Purpose Explore the predictive value of nomograms based on enhanced CT radiomics for invasiveness of thymic epithelial tumor.Materials and Methods The clinical and imaging data from 155 cases confirmed with thymic epithelial tumors at the First Affiliated Hospital of Wannan Medical College from January 2015 to January 2023 were retrospectively collected.All cases were randomly divided into training(n=108)and validation(n=47)groups in a 7∶3 ratio.The radiomics features from venous phase images were extracted.The least absolute shrinkage and selection operator algorithm for dimensionality reduction were utilized to establish radiomics labels and calculate the Rad-score.Univariate and multivariate regression analyses were conducted to identify independent risk factors.Imaging feature models,Rad-score and imaging omics clinical combined model were constructed to plot the corresponding nomograms.The diagnostic performance and clinical benefits of the models were evaluated via receiver operating characteristic curves and decision curves.The DeLong test was applied to compare area under the curve differences between models and used calibration curves to assess nomograms calibration.Results 16 optimal image omics features were selected by dimensionality reduction.Logistic regression analysis showed that tumor morphology(OR=2.932,P=0.025),peripheral tissue invasion(OR=11.461,P=0.005)and Rad-score(OR=255.27,P=0.002)were independent risk factors.The area under the curve in the training set and the verification set were 0.852 and 0.831,respectively.Compared with the image feature model and Rad-score in the training set,the differences were statistically significant(Z=3.607,2.270,P<0.05).The threshold probability of the column chart model training set was between 0.08 and 0.88 for clinical benefit.Conclusion The combined model nomograms based on enhanced CT radiomics and clinical features can effectively predict thymic epithelial tumor invasiveness and assist clinicians in formulating precise treatment plans before surgery.

Objective:To investigate the application of combined deep learning and radiomic features derived from enhanced arterial phase CT imaging with clinical data to differentiate between T2 and T3 staging in patients with esophageal cancer.Methods:A retrospective study was conducted using clinical and CT data from 388 patients with pathologically confirmed esophageal cancer treated at The First Affiliated Hospital of Wannan Medical College between May 2015 and April 2024.The dataset was randomly divided into a training set(271 cases)and validation set(117 cases)in a 7:3 ratio.Radiomic and deep learning features were extracted from enhanced arterial phase CT images.The least absolute shrinkage and selection operator algorithm was employed for feature reduction and selection,leading to the development of radiomic(Radscore)and deep learning(Deepscore)scores.Univariate and multivariate Logistic regression analyses were conducted to identify independent risk factors,and clinical,radiomic,deep learning,and combined models were constructed.A nomogram was gener-ated for the combined model.The diagnostic performance of the models was evaluated using the area under the receiver operating charac-teristic curve(AUC)and compared using the DeLong test.Clinical net benefit was assessed through decision curve analysis,and model calib-ration was evaluated using calibration curves.Results:Nine radiomicand 12 deep learning features were selected after dimensionality reduc-tion.Multivariate Logistic regression identified tumor length,boundary,Radscore,and Deepscore as independent risk factors for distinguish-ing between T2 and T3 staging.In the training set,the AUC of the combined model was 0.867,which was significantly higher than that of the clinical(0.774,P<0.001),radiomic(0.795,P<0.001),and deep learning(0.821,P=0.001)models.In the validation set,the AUC of the com-bined model was 0.810,which was significantly higher than that of the clinical(0.653,P=0.002),radiomic(0.719,P=0.033),and deep learn-ing(0.750,P=0.009)models.The decision curve analysis indicated that the combined model provided the highest clinical benefit in both datasets.The calibration curves demonstrated a good fit for both datasets(P=0.084,0.053).Conclusion:The integration of deep learning and radiomic features obtained from enhanced arterial phase CT images with clinical data offers a reliable method for accurately distinguishing between preoperative T2 and T3 staging in esophageal cancer,thereby supporting clinical decision-making for treatment planning.

Objective To explore the molecular mechanism of Atractylodes macrocephala in the treatment of Ulcerative colitis(UC)based on network pharmacology,and verify it with animal experiments.Methods The active components of Atractylodes macrocephala was screened from the TCMSP database,the TCM-ID database,and in combination with relevant references,and the corresponding targets were obtained through Swiss database.The relevant targets of UC were obtained from GeneCards database,construct the"drug-component-target-disease"network diagram and"pathway-active ingredient-target"network diagram and draw PPI network diagram;GO function enrichment analysis and KEGG signal pathway annotation analysis were carried out.Autodock software is used for molecular docking of active components and targets.Then,the experimental validation of the network pharmacology prediction was carried out.The mouse UC model was induced by dextran sodium sulfate(DSS).The pathological changes of the colon tissue,the number of goblet cells,and the positive expression of inflammatory factorswere detected by HE staining,AB-PAS staining and immunohistochemistry in colon tissue of UC mice.Results The results have shown 30 active ingredients including atractylolactone I,II and III were screened,and 591 corresponding targets were obtained,of which the key target was IL-1β、TNF-α and so on.Molecular docking show that the core components had good binding affinity with the key targets.And the results of animal experiments showed that the alcohol extract of Atractylodes macrocephala could significantly increase the colon length,reduce the DAI score,improve the pathological changes of colon tissue of UC mice,increase the number of goblet cells,and inhibit the expression of IL-1β,TNF-α in colon tissue.Conclusion This study indicated that Atractylodes macrocephala could regulate the release of inflammatory factors through multiple components,multi-target and multi-channel,which could inhibit inflammatory reaction and play a role in improving UC.

BACKGROUND:In clinical work,the stiffness of neck soft tissue in patients with neck and shoulder pain is mainly detected through palpation,which is highly subjective and lacks an objective basis.Real-time shear wave elastography is a quantitative elastic ultrasound technique that can objectively assess muscle elasticity and muscle status. OBJECTIVE:To apply real-time shear wave elastography to assess the stiffness of scalene muscles in patients with neck and shoulder pain and to observe the characteristics of muscle stiffness changes in the bilateral anterior,middle and posterior scalene muscles in patients with neck and shoulder pain. METHODS:From December 2021 to June 2022,36 healthy subjects(control group)and 36 patients with neck and shoulder pain(test group)were recruited at the Shenzhen Hospital of Guangzhou University of Chinese Medicine.Real-time shear wave elastography was applied to measure the mean values of elastic modulus and cross-sectional area of the anterior and middle and posterior scalene muscles bilaterally in the neutral and lateral flexion positions of the neck in both groups. RESULTS AND CONCLUSION:In the same position,there were no significant differences between the mean Values of elastic modulus of the left and right anterior scalene muscles as well as between the mean Values of elastic modulus of the left and right middle scalene muscles in each group(P>0.05);there were no significant differences between the cross-sectional area of the left and right anterior scalene muscles as well as the cross-sectional area of the left and right posteromedial scalene muscles in each group(P>0.05);and the elastic modulus and cross-sectional area of the posteromedial scalene muscles were significantly higher than those of the anterior scalene muscles in both groups(P<0.01,P<0.001).The mean Values of elastic modulus of the anterior and posteromedial scalene muscles were higher in the test group than in the control group in the neutral and lateral neck flexion positions(P<0.001),while the cross-sectional areas of the anterior and posteromedial scalene muscles were lower than those in the control group(P<0.01,P<0.001).To conclude,real-time shear wave elastography can be used to visually evaluate the differences in the mean Values of elastic modulus of the anterior and posteromedial scalene muscles in different states of the neck muscles in patients with neck and shoulder pain,whose bilateral scalene muscles are in a state of strain and stiffness.

Objective To explore the feasibility and accuracy of neutrophil-to-lymphocyte ratio(NLR)in the prediction of testicular torsion(TT)in children with acute scrotal pain.Methods A retrospective case-control study was performed on 158 pediatric patients with ultrasound suspicion of TT who underwent surgical testicular examination during Jan.2017 and Jan.2024.The patients were divided into TT group and non-TT group.Clinical data and laboratory data at admission were analyzed.Sensitivity and specificity of NLR to TT were determined with the area under the curve(AUC)represented on the receiver operating characteristic(ROC)curves.Results There were with no statistically significant differences in clinical data between the two groups(P＞0.05).The NLR was significantly higher in the TT group than in the non-TT group[(4.82±2.37)vs.(2.85±0.75),P＜0.05].The optimal cut-off value of TT predicted by NLR was 2.07,the AUC was 0.809(95％CI:0.709-0.909),and the sensitivity and specificity were 97.9％and 93.3％,respectively,which were significantly higher than other factors.Conclusion For suspicious ultrasound diagnosis of pediatric acute scrotal pain cases,NLR can be used to predict the possibility of TT and may help to evaluate the urgent surgical treatment in these patients.

【Objective】 To study the demographic characteristics of whole blood donors aged 56 to 60 in Guangzhou, so as to provide reference for smooth implementation of the recruitment and management of elderly blood donors in Guangzhou. 【Methods】 The data of whole blood donors, aged 56 to 60, in Guangzhou Blood Center from July 1, 2016 to June 30, 2021 were retrospectively analyzed, and such characteristics as the number of blood donations, gender, donation frequency, donation volume, occupation and educational background were analyzed. 【Results】 A total of 3 996 blood donors aged 56 to 60, including 3 013 males and 983 females, gave 14 416 donations during July 1, 2016 to June 30, 2021, with the proportion of 400 mL specification at 64.1% (6 999/10 918) of males, which was significantly higher than that of females 57.7% (2 017/3 498). The number of blood donors had been decreasing year by year, but the ratio of men to women was stable.The education background of blood donors were mainly high school, junior college, and undergraduate education, accounting for more than 60% in total, and the proportion of undergraduate and graduate degree trended to grow. Staff, workers, medical staff and civil servants were the majorities, and the proportion of medical staff trended to grow. 【Conclusion】 Male blood donors aged 56 to 60 in Guangzhou showed stronger intention to donate blood, and the proportion of blood donors with better education and medical staff was on the rise.

Red blood cell (RBC) transfusion is a clinically effective therapy in anemia, for example in patients with malignancies (Shander et al., 2020), bleeding (Odutayo et al., 2017), and preoperative anemia (Padmanabhan et al., 2019). The past few decades have witnessed a shortage of blood for transfusion due to limited health insurance coverage for blood use and the rapid expansion of hospitals (Chen et al., 2011; Shi et al., 2014). Blood donation levels may easily be affected by general changes in the environment, policy, major events such as disasters, and public sentiment (Hu et al., 2019). Meanwhile, the transfusion of allogeneic RBC is a double-edged sword, increasing the possibility of infectious and immunological complications, and also leading to higher morbidity and mortality after transfusion (Frank et al., 2012). Considering that the continual shortfall has been increasingly prominent, identifying the factors associated with RBC transfusion could help blood transfusion departments to improve their supply of blood products as well as their inventory management (O'Donnell et al., 2018).

【Objective】 To investigate the changes of platelet, white blood cell, red blood cell counts, Hb and PCV before and after plateletpheresis donation. 【Methods】 10 444 platelet donors who donated platelet from Aug 1, 2019 to Jul 31, 2020 were selected as subjects, among which first-time donors were selected as control group and donors who donated twice or more as donation group. After matching gender and age using Propensity Score Matching method in the two groups, the changes of platelet, white blood cell, red blood cell counts, Hb and PCV of platelet blood donors were compared by t test. 【Results】 There were a slight increase in Plt (t=-6.651, P<0.05), a decrease in WBC (t=2.312, P<0.05), a decrease in hemoglobin(t=4.643, P<0.05), and no change in RBC (t=1.439, P>0.05) and in PCV (t=0.030, P>0.05) after plateletpheresis donation. 【Conclusion】 Plateletpheresis donation has an effect on some peripheral blood parameters, but within the normal reference range.

Objective To report the clinical management of the first case of human infection with influenza A (H7N4) in the world ,and to explore the clinical characteristics and therapeutic regimen of H7N4 infection in humans .Methods A case of confirmed human infection with influenza A (H7N4) virus was hospitalized in the Third People′s Hospital of Changzhou in Jiangsu Province on January 1st ,2018 . The clinical characteristics and treatment were analyzed by reviewing the clinical data and management of the patient ,and compared with the clinical characteristics of human infection with H 7N9 cases .Results The patient was an elderly woman with hypertension ,who had an exposure history of live poultry before onset .The patient had flu-like symptoms including fever , cough and expectoration . The symptoms worsened in the fifth day and presented as respiratory failure and circulatory disturbance .The count of white blood cells ,lymphocytes and platelets counts declined ,while the levels of aspartate aminotransferase and c-reactive protein slightly increased .The levels of creatine kinase and lactate dehydrogenase deformity increased .The pulmonary lesions manifested as exudation and consolidation of both side in a short period of time after the onset . Treatment was initiated according to the epidemiology history , clinical manifestations ,laboratory and imaging characteristics . The primary diagnosis was human infection of avian influenza virus .The patient was treated with oxygen therapy ,antivirus ,anti-infection and short-duration corticosteroids treatment . Early and timely throat swab specimens were tested . The patient recovered and discharged from hospital after active treatment .It was confirmed by the Chinese Center for Disease Control and prevention that the patient was infected with avian influenza A (H7N4) virus ,and no close contact was infected .Conclusions There are many similarities of clinical features between case of human infection with H7N4 and that of H7N9 . The early treatment of neuraminidase inhibitors is recommended according to the diagnosis and treatment of human infection with H 7N9 .In the clinical practice ,the avian influenza nucleic acid should be tested in time to determine the cause of the disease in those patients with suspected viral pneumonia ,especially in those who has an avian contact history .