Objective To assess the accuracy of pN staging prediction in papillary thyroid carcinoma (PTC) using ultrasound radiomics and deep neural networks (DNN). Methods A retrospective analysis was conducted on 375 patients with pathologically confirmed PTC, comprising 261 cases in the training set and 114 in the test set. Staging was categorized as pN0 (no cervical lymph node metastasis), pN1a (central neck lymph node metastasis), and pN1b (lateral neck lymph node metastasis). An ultrasound physician manually segmented the regions of interest (ROIs) for PTC, extracting 1899 radiomic features. Dimensionality reduction was performed using the least absolute shrinkage and selection operator (LASSO) regression. A DNN model for predicting PTC pN staging was developed using the H2O deep learning platform, trained on the training set, and validated on the test set to assess the accuracy of the optimal model. Results A total of 153 patients were in the pN0 stage, 131 patients in the pN1a stage, and 91 patients in the pN1b stage. LASSO regression selected 15 radiomic features for each PTC. The optimal DNN model, constructed using these 15 features, achieved accuracies of 85.82% on the training set and 81.57% on the test set. Conclusion Ultrasound radiomics of PTC demonstrates high accuracy in predicting pN staging and shows potential for automating N staging in patients.

[Objective] To investigate the factors associated with alanine aminotransferase (ALT) abnormalities in multi-ethnic blood donors across five Zang autonomous prefectures in the plateau regions of Qinghai Province, and to provide evidence for ensuring blood safety and formulating screening strategies. [Methods] A retrospective analysis was performed on the ALT abnormal test results of blood donors in the Zang autonomous prefectures of Qinghai from 2022 to 2024. The correlations between ALT levels and factors including gender, age, altitude, and infectious markers were investigated. [Results] The overall ALT unqualified rate among blood donors in this region was 9.01%. Significant differences in ALT levels were observed across genders and age groups (P<0.05). Variations in ALT abnormality rates were also noted among different plateau regions (P<0.05). Overall, ALT values exhibited an increasing trend with rising altitude. The average ALT unqualified rates were 11.19% in Zang donors, 7.96% in Han donors, and 4.79% in donors from other ethnic groups (P<0.05). No statistically significant association was observed between ALT abnormality and the presence of HBV/HCV infectious markers (P>0.05). [Conclusion] In the plateau areas of Qinghai, multi-ethnic blood donors have a relatively high ALT levels and ALT unqualified rates, showing distinct regional characteristics. ALT elevation in voluntary blood donors is related to non-pathological factors such as gender, age, and dietary habits, but not to infectious indicators.

Idiopathic pulmonary fibrosis (IPF) is a progressive disease lacking effective therapy. Metformin, an antidiabetic medication, has shown promising therapeutic properties in preclinical fibrosis models; however, its precise cellular targets and associated mechanisms in fibrosis resolution remain incompletely defined. Most research on metformin's effects has focused on mesenchymal and inflammatory responses with limited attention to epithelial cells. In this study, we utilized Sftpc lineage-traced and Fgfr2b conditional knockout mice, along with BMP2/PPARγ and AMPK inhibitors, to explore metformin's impact on alveolar epithelial cells in a bleomycin-induced pulmonary fibrosis model and cell culture. We found that metformin increased the proliferation and differentiation of alveolar type 2 (AT2) cells, particularly the recently identified injury-activated alveolar progenitors (IAAPs)-a subpopulation characterized by low SFTPC expression but enriched for PD-L1. Single-cell RNA sequencing revealed a reduction in apoptosis among mature AT2 cells. Interestingly, metformin's therapeutic effects were not significantly affected by BMP2 or PPARγ inhibition, which blocked the lipogenic differentiation of myofibroblasts. However, Fgfr2b deletion in Sftpc lineage cells significantly impaired metformin's ability to promote fibrosis resolution, a process linked to AMPK signaling. In conclusion, metformin alleviates fibrosis by directly activating AT2 cells, especially the IAAPs, through a mechanism that involves AMPK and FGFR2b signaling, but is largely independent of BMP2/PPARγ pathways.

Objective: To retrospectively analyze the prevalence of hepatitis C virus (HCV) infection among voluntary blood donors in Qinghai Province over a ten-year period and to provide evidence for refining blood safety screening strategies. Methods: Blood samples from 362 066 blood donors in Qinghai collected between January 2015 and April 2024 were simultaneously screened using enzyme-linked immunosorbent assay (ELISA) and nucleic acid testing (NAT). Follow-up was conducted for donors with reactive HCV RNA screening results, and alanine transaminase (ALT) was detected by rate method. Results: The HCV positive rate among blood donors in Qinghai was 0.22%. Gender, marital status, number of blood donations, and educational level were associated with HCV infection. Significant differences in HCV positive rates were observed among donors across regions and ethnic groups. The HCV positive rate among donors in Golog Tibetan Autonomous Prefecture (with an average altitude of 4 330 m) was significantly higher than that in Xining (0.52% vs 0.21%, P<0.001). Positivity rates were also significantly higher in Salar (0.84%), Hui (0.81%), Zang (0.60%), and Tu (0.45%) ethnic groups compared to the Han ethnic group (0.17%) (P<0.001). The abnormal rate of ALT in HCV-positive donors was higher than in non-HCV donors (6.13% vs 1.55%) (P<0.001). Conclusion: The relatively high HCV positivity rate among blood donors in Qinghai highlights the need for further investigation into viral sources, risk factors, and transmission routes. Optimized screening strategies are essential to ensure blood safety.

Objective:To summarize the clinical features of primary segmental volvulus (PSV) in neonates.Methods:A retrospective analysis was conducted on the clinical data of neonates with PSV who were admitted to the Department of Neonatal Surgery, Children's Hospital Affiliated to Capital Institute of Pediatrics from May 2014 to May 2023. The clinical manifestations, auxiliary examinations, treatment and prognosis of the neonates were summarized, and descriptive statistical analysis was performed on the collected data.Results:A total of 10 neonates with PSV were included, with a mean gestational age of (34.1±3.0) weeks and birth weight of (2 291±646) g. Eight cases had an onset age of 3 d or less, and 2 cases had an onset age of more than 3 d. Abdominal distension was observed as the main manifestation in all cases, while bilious vomiting occurred in seven cases and hematochezia in five cases. Imaging examinations mainly revealed low intestinal obstruction without specific manifestations. Laboratory tests showed metabolic acidosis and varing degrees of anaemia. Nine cases underwent diagnostic abdominal puncture, of which five had bloody ascites, two had clear ascites, one had bloody mixed with fecal-like ascites, and one had chylous ascites. All the cases underwent emergency exploratory laparotomy and segmental small bowel resections with either primary intestinal anastomosis or enterostomy. All cases were successfully cured and had been followed up to the age of 4 months to 9 years with good growth and development as normal children of the same age.Conclusions:Neonatal PSV is an independent abdominal emergency characterized by non-specific clinical manifestations and difficult preoperative diagnosis, but the overall prognosis is favorable after active surgical treatment.

AIM:To investigate the effect of hydrogen sulfide(H2S)on ferroptosis and functional impairment induced by oxidized high-density lipoprotein(ox-HDL)in human umbilical vein endothelial cells(HUVECs),and to ex-plore its mechanisms.METHODS:The HUVECs were cultured in vitro and exposed to 200 mg/L ox-HDL,ferroptosis in-hibitor ferrostatin-1(Fer-1),protein kinase B(PKB/Akt)inhibitor MK-2206 2HCl(MK),Akt agonist SC79,and/or H2S for 24 h.Western blot was used to identify the relevant proteins.Intracellular levels of reactive oxygen species(ROS)were analyzed by flow cytometry and immunofluorescence staining.Intracellular iron was measured using an iron detection kit.The number of monocytes adhering to endothelial cells was counted using the monocyte adhesion assay.RESULTS:Compared with control group,acyl-CoA synthetase long-chain family member 4(ACSL4)protein expression in ox-HDL group was elevated by 1.45-fold(P<0.01),glutathione peroxidase 4(GPX4)protein expression was decreased by 29.79%(P<0.05),and ROS levels and iron ion content were elevated by 4.81-fold and 1.40-fold,respectively(P<0.01).The ratios of p-PI3K/PI3K and p-Akt/Akt were decreased by 45.65%and 41.68%,respectively(P<0.01),endo-thelial cell function-related protein IL-6,ICAM-1 and TNF-α expression was elevated 1.18-fold,1.24-fold and 1.41-fold(P<0.05),respectively,eNOS protein expression was decreased by 35.24%(P<0.01),and monocyte adhesion was ele-vated 3.43-fold(P<0.01).Compared with ox-HDL group,the endothelial cell iron death-related protein ACSL4 was de-creased by 22.32%(P<0.05),GPX4 was increased by 1.27-fold(P<0.01),and the p-Akt/Akt ratio was increased by 1.52-fold(P<0.01)in ox-HDL+H2S group.The fluorescence microscopy results showed that the ROS was decreased by 50.35%(P<0.01).The IL-6,ICAM-1 and TNF-α protein expression was decreased by 13.34%,9.83%and 13.46%(P<0.05),respectively,eNOS was elevated by 1.22-fold(P<0.01),and the number of monocyte adhesion was de-creased by 59.05%(P<0.01).Compared with ox-HDL group,GPX4 protein expression in ox-HDL+SC79 group was ele-vated by 1.49-fold(P<0.01),ACSL4 expression was decreased by 20.72%(P<0.05),and ROS and iron ions were de-creased by 59.31%and 23.85%(P<0.05),respectively.Compared with ox-HDL+H2S group,GPX4 protein expression was decreased by 21.28%,and ACSL4 protein expression was increased by 1.16-fold in ox-HDL+H2S+MK group(P<0.05).CONCLUSION:H2S activates Akt to inhibit ox-HDL-induced ferroptosis in HUVECs and alleviate their func-tional damage.

Objective:To construct an intelligent endoscopic image analysis system that could monitor the blind spot of the upper gastrointestinal tract, and to test its performance.Methods:A total of 87 167 upper gastrointestinal endoscopy images (dataset 1) including 75 551 for training and 11 616 for testing, and a total of 2 414 pharyngeal images (dataset 2) including 2 233 for training and 181 for testing were retrospectively collected from the Digestive Endoscopy Center of Renmin Hospital of Wuhan University between 2016 to 2020. A 27-category-classification model for blind spot monitoring in the upper gastrointestinal tract (model 1, which distinguished 27 anatomical sites such as the pharynx, esophagus, and stomach) and a 5-category-classification model for blind spot monitoring in the pharynx (model 2, which distinguished palate, posterior pharyngeal wall, larynx, left and right pyriform sinuses) were constructed. The above models were trained and tested based on dataset 1 and 2, respectively, and trained based on the EfficientNet-B4, ResNet50 and VGG16 models of the keras framework. Thirty complete upper gastrointestinal endoscopy videos were retrospectively collected from the Digestive Endoscopy Center of Renmin Hospital of Wuhan University in 2021 to test model 2 blind spot monitoring performance.Results:The cross-sectional comparison results of the accuracy of model 1 in identifying 27 anatomical sites of the upper gastrointestinal tract in images showed that the mean accuracy of EfficientNet-B4, ResNet50, and VGG16 were 90.90%, 90.24%, and 89.22%, respectively, with the EfficientNet-B4 model performance the best, and the accuracy of EfficientNet-B4 model for each site ranged from 80.49% to 97.80%. The cross-sectional comparison results of the accuracy of model 2 in identifying the 5 anatomical sites of the pharynx in the images showed that the mean accuracy of EfficientNet-B4, ResNet50, and VGG16 were 99.40%, 98.56%, and 97.01%, respectively, in which the EfficientNet-B4 model had the best performance, and the accuracy of EfficientNet-B4 model for each site ranged from 96.15% to 100.00%. The overall accuracy of model 2 in identifying the 5 anatomical sites of the pharynx in the video was 97.33% (146/150).Conclusion:The intelligent endoscopic image analysis system based on deep learning can monitor blind spots in the upper gastrointestinal tract, coupled with pharyngeal blind spot monitoring and esophagogastroduodenal blind spot monitoring functions. The system shows high accuracy in both images and videos, which is expected to have a potential role in clinical practice and assisting endoscopists to achieve full observation of the upper gastrointestinal tract.

Radiation-induced lung injury （RILI）， one of the common complications caused by radiotherapy， encompasses two phases： an early phase known as radiation pneumonitis （RP） and a late phase called radiation fibrosis （RF）， threatening the life and life quality of patients， with poor prognosis. Accumulating evidence has shown that the occurrence of RILI is related to a variety of cytokines and signaling pathways. This paper summarized the research on the effects of Chinese medicine on RILI from the perspective of cytokines and signaling pathways. Cytokines include transforming growth factor-β₁ （TGF-β₁）， interleukins （ILs）， tumor necrosis factor-α （TNF-α）， platelet-derived growth factor （PDGF）， vascular endothelial growth factor （VEGF）， and high mobility group box-1 （HMGB1）. Related signaling pathways are phosphatidylinositol-3-kinase/protein kinase B（PI3K/Akt） signaling pathway， mitogen-activated protein kinase （MAPK） signaling pathway， Wnt/β-catenin signaling pathway， Notch1/Jagged1 signaling pathway， and nuclear factor-E₂-related factor2/antioxidant response element （Nrf2/ARE） signaling pathway. Cytokines may interfere with RILI progression by initiating various downstream signaling pathways， such as TGF-β₁/Smads signaling pathway， TGF-β₁/VEGF signaling pathway， TNF-α/nuclear factor-κB （NF-κB） signaling pathway， and HMGB1/Toll-like receptor 4 （TLR4） signaling pathway. In recent years， many scholars have attempted to delay RILI progression by down-regulating the expression of cytokines， antagonizing the effect of cytokines or regulating signaling pathways. It has been verified that many Chinese medicines， Chinese medicine monomers， and compound Chinese medicine prescriptions can inhibit the release of some cytokines or regulate some signaling pathways to reduce the incidence/severity of RILI， with satisfactory therapeutic effects， which have attracted the interest of scholars.

Objective:To investigate the effect of rumination on learning burnout of nursing undergraduate students and the mediating role of psychological capital between rumination and learning burnout of nursing undergraduate students.Methods:A total of 296 undergraduate nursing students from three medical colleges were assessed by using ruminative responses scale, learning burnout questionnaire and psychological capital scale. SPSS 20.0 was used for t-test. Pearson correlation was to analyze the relationship among psychological capital, learning burnout and ruminative thinking. AMOS 20.0 was used to construct and analyze the mediating model of psychological capital and its mediating effect was tested by Bootstrap method. Results:The average score of rumination of nursing undergraduate students was 46.60±11.40, learning burnout score was 56.18±11.25, and psychological capital scale score was 99.93±15.27. There was a significant difference among the rumination, psychological capital, and learning burnout scores in whether there was curriculum failure ( P < 0.05). The total score of rumination was positively related to the total score of learning burnout ( r = 0.39, P < 0.01), and was negatively related to the total score of psychological capital ( r = -0.53, P < 0.01). The total score of rumination was negatively related to the total score of psychological capital ( r = -0.46, P < 0.01). The psychological capital played a partial mediating role between rumination and learning burnout. The mediating effect value was 0.216, accounting for 61.521% of the total variation. Conclusion:The rumination can both directly affect the learning burnout of nursing undergraduate students and indirectly affect the learning burnout through psychological capital. Psychological capital plays a bridge role in improving rumination related to learning burnout.

Objective:To detect the expression of MYBL2 gene in gastric adenocarcinoma tissue and its effects on cell proliferation and invasion. Methods:A total of 100 cases of gastric adenocarcinoma tissue and 100 cases of paracancerous tissue were selected from patients who received surgery in The People's Hospital of Yuhuan between January 2017 and December 2020. Gastric adenocarcinoma cell lines MGC-803 were transfected with MYBL2 siRNA and siRNA control. The cells not transfected were used as controls. MYBL2 gene expression in gastric adenocarcinoma tissue and paracancerous tissue as well as MGC-803 were determined by quantitative real time-polymerase chain reaction. MGC-803 cell proliferation was determined by MTT. The invasive ability of MGC-803 cells was determined by Transwell assay. The migration ability of MGC-803 cells was determined by Scratch testing. MYBL2 protein expression in gastric adenocarcinoma tissue and paracancerous tissue as well as MGC-803 cells was determined by western blotting. Results:The relative mRNA expression of MYBL2 in gastric adenocarcinoma tissue was significantly higher than that in paracancerous tissue [(0.65 ± 0.17) vs. (0.18 ± 0.05), t = 26.52, P < 0.05). The relative mRNA expression of MYBL2 in the MYBL2 siRNA group (0.29 ± 0.07) was significantly lower than that in the control group (0.73 ± 0.12) and siRNA group (0.71 ± 0.16, t = 5.48, 4.16, both P < 0.05). MTT assay showed that after 24 and 48 hours of culture, MGC-803 cell proliferation rate in the MYBL2 siRNA group [(40.95 ± 5.46)%, (52.12 ± 12.27)%] was significantly lower than that in the control group [(67.84 ± 6.45)%, (87.83 ± 9.96)%] and siRNA group [(66.98 ± 7.85)%, (85.98 ± 10.24)%, t = 5.51, 3.91, 4.71, 3.67, all P < 0.05]. MGC-803 cell invasion rate in the MYBL2 siRNA group [ (62.12 ± 6.43)%] was significantly lower than that in the control group [(89.74 ± 6.56)%] and siRNA group [(88.83 ± 7.85)%, t = 5.20, 4.55, both P < 0.05]. The number of MGC-803 cells migrated in the MYBL2 siRNA group [(4.32 ± 0.84) × 10 3] was significantly lower than that in the control group [(8.95 ± 1.64) × 10 3] and siRNA group [(8.83 ± 1.78) × 10 3, t = 4.35, 3.96, both P < 0.05]. The gray value of MYBL2 protein in the gastric adenocarcinoma tissue was (0.56 ± 0.15), which was significantly higher than that in the paracancerous tissue [(0.23 ± 0.07), t = 19.93, P < 0.001]. The gray value of MYBL2 protein in the MYBL2 siRNA group was (0.21 ± 0.03), which was significantly lower than that in the control group (0.67 ± 0.15) and siRNA group (0.65 ± 0.19) ( t = 5.20, 3.96, both P < 0.05). Conclusion:MYBL2 gene is highly expressed in gastric adenocarcinoma tissue. siRNA silencing MYBL2 can decrease the ability of MGC-803 cells to proliferate, invade and migrate and downregulate MYBL2 expression. This study is highly innovative and scientific.