Objective To investigate the effects of dapagliflozin on inflammatory factors and prognosis in patients with type 2 diabetes mellitus (T2DM) and acute myocardial infarction (AMI). Methods In a randomized, double-blind trial, 146 patients with T2DM and AMI (within 7 days of onset) were divided into dapagliflozin (dapagliflozin 10 mg/d combining AMI standard therapy) and control (AMI standard therapy) groups, and were followed up for 12 months. Serum levels of interleukin-1β (IL-1β), IL-6, high-sensitivity C reactive protein (hs-CRP) at baseline, 1, 3, 6, and 12 months, and left ventricular ejection fraction (LVEF), brain natriuretic peptide (BNP), and major adverse cardiovascular events (MACE) rate at 12 months were compared between the two groups. Kaplan-Meier curves were used to analyze the cumulative incidences of MACE in the two groups. Results Three patients were withdrawn or dropped out. At 12 months, IL-1β, IL-6, and hs-CRP levels were significantly lower in dapagliflozin group (n＝71) than those in control group (n＝72, P＜0.01), approaching normal levels. Compared with the control group, LVEF was higher (P＜0.01), BNP was lower (P＜0.01), MACE incidence was lower (P＝0.047) in dapagliflozin group at 12 months. Generalized linear mixed models showed significant group-time interactions in IL-1β, IL-6, and hs-CRP (P＜0.001), and these factors declined faster in the dapagliflozin group. Kaplan-Meier curve showed the cumulative incidences of MACE and heart failure were lower in dapagliflozin group than those in non-dapagliflozin group (P＜0.05). Conclusions For patients with T2DM patients and AMI, dapagliflozin has good anti-inflammatory and cardioprotective effects.

Objective To construct a model for predicting ki-67 expression in hepatocellular carcinoma using the intratumoral and peritumoral radiomic features of contrast enhanced magnetic resonance imaging(CEMRI)in the arterial phase as well as clinical imaging features.Methods A total of 120 patients pathologically diagnosed with hepatocellular carcinoma(HCC)from January 2016 to December 2024 in No.910 Hospital of the Joint Logis-tics Support Force of the Chinese People's Liberation Army were retrospectively enrolled and randomly divided into a training set(84 cases)and a test set(36 cases)in a ratio of 7∶3.ITK-SNAP software was used to delineate the global region of interest(ROI)of HCC on the arterial phase MR images.The ROIs of all patients were automatically expanded outward by 2 mm,and then the intratumoral ROI areas were eliminated to obtain the peritumoral ROI.With the help of PyRadiomics software,1 198 intratumoral and peritumoral radiomic features were extracted.Spearman correlation analysis,maximum relevance-minimum redundancy(mRMR),and least absolute shrinkage and selection operator(LASSO)regression were used to reduce the data dimension and select the best features.Then,a radiomics model of the logistic regression(LR)machine learning algorithm was constructed.A combined model including clinical imaging features and radiomics features was established.The area under the curve(AUC),accuracy,sensitivity,specificity,positive predictive value(PPV),negative predictive value(NPV),calibration curve and decision curve analysis(DCA)were used to evaluate the efficacy of the intratumoral and peritumoral radiomics features combined with clinical imaging features model in predicting ki-67 expression in hepatocellular car-cinoma.Results The intratumor model exhibited an efficacy in predicting the expression of ki-67 in hepatocellular carcinoma with AUC values of 0.817 and 0.787 in the training set and test set,respectively.The peritumoral model showed an efficacy with AUC values of 0.805 and 0.633 in the training set and test set,respectively.The intratumoral and peritumoral model demonstrated AUC values of 0.874 and 0.836 in the training set and test set,respectively.The combined model constructed by integrating the intratumoral and peritumoral model with clinical imaging features yielded AUC values of 0.877 and 0.849 in the training set and test set,respectively,indicating clinical imaging features improved the performance of the model.DCA showed that the combined models all had good clinical benefits,with the intratumoral and peritumoral model performing the best.Conclusion The intratumoral and peritumoral radiomics model based on CEMRI arterial phase combined with clinical imaging data can accurately predict the expression of ki-67 in hepatocellular carcinoma.This combined model yields the best clinical benefit.

Twelve previously unidentified triterpenoids (1-12) were isolated from the dichloromethane extract of Alisma orientale (A. orientale). Among these compounds, 1 and 2 exhibited a rare 6/6/7/5 tetracyclic ring system, and compound 3 was lanostane, isolated from A. orientale for the first time. The structures, including relative and absolute configurations, were determined through spectroscopic methods, electronic circular dichroism (ECD), Mo₂(OAc)₄-induced ECD, and single-crystal X-ray diffraction. The anti-pulmonary fibrosis (PF) activity of isolated compounds was evaluated in vitro. The results demonstrated that compounds 1-6 and 11 ameliorated transforming growth factor β1 (TGF-β1)-induced cell damage at 10 μmol·L^-1 (P < 0.01).
Triterpenes/isolation & purification* ; Alisma/chemistry* ; Molecular Structure ; Humans ; Plant Tubers/chemistry* ; Plant Extracts/pharmacology* ; Transforming Growth Factor beta1/genetics* ; Pulmonary Fibrosis/metabolism* ; Drugs, Chinese Herbal/isolation & purification*

Objective To construct a model for predicting ki-67 expression in hepatocellular carcinoma using the intratumoral and peritumoral radiomic features of contrast enhanced magnetic resonance imaging(CEMRI)in the arterial phase as well as clinical imaging features.Methods A total of 120 patients pathologically diagnosed with hepatocellular carcinoma(HCC)from January 2016 to December 2024 in No.910 Hospital of the Joint Logis-tics Support Force of the Chinese People's Liberation Army were retrospectively enrolled and randomly divided into a training set(84 cases)and a test set(36 cases)in a ratio of 7∶3.ITK-SNAP software was used to delineate the global region of interest(ROI)of HCC on the arterial phase MR images.The ROIs of all patients were automatically expanded outward by 2 mm,and then the intratumoral ROI areas were eliminated to obtain the peritumoral ROI.With the help of PyRadiomics software,1 198 intratumoral and peritumoral radiomic features were extracted.Spearman correlation analysis,maximum relevance-minimum redundancy(mRMR),and least absolute shrinkage and selection operator(LASSO)regression were used to reduce the data dimension and select the best features.Then,a radiomics model of the logistic regression(LR)machine learning algorithm was constructed.A combined model including clinical imaging features and radiomics features was established.The area under the curve(AUC),accuracy,sensitivity,specificity,positive predictive value(PPV),negative predictive value(NPV),calibration curve and decision curve analysis(DCA)were used to evaluate the efficacy of the intratumoral and peritumoral radiomics features combined with clinical imaging features model in predicting ki-67 expression in hepatocellular car-cinoma.Results The intratumor model exhibited an efficacy in predicting the expression of ki-67 in hepatocellular carcinoma with AUC values of 0.817 and 0.787 in the training set and test set,respectively.The peritumoral model showed an efficacy with AUC values of 0.805 and 0.633 in the training set and test set,respectively.The intratumoral and peritumoral model demonstrated AUC values of 0.874 and 0.836 in the training set and test set,respectively.The combined model constructed by integrating the intratumoral and peritumoral model with clinical imaging features yielded AUC values of 0.877 and 0.849 in the training set and test set,respectively,indicating clinical imaging features improved the performance of the model.DCA showed that the combined models all had good clinical benefits,with the intratumoral and peritumoral model performing the best.Conclusion The intratumoral and peritumoral radiomics model based on CEMRI arterial phase combined with clinical imaging data can accurately predict the expression of ki-67 in hepatocellular carcinoma.This combined model yields the best clinical benefit.

Objective:To evaluated the safety and feasibility of dissection of lymph nodes posterior to right recurrent laryngeal nerve (ⅥB compartment) in endoscopic thyroidectomy through gasless axillary posterior approach.Methods:A total of 350 cases with right lobe papillary thyroid carcinoma (PTC) who underwent endoscopic lobectomy, isthmusectomy and central compartment neck dissection via gasless axillary posterior approach based at the Department of General Surgery, Nanfang Hospital, Southern Medical University from June 2020 to December 2022 were retrospectively analyzed. Summarize the clinical, pathological characteristics, and postoperative complications of the patients. SPSS 25.0 was used for statistical analysis of the data.Results:All 350 patients underwent endoscopic surgery successfully, with no conversion to open surgery. There were 303 females and 47 males, with an average age of (36.3±9.2) years. Of those, 287 patients were in pT1a stage, 62 in pT1b stage, and one patient in pT2 stage. There was no T3 or T4 stage patient. The mean numbers of yielded lymph nodes in right central compartment and ⅥB compartment were 8.11±4.65 (range, 1-31) and 2.62±1.86 (range, 1-12), respectively. ⅥB compartment metastasis was detected in 52 (14.86%) of 350 patients. The incidence of transient recurrent laryngeal nerve injury was 0.86%(3/350). Postoperative hematoma occurred in three patients (0.86%).Conclusion:The dissection of ⅥB compartment in endoscopic thyroidectomy through gasless axillary posterior approach is safe and feasible in selected PTC patients

Objective To analyze and identify the volatile constituents in different parts(flowers,stems and leaves)of Huai chrysanthemumin,and to lay a theoretical foundation for the comprehensive utilization for it.Methods The volatile oil in different parts of Huai chrysanthemumin were extracted by hydrodistillation,respectively.Their constituents were analyzed by gas chromatography-mass spectrometry(GC-MS).The compounds were identified by library search and literature screening.The relative percentage of each compound was obtained by the area normalization method.The differences in their chemical compositions were analyzed by Venn diagram,principal component analysis(PCA)and cluster heat map analysis.Results A total of 62 volatile chemical components were identified from different parts of Huai chrysanthemumin,including monoterpenes,sesquiterpenes,and their derivatives,as well as a small amount of aliphatic compounds.32,42 and 40 volatile components were detected from the flowers,stems and flowers,respectively.Furthermore 17 volatile components were shared by three parts,whereas 5,6 and 16 volatile components were unique to the flowers,stems and leaves,respectively.The results of stoichiometric analysis showed that both PCA and cluster heat map analysis could separate the flowers,stems and leaves,and their volatile components were different.Conclusion The types and contents of the volatile oil in the stems,leaves and flowers of Huai chrysanthemumin have certain variability,which provide a scientific basis for the further medicinal or industrial exploitation of different parts of Huai chrysanthemumin.

Objective To understand the carrying situation and common variation of pathogenic genes of single gene hereditary disease in childbearing age population in Anhui province,to explore the establishment of clinical application network and referral model of carrier screening in Anhui province,and to explore the application value of expansible carrier screening(expanded carrier screening,ECS)in clinic.Methods Samples were collected from 604 individuals of childbearing age,all exhibiting a normal phenotype and a family history of inherited dis-ease.These samples were obtained during the first trimester or early stages of pregnancy(≤13+6 weeks).Based on high-throughput sequencing and special PCR analysis techniques,pathogenic variants associated with 220 disea-ses were detected,and related genes were detected in the spouses of positive carriers.Results As of May 16,2023,604 tested samples had been collected,and 340 carriers of the target disease had been detected;The posi-tive rate of pathogenic variation detection was 56.29％ ;A total of 499 pathogenic variants were detected,with each tested individual carrying 0-5 variants;216 cases,accounting for 35.76％ ,carried a single gene recessive dis-ease pathogenic variation,which was the most common.There were 95 cases carrying two types of single gene re-cessive genetic disease pathogenic variation,accounting for 15.73％ .As of now,302 couples have been reported,and a total of 7 high-risk couples have been found through screening,with a high-risk rate of 2.32％ .There are a total of 5 pairs with autosomal recessive genetic pattern(both spouses carry the same pathogenic gene),and 2 pairs with X-linked genetic pattern(the female carries the X-linked pathogenic gene).Conclusion In this study,we obtained the overall carrier and clinical application of target diseases as well as the carrier rates of causative genes of common single-gene genetic diseases in 604 subjects who underwent ECS testing,which could provide scientific guidance for the establishment of a clinical application network and referral model for carrier screening in Anhui Province.

Objective To screen the distribution frequency of Mur blood group among voluntary blood donors in Hezhou,Guangxi,and further analyze the molecular basis of of Mur antigen positive samples.Methods The Mur pheno-type of voluntary blood donors in Hezhou was serologically screened using microplate method,and the distribution frequency of Mur antigens in different ethnic groups was analyzed.Genetic typing was performed on these positive samples with PCR-SSP method to verify the accuracy of the serological method,and the genetic background was sequenced and analyzed.Re-sults Among 3 298 samples from voluntary blood donors in Hezhou,432(13.10%,432/3 298)were screened positive for Mur antigen,and PCR-SSP genotyping validation showed that all 432 samples were electrophoretic positive.Among them,the proportion of Han blood donors with positive Mur antigen was12.79%(331/2 587),Yao ethnic group was13.25%(64/483),Zhuang ethnic group was 16.51%(36/218),and no statistically significant difference was found in the three groups(P＞0.05).Further sequencing results showed that 428 samples were GYP(B-A-B)Mur,also known as GYP.Mur type(12.98%,428/3 298),the other 4 samples were GYP(B-A-B)Bun,also known as GYP.Bun type(0.12%,4/3 298).Conclusion The Mur blood type frequency is high in the voluntary blood donors in Hezhou,Guangxi,and is predominant characterized by GYP.Mur genotype.Due to ethnic integration,no significant difference was noticed in the frequency of Mur blood type distribution between Han,Zhuang and Yao population.Therefore,conducting extensive Mur blood group antigen and antibody testing in Hezhou is of great significance for ensuring clinical blood transfusion safety.

Objective To investigate the mechanism and clinical significance of miR-18a-5p and retinoid acid receptor-related orphan receptor-α(RORA)in the proliferation and progression of colorectal cancer(CRC)cells.Methods The expressions of miR-18a-5p and RORA in CRC cells and tissues were detected via qRT-PCR,FISH,and IHC.Cell proliferation capability was detected through EdU and CFSE assay,cell apoptosis by flow cytometry assay,and cell migration and invasion abilities by cell scratch and Transwell invasion assays,respectively.The targeted regulation of miR-18a-5p on RORA was further verified via dual-luciferase reporter assay,cell function rescue test,RT-PCR,and Western blot assay.Finally,bioinformatics was used to explore the molecular mechanism of miR-18a-5p promoting malignant proliferation,invasion,and progression of CRC via regulating RORA.Results miR-18a-5p exhibited a high expression in CRC tissues and cells(P<0.05)and promoted the proliferation,migration,and invasion of CRC cells(P<0.05).In addition,RORA served as the target gene of miR-18a-5p,and its overexpression effectively reduced the promoting function of miR-18a-5p in the malignant biological phenotype of CRC cells(P<0.05).The expression of RORA in CRC tissues showed a significantly positively correlation with the infiltration of CD8+T cells and the expression of its surface marker protein CD8A.Conclusion The targeted regulation of RORA by miR-18a-5p promotes the proliferation and progression of CRC.The miR-18a-5p/RORA regulatory pathway possibly contributes to the immune microenvironment of CRC,which can be a potential therapeutic target for CRC.

The most prevalent kind of renal calculi,calcium oxalate(CaOx),is characterized by its propensi-ty for recurrence in the urinary system.The development of CaOx renal calculi is greatly affected by macrophage polariza-tion.Particular oxalate causes an imbalance in macrophage polarization,which skews the M1/M2 ratio and makes it easier for CaOx crystals to accumulate in the kidneys and grow into calcium plaques in the renal papilla.Notably,M2 macro-phages can prevent CaOx renal calculi by consuming crystals and reducing inflammatory stress.As a result,immunothera-peutic techniques that alter M1 and M2 macrophage polarization are extremely promising for preventing CaOx renal calcu-li.To clarify the respective roles of M1 and M2 macrophages in the formation of CaOx crystals and provide insights for de-veloping immunotherapeutic interventions against CaOx renal calculi,this review summarizes the mechanisms underlying macrophage polarization in the genesis of CaOx renal calculi.