Purpose To achieve intelligent detection of acute pulmonary embolism(APE)in CT pulmonary angiography based on the Res2Net attention mechanism network.Materials and Methods Retrospectively included patients with suspected of APE who underwent CT pulmonary angiography examination and were diagnosed as APE at the First Affiliated Hospital of Henan University of Chinese Medicine from February 2015 to May 2023.The dataset was randomly divided into training,validation and test set in a ratio of 7∶2∶1.The model was trained based on the Res2Net network,combined with atrous spatial pyramid pooling and attention mechanism modules,and was performed five-fold cross internal validation.Using the area under the receiver operator characteristic curve,sensitivity and specificity to assess the diagnostic performance of the model.Dice similarity coefficient,precision and intersection over union(IOU)were used to assess the segmentation performance of thrombus on the test set and plot the corresponding curves.The performance of the Res2Net attention mechanism network was compared with the classic U-Net and CE-Net model.Results A total of 303 patients with APE were included in this study.There were 212,61 and 30 cases in the training set,validation set and test set,respectively.The model's area under the curve was 0.95,sensitivity was 0.90,specificity was 1.00,Dice similarity coefficient was 0.86,precision was 0.90,Pos-IOU was 0.78 and Neg-IOU was 1.00,respectively.The parameter curves and radar chart showed that the Res2Net attention mechanism network performed better than the U-Net and CE-Net models.The visualization results of the segmentation comparison showed that the Res2Net attention mechanism network achieved higher precision in segmenting pulmonary artery thrombus.Conclusion The Res2Net attention mechanism network has good performance for detection of APE.

Objective:To evaluate the cost-effectiveness of interventional bronchoscopy with rigid bronchoscopy(scleroscope),laryngeal mask airway and endotracheal intubation access for the treatment of central airway stenosis.Methods:The data of patients with central airway stenosis who underwent interventional bronchoscopy under general anesthesia were collected,and divided into rigid bronchoscopy group,laryngeal mask group and tracheal intubation group.The average Cost-Effectiveness Ratio(CER)was calculated using total hospitalization cost and total surgery cost as the cost indices,and improvement of shortness of breath symptoms as the effect index.The stability of the evaluation result was analyzed by one-factor sensitivity analysis and probabilistic sensitivity analysis.Results:A total of 205 patients were included:rigid bronchoscopy group(66 patients),laryngeal mask group(64 patients)and tracheal intubation group(75 patients).The CERs were 8 851.29 for the rigid bronchoscopy group,10 942.62 for the laryngeal mask group,and 8 902.98 for the tracheal intubation group when using total hospitalization cost as the cost index.For total surgery cost,the CERs were 2 617.80,3 389.73,and 2 741.38,respectively.The order was rigid bronchoscopy＜tracheal intubation＜laryngeal mask.The main factors affecting the model results were the discount rate,non-surgical costs,and improvement of shortness of breath symptoms.Probabilistic sensitivity analysis shows that the results of the basic analysis are stable.Conclusion:Interventional bronchoscopy via rigid bronchoscope is the most economical method for treating central airway stenosis.

Purpose To investigate the expression of thioredoxin-interacting protein(TXNIP)in placental tissues of gestational diabetes mellitus(GDM)and its role in lipid deposition in the placental trophoblast.Methods The pla-centa tissues of 16 GDM pregnant women and 25 women with normal glucose tolerance(NGT)were collected.Mean-while,in vitro models of high-glucose induced human chorionic trophoblast cells(HTR-8/SVneo)were established,which were divided into normal glucose control group(NG),high glucose group(HG),high glucose+si nonsense in-terference group(HG+siNC)and high glucose+TXNIP siRNA group(HG+siTXNIP).The pathological structure and morphological changes of placenta were observed by HE staining.Lipid droplet formation was detected by oil red O staining.The expression and localization of TXNIP in cells were detected by immunocytochemical EnVision method.The mRNA and protein expression levels of TXNIP and lipogenic protein SREBP1 were detected by real-time fluorescent quantitative PCR and Western blot.The relationships between TXNIP expression and lipid droplet accumulation in-duced by high glucose was analyzed.Results High glucose results in abnormal placental structure of GDM.The area of human chorionic intervillous tissue in placenta of GDM group was decreased,the size of fetal capillaries was different and the lumen was dilated.Compared with those NGT group,the accumulation of lipid droplets and the expression of TXNIP mRNA and protein in placental tissue of GDM were increased(P＜0.05).The TXNIP and SREBP1 were up-regulated and the formation of droplets increased in high glucose induced HTR-8/SVneo cells(P＜0.05).On the con-trary,TXNIP siRNA transfection reversed the gene expression level and lipid deposition in high glucose induced cells(P＜0.05).Conclusion TXNIP is involved in abnormal lipid deposition in the placental trophoblast of GDM.

Objective:To evaluate the cost-effectiveness of interventional bronchoscopy with rigid bronchoscopy(scleroscope),laryngeal mask airway and endotracheal intubation access for the treatment of central airway stenosis.Methods:The data of patients with central airway stenosis who underwent interventional bronchoscopy under general anesthesia were collected,and divided into rigid bronchoscopy group,laryngeal mask group and tracheal intubation group.The average Cost-Effectiveness Ratio(CER)was calculated using total hospitalization cost and total surgery cost as the cost indices,and improvement of shortness of breath symptoms as the effect index.The stability of the evaluation result was analyzed by one-factor sensitivity analysis and probabilistic sensitivity analysis.Results:A total of 205 patients were included:rigid bronchoscopy group(66 patients),laryngeal mask group(64 patients)and tracheal intubation group(75 patients).The CERs were 8 851.29 for the rigid bronchoscopy group,10 942.62 for the laryngeal mask group,and 8 902.98 for the tracheal intubation group when using total hospitalization cost as the cost index.For total surgery cost,the CERs were 2 617.80,3 389.73,and 2 741.38,respectively.The order was rigid bronchoscopy＜tracheal intubation＜laryngeal mask.The main factors affecting the model results were the discount rate,non-surgical costs,and improvement of shortness of breath symptoms.Probabilistic sensitivity analysis shows that the results of the basic analysis are stable.Conclusion:Interventional bronchoscopy via rigid bronchoscope is the most economical method for treating central airway stenosis.

Purpose To investigate the expression of thioredoxin-interacting protein(TXNIP)in placental tissues of gestational diabetes mellitus(GDM)and its role in lipid deposition in the placental trophoblast.Methods The pla-centa tissues of 16 GDM pregnant women and 25 women with normal glucose tolerance(NGT)were collected.Mean-while,in vitro models of high-glucose induced human chorionic trophoblast cells(HTR-8/SVneo)were established,which were divided into normal glucose control group(NG),high glucose group(HG),high glucose+si nonsense in-terference group(HG+siNC)and high glucose+TXNIP siRNA group(HG+siTXNIP).The pathological structure and morphological changes of placenta were observed by HE staining.Lipid droplet formation was detected by oil red O staining.The expression and localization of TXNIP in cells were detected by immunocytochemical EnVision method.The mRNA and protein expression levels of TXNIP and lipogenic protein SREBP1 were detected by real-time fluorescent quantitative PCR and Western blot.The relationships between TXNIP expression and lipid droplet accumulation in-duced by high glucose was analyzed.Results High glucose results in abnormal placental structure of GDM.The area of human chorionic intervillous tissue in placenta of GDM group was decreased,the size of fetal capillaries was different and the lumen was dilated.Compared with those NGT group,the accumulation of lipid droplets and the expression of TXNIP mRNA and protein in placental tissue of GDM were increased(P＜0.05).The TXNIP and SREBP1 were up-regulated and the formation of droplets increased in high glucose induced HTR-8/SVneo cells(P＜0.05).On the con-trary,TXNIP siRNA transfection reversed the gene expression level and lipid deposition in high glucose induced cells(P＜0.05).Conclusion TXNIP is involved in abnormal lipid deposition in the placental trophoblast of GDM.

Purpose To explore the feasibility and validity of radiomics combined with blind/referenceless image spatial quality evaluator(Brisque)for automated assessment of arterial-phase image quality in hepatic gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid(Gd-EOB-DTPA)dynamic enhanced MRI examinations.Materials and Methods A total of 326 arterial phase images from January 2020 to March 2024 in the First Affiliated Hospital of Henan University of Chinese Medicine for liver Gd-EOB-DTPA dynamic enhancement MRI examination were retrospectively collected.A 4-level(1-4 points)Likert scale was used for subjective image quality scoring,and then binary classification was used to divide the images into clinically acceptable group(166 images with a score of 2-4)and clinically unacceptable group(160 images with a score of 1).All images were randomly divided into a training set(227 images)and a test set(99 images)in a 7∶3 ratio.Brisque images were created based on arterial-phase images,and subsequently Brisque image features,image histologic features of the original arterial-phase images and combined features of the two were extracted.The extracted data were reduced in dimension and the optimal features of radiomics were selected.Based on the Logistic regression algorithm,radiomics models,Brisque models and combined models of the two were constructed.The receiver operating characteristic curve was drawn for each subject,and the area under the curve(AUC),threshold,sensitivity,specificity,accuracy,negative predictive value and positive predictive value were calculated to analyze the diagnostic performance of each model,and the net benefit of the models was evaluated by decision curve analysis.Results The AUC values of the radiomics model,Brisque model and combined model in the training set were 0.942(95%CI 0.914-0.969),0.722(95%CI 0.655-0.788)and 0.967(95%CI 0.947-0.987),respectively.In the test set,the AUC values were 0.904(95%CI 0.848-0.960),0.684(95%CI 0.579-0.789)and 0.920(95%CI 0.866-0.972),respectively.There was statistically significant difference between two of the three models in the training set(Z=6.493,3.397,7.427;all P<0.05);in the test set,there was statistically significant difference between the combined model and the Brisque model,and between the radiomics model and the Brisque model(Z=4.137,3.740,both P<0.05),but no statistically significant difference between the combined model and the radiomics model(P>0.05).The diagnostic performance was higher in the combined model in both the training set and the test set.The decision curve analysis curve suggested that the net benefit of the combined model was greater than that of the other two models.Conclusion Radiomics combined with Brisque can be applied in the assessment of the quality of arterial-phase images in Gd-EOB-DTPA dynamic-enhanced MRI examinations of the liver to automatically detect clinically unacceptable arterial-phase images of the liver with high diagnostic efficacy,which contributes to the improvement of the quality of the images at the time of acquisition,leading to a reduction in the number of duplicate scans and an increase in the accuracy of the diagnosis.

Objective·To investigate the clinical manifestations and immunophenotypic features of peripheral T-cell lymphoma,not otherwise specified(PTCL-NOS),involving the oral cavity.Methods·The medical histories and pathology records of patients diagnosed with oral PTCL-NOS in the Department of Oral Mucosal Diseases of Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,between August 2020 and August 2024 were retrospectively analyzed.In addition,5 databases,including PubMed,Web of Science,Embase,Scopus,and CNKI,were searched,and relevant cases reported internationally from January 2014 to September 2024 were reviewed.Results·A total of 20 oral PTCL-NOS cases were included,comprising 11 males(55.0%)and 9 females(45.0%).The patients' ages at initial diagnosis ranged from 25 to 77 years,with a mean age of(52.53±12.94)years.The most common sites were the tongue(25.0%),palate(25.0%),and buccal mucosa(20.0%).Nineteen cases(95.0%)had no B symptoms.The cases were positive for CD3(19/19),CD4(11/13),CD8(7/12),CD2(5/6),CD7(5/5),TIA-1(6/7),GB(9/13),perforin(4/6).EBER expression was negative(8/8).The Ki-67 proliferation index was≥60%in 85%of cases.Conclusions·Oral PTCL-NOS is extremely rare and has an aggressive clinical behavior.The oral manifestation presents as deep and large mucosal ulcers with uneven bases,and nodules can be palpable.The pathological features are heterogeneous.Immunophenotype detection is useful for early diagnosis and classification.It is essential for stomatologists to enhance their awareness of this malignancy to avoid delayed diagnosis and treatment.

Cryopreservation is the primary technique for in vitro preservation of allogeneic tissue. However, its success is often hindered by factors such as low temperature, ischemia, and hypoxia. This study investigated the potential of Sini Decoction, known for its antioxidant and anti-apoptotic properties, to reduce cryopreservation-induced injury in rats' sciatic nerves. Sini Decoction was prepared according to the Chinese Pharmacopoeia, and its cytotoxicity on Rsc96 cells was assessed by using the CCK-8 method. Sini Decoction at concentrations of 4, 8, and 16 mg·mL~(-1), termed as low-(SL), medium-(SM), and high-(SH) doses group, was used for cryopreservation of rats' sciatic nerves. A normal control(NC) group and a fresh nerve control(fresh) group were set. Flow cytometry and TUNEL staining were used to detect the apoptosis of neural tissue cells after cryopreservation. Western blot was used to detect the expression of apoptosis-related proteins(Bcl-2, Bax, caspase-3, and caspase-8) and nerve regeneration proteins(NGF and BDNF) in vitro after cryopreservation. Oxidative damage of neural tissue after cryopreservation was evaluated by measuring levels of GSH, SOD, MDA, ROS, and ATP. Cryopreserved nerves were then used for allogeneic transplantation. One week after transplantation, CD4~+ and CD8~+ fluorescent double staining assessed inflammatory cell invasion in the transplanted nerve segment, and ELISA evaluated the expression of serum inflammatory factors(IL-1, IFN-γ, and TNF-α) in recipients. Twenty weeks after transplantation, electrophysiology and NF200 neurofilament staining were used to evaluate nerve regeneration. RESULTS:: showed that Sini Decoction at concentrations of below 32 mg·mL~(-1) exhibited no cytotoxicity to Rsc96 cells. During in vitro nerve cryopreservation, Sini Decoction significantly reduced cell apoptosis, ROS, and MDA production compared to the NC group. In the SH group, the protein expression of NGF and BDNF in vitro, as well as ATP, SOD, and GSH production, were significantly increased. In the rejection reaction one week after transplantation, compared to the fresh nerve transplantation group, the SL and SM groups showed reduced CD4~+ and CD8~+ T cell invasion in the transplanted nerve segment and down-regulated IL-1, IFN-γ, and TNF-α expression in recipient serum. Twenty weeks after transplantation, the electrophysiological test results of CMAP, NCV, and NF200 neurofilament protein fluorescent staining in the SM and SH groups were superior to those in the NC and fresh groups. These findings indicate that Sini Decoction offers protective benefits in the cryopreservation of rats' sciatic nerves and holds significant potential for the in vitro preservation of tissue and organs.
Animals ; Apoptosis/drug effects* ; Rats ; Oxidative Stress/drug effects* ; Sciatic Nerve/cytology* ; Cryopreservation ; Drugs, Chinese Herbal/administration & dosage* ; Male ; Rats, Sprague-Dawley ; Protective Agents/pharmacology*

This study aims to explore the impact of host plants on the quality of Taxilli Herba and provide a theoretical basis for the quality control of Taxilli Herba. The components of Taxilli Herba from three different host plants(Morus alba, Salix babylonica, and Cinnamomum cassia) and its 3 hosts(mulberry branch, willow branch, and cinnamon branch) were detected by widely targeted metabolomics based on ultra-high performance liquid chromatography-tandem mass spectrometry(UPLC-MS/MS). Principal component analysis(PCA), orthogonal partial least squares discriminant analysis(OPLS-DA), and Venn diagram were employed for analysis. A total of 717 metabolites were detected in Taxilli Herba from the three host plants and the branches of these host plants by UPLC-MS/MS. The results of PCA and OPLS-DA of Taxilli Herba from the three different host plants showed an obvious separation trend due to the different effects of host plants. The Venn diagram showed that there were 32, 8, and 26 characteristic metabolites in samples of Taxilli Herba from M. alba host, S. babylonica host, and C. cassia host, respectively. It was found by comparing the characteristic metabolites of Taxilli Herba and its hosts that each host transmits its characteristic components to Taxilli Herba, so that the Taxilli Herba contains the characteristic components of the host. The Kyoto Encyclopedia of Genes and Genomes(KEGG) pathway analysis showed that the differential metabolites of Taxilli Herba from the three hosts were mainly enriched in flavonoid biosynthesis, arginine and proline metabolism, and glycolysis/gluconeogenesis pathways. Furthermore, the differential metabolites enriching pathways of Taxilli Herba from the three hosts were different depending on the host. In a word, host plants have a significant impact on the metabolites of Taxilli Herba, and it may be an important factor for the quality of Taxilli Herba.
Metabolomics/methods* ; Drugs, Chinese Herbal/chemistry* ; Chromatography, High Pressure Liquid ; Tandem Mass Spectrometry ; Quality Control ; Salix/chemistry* ; Cinnamomum aromaticum/metabolism* ; Principal Component Analysis

From the perspective of competitive endogenous RNA(ceRNA) constructed by metastasy-associated lung adenocarcinoma transcript 1(Malat1) and microRNA 16-5p(miR-16-5p), the improvement mechanism of Tonggu Xiaotong Capsules(TGXTC) on the imbalance and disorder of "cholesterol-iron" metabolism in chondrocytes of osteoarthritis(OA) was explored. In vivo experiments, 60 8-week-old C57BL/6 mice were acclimatized and fed for 1 week and then randomly divided into two groups: blank group(12 mice) and modeling group(48 mice). The animals in modeling group were anesthetized by 5% isoflurane inhalation, which was followed by the construction of OA model. They were then randomly divided into model group, TGXTC group, Malat1 overexpression group, and TGXTC+Malat1 overexpression(TGXTC+Malat1-OE) group, with 12 mice in each group. The structural changes of mouse cartilage tissues were observed by Masson staining after the intervention in each group. RT-PCR was employed to detect the mRNA levels of Malat1 and miR-16-5p in cartilage tissues. Western blot was used to analyze the protein expression of ATP-binding cassette transporter A1(ABCA1), sterol regulatory element-binding protein(SREBP), cytochrome P450 family 7 subfamily B member 1(CYP7B1), CCAAT/enhancer-binding protein homologous protein(CHOP), acyl-CoA synthetase long-chain family member 4(ACSL4), and glutathione peroxidase 4(GPX4) in cartilage tissues. In vitro experiments, mouse chondrocytes were induced by thapsigargin(TG), and the combination of Malat1 and miR-16-5p was detected by double luciferase assay. The fluorescence intensity of Malat1 in chondrocytes was determined by fluorescence in situ hybridization. The miR-16-5p inhibitory chondrocyte model was constructed. RT-PCR was used to analyze the levels of Malat1 and miR-16-5p in chondrocytes under the inhibition of miR-16-5p. Western blot was adopted to analyze the regulation of TG-induced chondrocyte proteins ABCA1, SREBP, CYP7B1, CHOP, ACSL4, and GPX4 by TGXTC under the inhibition of miR-16-5p. The results of in vivo experiments showed that,(1) compared with model group, TGXTC group exhibited a relatively complete cartilage layer structure. Compared with Malat1-OE group, TGXTC+Malat1-OE group showed alleviated cartilage surface damage.(2) Compared with model group, TGXTC group had a significantly decreased Malat1 mRNA level and an increased miR-16-5p mRNA level in mouse cartilage tissues(P<0.01).(3) Compared with the model group, the protein levels of ABCA1 and GPX4 in the cartilage tissue of mice in the TGXTC group increased, while the protein levels of SREBP, CYP7B1, CHOP and ACSL4 decreased(P<0.01). The results of in vitro experiments show that,(1) dual-luciferase was used to evaluate that miR-16-5p has a targeting effect on the Malat1 gene.(2)Compared with TG+miR-16-5p inhibition group, TG+miR-16-5p inhibition+TGXTC group had an increased mRNA level of miR-16-5p and an decreased mRNA level of Malat1(P<0.01).(3) Compared with TG+miR-16-5p inhibition group, TG+miR-16-5p inhibition+TGXTC group exhibited increased expression of ABCA1 and GPX4 proteins and decreased expression of SREBP, CYP7B1, CHOP, and ACSL4 proteins(P<0.01). The reasults showed that TGXTC can regulate the ceRNA of Malat1 and miR-16-5p to alleviate the "cholesterol-iron" metabolism disorder of osteoarthritis chondrocytes.
Animals ; MicroRNAs/metabolism* ; RNA, Long Noncoding/metabolism* ; Chondrocytes/drug effects* ; Drugs, Chinese Herbal/pharmacology* ; Mice, Inbred C57BL ; Mice ; Osteoarthritis/drug therapy* ; Iron/metabolism* ; Male ; Cholesterol/metabolism* ; Humans ; Capsules ; RNA, Competitive Endogenous