro-1-nitrosoguanidine with alternating fasting and full feeding. Model rats were divided into model group， weifuchun group （positive control， 0.40 g/kg）， low-， medium- and high-dose Jiawei qifang weitong granule groups （9.73， 19.44， 38.90 g/kg）， with 10 rats in each group. Another 10 unmodeled rats were set as control group. Rats in each group were intragastrically administered corresponding liquid medicine or normal saline once a day for 30 consecutive days. After the last administration， pathological morphological changes of rat gastric tissues were observed， and the mRNA expression levels of hub target genes as well as partial protein expression levels in gastric tissues were detected. RESULTS Transcriptomics and network pharmacology analyses revealed that the top 6 hub target genes ranked by connectivity included MMP9 （matrix metalloproteinase 9）， BCL2（B-cell lymphoma 2）， IL10（interleukin 10），ICAM1（intercellular adhesion molecule 1）， PTGS2 （prostaglandin-endoperoxide synthase 2）， and HIF1A （hypoxia-inducible factor 1α subunit）. Animal experiments showed that compared with the model group， gastric mucosal pathological injury was significantly alleviated in medium- and high-dose Jiawei qifang weitong granule groups and weifuchun group. The pathological injury score of gastric mucosa， the mRNA expression levels of MMP9， PTGS2， ICAM1， BCL2 and HIF1A， as well as the protein expression levels of PTGS2 and BCL2 in gastric tissues were significantly decreased （P＜0.05）， while the mRNA expression level of IL10 was significantly increased （P＜0.05）. CONCLUSIONS Jiawei qifang weitong granule may ameliorate PLGC by targeted down-regulating the mRNA expression of MMP9， PTGS2， ICAM1， BCL2 and HIF1A， up-regulating IL10 mRNA expression， and regulating the imbalance between gastric mucosal inflammatory response and injury repair.

This article reports the diagnosis and treatment course of a patient with granulomatosis with polyangiitis (GPA) complicated with Kennedy disease (KD). The patient presented with headache, purulent and bloody rhinorrhea, ocular pain, decreased hearing and vision, multiple nodular erythema with ulcers on both lower extremities, and lower limb weakness. Chest imaging revealed a nodule with cavity formation in the right lung, and cytoplasmic anti-neutrophil cytoplasmic antibody (c-ANCA) and proteinase 3-antineutrophil cytoplasmic antibody (PR3-ANCA) were positive. The patient was initially diagnosed with granulomatosis with polyangiitis. After treatment with glucocorticoids and cyclophosphamide, the vasculitis-related symptoms were relieved while lower limb weakness got worse. Genetic testing identified 50 CAG repeats in exon 1 of the androgen receptor (AR) gene, and the final diagnosis was GPA complicated with KD. After rehabilitation therapy, the patient′s lower limb weakness improved. Methylprednisolone combined with leflunomide was administered for maintenance treatment, and the condition remained stable during long-term follow-up.

The ultrasound probe is the most important accessory in ultrasound equipment,which adopted the piezoelectric vibrator as its core component,and it can complete ultrasonic emission and receiving echoes.A deep understanding for the operational characteristics of the probe's array elements is important premise that user can accurately judge the running situation of the probe.This study employed pulse-echo technique to detect sensitivity and capacitance of the array elements of ultrasonic probe.The detected data of 60 probes at China-Japan Friendship Hospital were collected,and 75%of the 60 probes existed residual couplant,and 80%of them existed indentation or damage to the outer skin.The tested results of leakage current indicated that 1 probe(1.7%)existed excessively high leakage current.In test for array elements,2 probes(3.4%)displayed partial damage at array elements,and 6 probes(10.2%)were irreparably damaged.The preventive test for the diagnostic equipment with ultrasound is helpful to establish a quality control system for ultrasound,and to provide analysis materials with reliability in using diagnostic equipment with ultrasound,and to also provide decision-making basis for equipment departments and clinical department of using equipment in hospital.

Objective To explore the efficacy of extracting biopsy needle pose in chest CT images based on point cloud processing.Methods Three-dimensional point clouds were generated through segmentation of chest CT images and surface reconstruction.Spatial point cloud clustering and geometric constraints were applied to filter regions contained the puncture needle in space.The principal direction of the needle was judged using principal component analysis,and a cylindrical model was constructed to enclose the needle data.Then random sample consensus algorithm was used for needle trajectory fitting to accurately extract the spatial position and orientation of the puncture needle.The efficacy of the above method was evaluated using a 3D-printed anatomical model based on common clinical combinations of puncture depths and angles.Results The anatomical model experiments showed a 100％success rate in puncture needle identification,with angular error of(1.013±0.424)° and positional error of(2.023±1.553)mm,indicating that this method had good accuracy and stability.Conclusion The puncture needle's position in chest CT images could be extracted with high precision based on point cloud processing.

Objective To compare the changes in biological indicators of human corneal epithe-lial(HCET)cells and rabbit corneas after exposure to different doses of ultraviolet B(UVB)radia-tion,so as to evaluate the impact of UVB radiation on corneal injury effects.Methods In cell exper-iment,HCET cells were divided into groups with radiation doses of 0,6,12,18,and 24 mJ/cm2.The effect of UVB radiation on HCET cell viability was detected using the CCK-8 assay,and the level of intracellular DNA damage was assessed by immunofluorescence.In the animal experiment,15 healthy New Zealand white rabbits(30 eyes)were randomly divided into groups with radiation doses of 0,1.35,2.16,4.32,and 6.48 J/cm2.The UVB exposure time for the radiation groups was 30 minutes per day for 3 consecutive days.Corneal injury was evaluated using methods such as slit-lamp microscopy,sodium fluorescein staining,central corneal thickness measurement,optical coherence tomography(OCT)imaging,and hematoxylin and eosin(HE)staining.Results Compared with the control group,cell viability in the radiation groups gradually decreased,and the level of DNA damage gradually increased with increasing radiation dose.As the radiation dose increased in the radiation groups,the degree of corneal opacity in rabbits gradually worsened,the central corneal area gradu-ally thickened,and OCT revealed high-intensity scattered light signals with the formation of shadow areas.Results from HE staining,immunohistochemistry,Western blot(WB),and sodium fluores-cein staining showed that the 1.35 J/cm2 group caused mild corneal injury,with damage reaching the corneal epithelial layer.In the 2.16 J/cm2 group,the corneal injury presented as dense punctate distribution,with damage extending from the epithelial layer to the superficial stroma.The number of ephrin type-A receptor 2(EphA2)protein-stained cells was relatively small,and the staining was light,showing a weak positive result.In the 4.32 J/cm2 and 6.48 J/cm2 groups,the corneal injury was irreversible,with damage gradually progressing from the corneal epithelial layer and superficial stroma to the endothelial layer.The number of EphA2 protein-stained cells was relatively large,and the staining was dark,showing a strong positive result.Conclusion This study comprehensively e-valuates the dose-dependent injury effects of UVB on HCET cells and New Zealand white rabbit cor-neas through cell and animal experiments.It elucidates that UVB radiation could induce corneal cell DNA damage,promote inflammatory responses,and trigger apoptosis by upregulating γ-phosphoryla-ted histone H2AX(γH2AX)and EphA2.The self-repair ability and process of corneal injury are preliminarily explored,providing a basis for further research on mechanisms of corneal injury caused by ultraviolet radiation and the development of protective drugs.

Gastroesophageal reflux disease(GERD)is a chronic recurrent disorder characterized by typical symptoms such as acid regurgitation and heartburn.Its high recurrence rate and long-term complications not only significantly impact patients' quality of life but also impose a heavy healthcare burden.Traditional proton pump inhibitors(PPIs),as first-line therapeutic agents,are often inadequate for long-term maintenance therapy of GERD due to shortcomings such as short half-life,susceptible to genetic polymorphisms,and nocturnal acid breakthrough.Recently,the potassium-competitive acid blocker(P-CAB)vonoprazan has demonstrated advantages increasingly in the maintenance therapy of GERD.This article reviewed the research progress on vonoprazan in the maintenance therapy of GERD,aiming to provide a reference for optimizing the long-term management of GERD.

Objective:To explore cortical activation during the obstacle avoidance task in convalescent stroke patients,and examine the effect of obstacle avoidance difficulty on brain activation.Method:A total of 20 convalescent stroke patients were recruited to perform various motor tasks,including walking,simple obstacle avoidance,difficult obstacle avoidance,and motor imagery.Functional near-infrared spectroscopy(fNIRS)was used to detect the oxygenated hemoglobin concentration in the prefrontal cortex(PFC),premotor cortex(PMC)and supplementary motor area(SMA)of the patients.Additional relevant sec-ondary indicators were evaluated and collected.Statistical analysis was performed without grouping and with grouping.Result:The activation levels of bilateral PFC,PMC and SMA during the dynamic task were significantly dif-ferent from those during the static tasks(P＜0.05),with the highest activation observed in the PFC.There were significant differences between simple and difficult obstacle avoidance tasks in the unaffected-side SMA(P＜0.05).In addition,there was a linear positive correlation between the peak activation level of PMC on the unaffected side and Tinetti score(P＜0.05).Conclusion:Bilateral PFC,PMC and SMA are involved in limb movement in convalescent stroke patients,with PFC showing the highest level of activation.In addition,SMA on the unaffected side may contribute to regulating the difficulty of obstacle avoidance.Moreover,the peak activation level of PMC on the unaffected side is associated with balance and walking function.

To construct a safe and effective multi-epitope vaccine against the S1 protein of chicken infectious bronchitis virus(IBV).In this study,homologous and non-homologous dominant epitopes of IBV M41,T,QX and H120 virulent strain S1 proteins were screened by various online bioprediction software,respectively,and a new peptide W with high immunogenicity was construc-ted by connecting the screened B-cell and T-cell epitopes with a linker peptide.W was ligated to the truncated sequence of the four viral strains by T2A yietding to the eukaryotic expression vector pEGFP-N1,and it was identified by PCR and double digestion,the obtained recombinant plasmid was transfected into HEK293A cells and target protein expression was measured by Western blot.The constructed plasmid was injected intramuscularly twice to detect the antibody level,cytokine level,and peripheral blood T cell subsets were detected after two immunizations.The epitope pro-tein W was successfully constructed,which was structurally stable,antigenic,and soluble;the re-combinant plasmid pEGFP-WMQtH,pEGFP-W,and pEGFP-MQtH matched the expected size;anti-IBV IgG antibody levels in pEGFP-N1 was increased greatly compared to the PBS group.cyto-kines IL-2,and γ interferon(IFN-γ)were increased greatly(P＜0.05);peripheral blood CD4+/CD8a value(P＜0.05)was increased greatly.The W epitope protein was successfully constructed,which can effectively activate the humoral immunity and cellular immunity against four infectious bronchitis viruses(IBV),laying a foundation for the development of an effective vaccine against IB.

CT-guided thermal ablation is a critical modality for treating lung cancer.Invasive thermometry techniques demonstrated sufficient accuracy for monitoring temperature of the target area during ablation,but their clinical application were limited since procedural invasiveness and relatively high risk of complications.Being non-invasive,safe and capable of global monitoring,non-invasive thermometry techniques have broad application prospects.The status of non-invasive thermometry techniques for CT-guided thermal ablation for lung cancer were reviewed in this article.