Objective To investigate the effects of hyaluronic acid and proteoglycan-linked protein 1 (HAPLN1) secreted by synovial fibroblasts (FLS) on the polarization of macrophages (Mϕ) in rheumatoid arthritis (RA). Methods Human monocytic leukemia cells (THP-1) were differentiated into Mϕ, which were subsequently exposed to recombinant HAPLN1 (rHAPLN1). RA-FLS were transfected separately with HAPLN1 overexpression plasmid (HAPLN1^OE) or small interfering RNA targeting HAPLN1 (si-HAPLN1), and then co-cultured with Mϕ to establish a co-culture model. The viability of Mϕ was assessed using the CCK-8 assay, and the proportions of pro-inflammatory M1-type and anti-inflammatory M2-type Mϕ were analyzed by flow cytometry. Additionally, the expression levels of inflammatory markers, including interleukin 1β (IL-1β), tumor necrosis factor α (TNF-α), and inducible nitric oxide synthase (iNOS), were quantified using quantitative real-time PCR and Western blot analysis. Results The viability of Mϕ was increased in the rHAPLN1 group compared to the control group. Furthermore, both the M1/Mϕ ratio and inflammatory factor levels were elevated in the rHAPLN1 and HAPLN1^OE groups. In contrast, the si-HAPLN1 group exhibited a decrease in the M1/Mϕ ratio and inflammatory factor expression. Notably, the introduction of rHAPLN1 in rescue experiments further promoted Mϕ polarization towards the M1 phenotype. Conclusion HAPLN1, secreted by RA fibroblast-like synoviocytes (RA-FLS), enhances Mϕ polarization towards the M1 phenotype.
Humans ; Arthritis, Rheumatoid/genetics* ; Macrophages/immunology* ; Fibroblasts/metabolism* ; Phenotype ; Extracellular Matrix Proteins/genetics* ; Proteoglycans/genetics* ; Synovial Membrane/cytology* ; Tumor Necrosis Factor-alpha/genetics* ; Interleukin-1beta/genetics* ; Nitric Oxide Synthase Type II/genetics* ; Cell Differentiation ; Coculture Techniques ; THP-1 Cells

Autism spectrum disorder(ASD),characterized by unknown etiology and high heterogeneity,ne-cessitates precise diagnostic and intervention strategies.Neuroimaging techniques have shown great promise in un-covering the neural mechanisms of ASD,providing a foundation for aided diagnosis and transcranial magnetic stim-ulation(TMS)interventions.This review highlights that integrating multimodal neuroimaging and developing indi-vidualized indices with developmental specificity can significantly improve the accuracy of ASD diagnosis and clas-sification.Furthermore,TMS interventions guided by functional connectivity derived from functional magnetic reso-nance imaging(fMRI)offer a personalized approach to ASD treatment.

Objective:To evaluate the consistency between architectural distortion（AD）observed on coronal images in three-dimensional ultrasonography（3D-US）and full-field digital mammography（FFDM），and to analyze the influencing factors of the presence of AD on 3D-US coronal images.Methods:A retrospective study was conducted on 96 female patients（97 lesions）with AD identified via FFDM that examined at Affiliated Hangzhou First People's Hospital，School of Medicine，Westlake University from January 2019 to December 2021，all of which with corresponding 3D-US results. Kappa analysis was used to assess the consistency between AD on 3D-US and FFDM.The differences of the lesion characteristics on FFDM（glandular density，presence of calcifications，and degree of distortion），3D-US features（number of lesions，presence of mass or non-mass lesions，and skipping sign in coronal images），clinical pathological characteristics（age，location，and pathology）between groups with AD and without AD in 3D-US were compared. Multivariate Logistic regression was used to identify the influencing factors.Results:Among the FFDM-identified AD lesions，62（63.92%，62/97）lesions showed AD on 3D-US coronal images，including 30 malignant lesions（48.39%，30/62）；35（36.08%，35/97）lesions without AD on 3D-US，in which 4（11.43%，4/35）were malignant. The consistency of distortion degree between FFDM and 3D-US was moderate（Kappa=0.455， P<0.001），with no statistically significant difference（ χ2=2.882， P=0.143）. The probability of malignancy was higher in typical AD compared to atypical AD. The comparisons of age，location，number of lesions，presence of skipping sign in 3D-US，breast density，and presence of calcification in the lesion showed no statistically significant differences between the groups with and without AD（all P >0.05）.The pathological results of malignancy，presence of lesions in 3D-US（mass and non-mass lesions），and the degree of distortion in FFDM showed statistically significant differences（all P < 0.05）. The multivariate Logistic regression analysis indicated that there were no independent risk factors for the appearance of AD in 3D-US（all P > 0.05）. Conclusions:In breast FFDM AD lesions，the incidence of 3D-US coronal plane AD was 63.92%，and the consistency between the degree of distortion in FFDM and 3D-US was moderate. The probability of malignancy is higher with typical AD. Pathological malignancy，presence of lesions in 3D-US（both mass and non-mass lesions），and typical AD in FFDM are more likely to correspond with AD in the coronal.

Objective:To compare the efficacy of endoscopic mucosal resection with grasping forceps (EMR-G) and endoscopic submucosal dissection (ESD) for the resection of rectal neuroendocrine tumors (NET)≤10 mm.Methods:Data of 74 patients with ≤10 mm rectal NET admitted to Shantou Central Hospital from August 2020 to June 2024 were retrospectively analyzed. Patients were divided into the ESD group and the EMR-G group according to the surgical method. Outcomes included R0 resection rate, margin-to-base distance, operative time, cost, and hospital stay.Results:The EMR-G group demonstrated significantly higher R0 resection rates [100.0% (37/37) VS 81.1% (30/37), χ2=7.731, P=0.006], greater margin-to-base distance (median 330 μm VS 110 μm, Z=-5.890, P<0.001), shorter operative time (15.22±2.94 min VS 27.95±6.50 min, t=-10.854, P<0.001), lower cost (2 409.51±205.00 yuan VS 7 899.19±420.14 yuan, t=-71.430, P=0.001), and reduced hospital stay (1.08±0.27 days VS 2.76±0.80 days, t=-12.095, P<0.001). Conclusion:EMR-G outperforms ESD for ≤10 mm rectal NETs by improving R0 resection, shortening procedure duration and hospitalization, and reducing costs, which is worth promotion.

Autism spectrum disorder(ASD),characterized by unknown etiology and high heterogeneity,ne-cessitates precise diagnostic and intervention strategies.Neuroimaging techniques have shown great promise in un-covering the neural mechanisms of ASD,providing a foundation for aided diagnosis and transcranial magnetic stim-ulation(TMS)interventions.This review highlights that integrating multimodal neuroimaging and developing indi-vidualized indices with developmental specificity can significantly improve the accuracy of ASD diagnosis and clas-sification.Furthermore,TMS interventions guided by functional connectivity derived from functional magnetic reso-nance imaging(fMRI)offer a personalized approach to ASD treatment.

Objective:To evaluate the consistency between architectural distortion（AD）observed on coronal images in three-dimensional ultrasonography（3D-US）and full-field digital mammography（FFDM），and to analyze the influencing factors of the presence of AD on 3D-US coronal images.Methods:A retrospective study was conducted on 96 female patients（97 lesions）with AD identified via FFDM that examined at Affiliated Hangzhou First People's Hospital，School of Medicine，Westlake University from January 2019 to December 2021，all of which with corresponding 3D-US results. Kappa analysis was used to assess the consistency between AD on 3D-US and FFDM.The differences of the lesion characteristics on FFDM（glandular density，presence of calcifications，and degree of distortion），3D-US features（number of lesions，presence of mass or non-mass lesions，and skipping sign in coronal images），clinical pathological characteristics（age，location，and pathology）between groups with AD and without AD in 3D-US were compared. Multivariate Logistic regression was used to identify the influencing factors.Results:Among the FFDM-identified AD lesions，62（63.92%，62/97）lesions showed AD on 3D-US coronal images，including 30 malignant lesions（48.39%，30/62）；35（36.08%，35/97）lesions without AD on 3D-US，in which 4（11.43%，4/35）were malignant. The consistency of distortion degree between FFDM and 3D-US was moderate（Kappa=0.455， P<0.001），with no statistically significant difference（ χ2=2.882， P=0.143）. The probability of malignancy was higher in typical AD compared to atypical AD. The comparisons of age，location，number of lesions，presence of skipping sign in 3D-US，breast density，and presence of calcification in the lesion showed no statistically significant differences between the groups with and without AD（all P >0.05）.The pathological results of malignancy，presence of lesions in 3D-US（mass and non-mass lesions），and the degree of distortion in FFDM showed statistically significant differences（all P < 0.05）. The multivariate Logistic regression analysis indicated that there were no independent risk factors for the appearance of AD in 3D-US（all P > 0.05）. Conclusions:In breast FFDM AD lesions，the incidence of 3D-US coronal plane AD was 63.92%，and the consistency between the degree of distortion in FFDM and 3D-US was moderate. The probability of malignancy is higher with typical AD. Pathological malignancy，presence of lesions in 3D-US（both mass and non-mass lesions），and typical AD in FFDM are more likely to correspond with AD in the coronal.

Objective:To compare the efficacy of endoscopic mucosal resection with grasping forceps (EMR-G) and endoscopic submucosal dissection (ESD) for the resection of rectal neuroendocrine tumors (NET)≤10 mm.Methods:Data of 74 patients with ≤10 mm rectal NET admitted to Shantou Central Hospital from August 2020 to June 2024 were retrospectively analyzed. Patients were divided into the ESD group and the EMR-G group according to the surgical method. Outcomes included R0 resection rate, margin-to-base distance, operative time, cost, and hospital stay.Results:The EMR-G group demonstrated significantly higher R0 resection rates [100.0% (37/37) VS 81.1% (30/37), χ2=7.731, P=0.006], greater margin-to-base distance (median 330 μm VS 110 μm, Z=-5.890, P<0.001), shorter operative time (15.22±2.94 min VS 27.95±6.50 min, t=-10.854, P<0.001), lower cost (2 409.51±205.00 yuan VS 7 899.19±420.14 yuan, t=-71.430, P=0.001), and reduced hospital stay (1.08±0.27 days VS 2.76±0.80 days, t=-12.095, P<0.001). Conclusion:EMR-G outperforms ESD for ≤10 mm rectal NETs by improving R0 resection, shortening procedure duration and hospitalization, and reducing costs, which is worth promotion.

Objective:To explore the validity and safety of flat-tipped injection needle and conical catheter these 2 instruments in the hydrodynamic releasing treatment of fecal calculus incarceration in the colonic diverticulum.Methods:From 1 May 2022 to 31 July 2023, 77 patients with fecal calculus incarceration in colonic diverticulum detected by colonscopy at the Endoscope Center of Shantou Central Hospital were prospectively selected. According to the random number table method, 77 patients were randomly divided into the flat-tipped injection needle group (39 cases, 51 fecal stone embedded) and the conical catheter group (38 cases, 49 fecal stone embedded). The successful rate of fecal stone releasing, operation time and complications of 2 groups were observed. Independent samples t test and chi-square test were used for statistical analysis. Results:The successful rate of fecalith releasing of flat-tipped injection needle group was higher than that of the conical catheter group (100.0%, 51/51 vs. 83.7%, 41/49), and the difference was statistically significant ( χ2=9.05, P=0.002). There was no significant difference in the operation time of successful cases between the flat-tipped injection needle group and the conical catheter group ((5.7±1.2) s vs. (5.9±0.8) s, P>0.05). There were no cases of intraoperative or postoperative bleeding or perforation in the process of fecal stone releasing in both groups. Missed submucosal injection occurred in 4 cases of the flat-tipped injection needle group and occurred in three cases of the conical catheter group, and there was no significant difference in the incidence of complications between the 2 groups ( P>0.05). Conclusion:Both instruments are effective and safe in the hydrodynamic releasing treatment of fecal calculus incarceration in the colonic diverticulum, and the success rate of flat-tipped injection needle is higher than that of conical catheter.

Objective:To evaluate the efficacy and safety of oliceridine for treatment of moderate to severe pain after surgery with general anesthesia in patients.Methods:The patients with moderate to severe pain (numeric pain rating scale ≥4) after abdominal surgery with general anesthesia from 14 hospitals between July 6, 2021 and November 9, 2021 were included in this study. The patients were assigned to either experiment group or control group using a random number table method. Experiment group received oliceridine, while control group received morphine, and both groups were treated with a loading dose plus patient-controlled analgesia and supplemental doses for 24 h. The primary efficacy endpoint was the drug response rate within 24 h after giving the loading dose. Secondary efficacy endpoints included early (within 1 h after giving the loading dose) drug response rates and use of rescue medication. Safety endpoints encompassed the development of respiratory depression and other adverse reactions during treatment.Results:After randomization, both the full analysis set and safety analysis set comprised 180 cases, with 92 in experiment group and 88 in control group. The per-protocol set included 170 cases, with 86 in experiment group and 84 in control group. There were no statistically significant differences between the two groups in 24-h drug response rates, rescue analgesia rates, respiratory depression, and incidence of other adverse reactions ( P>0.05). The analysis of full analysis set showed that the experiment group had a higher drug response rate at 5-30 min after giving the loading dose compared to control group ( P<0.05). The per-protocol set analysis indicated that experiment group had a higher drug response rate at 5-15 min after giving the loading dose than control group ( P<0.05). Conclusions:When used for treatment of moderate to severe pain after surgery with general anesthesia in patients, oliceridine provides comparable analgesic efficacy to morphine, with a faster onset.

【Objective】 To explore the effect of intraoperative cell salvage on allogeneic blood transfusion requirements, coagulation function and electrolytes in postpartum hemorrhage patients. 【Methods】 A study on postpartum hemorrhage patients undergoing cesarean section in the Third Affiliated Hospital of Guangxi Medical University form September 2016 to May 2022 was conducted retrospectively. A total of 137 patients were enrolled and divided into experimental group (n=70) and control group (n=67) according to whether intraoperative cell salvage was used during operation. The blood loss, proportion and volume of allogeneic red blood cells (RBCs) and coagulation component transfusion, hemoglobin (Hb) level, coagulation function, electrolyte, the incidence of complications, proportion of ICU admission, ICU stay and in-hospital stay were compared between the two groups. 【Results】 The proportion of patients receiving allogeneic RBCs in the experimental group and in the control group was 31.4% vs 100.0% (P<0.05). The experimental group also had lower use of plasma (31.4% vs 53.7%, P<0.05). The postoperative 24 h of activated partial thromboplastin time (APTT) and prothrombin time (PT) in the two groups was longer than preoperative, and APTT in the control group did not recover at discharge (P<0.05). Fibrinogen (Fib) decreased postoperative 24 h in the two groups (P<0.05). The blood calcium in the two groups decreased 30 minutes after operation, but the decrease in the experimental group was slight, and two groups did not recover 24 h after operation (P<0.05). There was no statically significant difference in blood loss, volume of allogeneic RBCs and coagulation component transfusion, Hb level, incidence of complications, the proportion of ICU admission, ICU stay and in-hospital stay (P>0.05). 【Conclusion】 This study demonstrated that intraoperative cell salvage could reduce the requirement for allogeneic RBCs without compromising coagulation function in postpartum hemorrhage patients undergoing cesarean section, but the changes of calcium need to be concerned after transfusion.