Objective To investigate the predictive value of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)radiomics combined with Magee equation 3(ME3)for pathological response following neoadjuvant chemotherapy(NAC)in patients with hormone receptor-positive/human epidermal growth factor receptor 2-negative(HR+/HER2-)breast cancer.Methods A ret-rospective analysis was performed on 325 breast cancer patients diagnosed with HR+/HER2-in two hospitals.Patients from the first hospital were randomly divided into training and internal validation sets at a ratio of 7∶3.Patients from the second hospital served as external validation set.The volume of interest(VOI)of breast cancer was delineated on DCE-MRI images.Then the rele-vant radiomics features were extracted and selected,and the Radiomics score(Radscore)was calculated.The statistically significant clinical and pathological features and Radscore were incorporated into a multivariate analysis.The combined radiomics-clinical model and nomogram were established,and the prediction performance was evaluated by using the receiver operating characteristic(ROC)curve,calibration curve,and decision curve analysis(DCA).Results In the training set,seven radiomics features were selected to construct the radiomics model.ME3 score emerged as the independent factor for pathological complete response(pCR)(P＜0.001).By integrating ME3 score and Radscore,a combined radiomics-clinical model was developed.This model demonstrated robust predictive accuracy,with area under the curve(AUC)of 0.88[95％confidence interval(CI)0.80-0.95],0.90(95％CI 0.82-0.98),and 0.82(95％CI 0.70-0.93)in the training,internal validation,and external validation sets,respectively.The nomogram construc-ted from the combined model exhibited excellent discrimination and calibration,with P-values of 0.455,0.312 and 0.062 in the train-ing,internal validation,and external validation sets.Conclusion DCE-MRI radiomics combined with ME3 can be used to predict the pathological response of NAC in HR+/HER2-breast cancer.

Objective To investigate the predictive value of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)radiomics combined with Magee equation 3(ME3)for pathological response following neoadjuvant chemotherapy(NAC)in patients with hormone receptor-positive/human epidermal growth factor receptor 2-negative(HR+/HER2-)breast cancer.Methods A ret-rospective analysis was performed on 325 breast cancer patients diagnosed with HR+/HER2-in two hospitals.Patients from the first hospital were randomly divided into training and internal validation sets at a ratio of 7∶3.Patients from the second hospital served as external validation set.The volume of interest(VOI)of breast cancer was delineated on DCE-MRI images.Then the rele-vant radiomics features were extracted and selected,and the Radiomics score(Radscore)was calculated.The statistically significant clinical and pathological features and Radscore were incorporated into a multivariate analysis.The combined radiomics-clinical model and nomogram were established,and the prediction performance was evaluated by using the receiver operating characteristic(ROC)curve,calibration curve,and decision curve analysis(DCA).Results In the training set,seven radiomics features were selected to construct the radiomics model.ME3 score emerged as the independent factor for pathological complete response(pCR)(P＜0.001).By integrating ME3 score and Radscore,a combined radiomics-clinical model was developed.This model demonstrated robust predictive accuracy,with area under the curve(AUC)of 0.88[95％confidence interval(CI)0.80-0.95],0.90(95％CI 0.82-0.98),and 0.82(95％CI 0.70-0.93)in the training,internal validation,and external validation sets,respectively.The nomogram construc-ted from the combined model exhibited excellent discrimination and calibration,with P-values of 0.455,0.312 and 0.062 in the train-ing,internal validation,and external validation sets.Conclusion DCE-MRI radiomics combined with ME3 can be used to predict the pathological response of NAC in HR+/HER2-breast cancer.

Objective To investigate the effect of long non-coding RNA(lncRNA)potassium voltage-gated channel subfamily Q member 1 overlapping transcript 1(KCNQ1OT1)on oxidative glucose deprivation/reoxygenation(OGD/R)-induced microglia injury through regulating the miR-145-5p/Rho-associated coiled-coil forming protein kinase 1(ROCK1)axis.Methods Microglia N9 were divided into the control group(normal culture),the OGD/R group(OGD/R-induced injury),the sh-NC group(transfected with sh-NC after OGD/R-induced injury),the sh-KCNQ1OT1 group(transfected with sh-KCNQ1OT1 after OGD/R-induced injury),the sh-KCNQ1OT1+inhibitor NC group(co-transfected with sh-KCNQ1OT1 and inhibitor NC after OGD/R-induced injury),and the sh-KCNQ1OT1+miR-145-5p inhibitor group(co-transfected with sh-KCNQ1OT1 and miR-145-5p inhibitor after OGD/R-induced injury).RT-qPCR was applied to detect the expression of lncRNA KCNQ1OT1,miR-145-5p,and ROCK1 mRNA in cells.The expression of ROCK1 protein was detected by Western blot.CCK-8 was applied to detect the cell proliferation.Flow cytometry was applied to detect cell apoptosis.ELISA was applied to detect the levels of interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α),and interleukin-6(IL-6)in cells.The action sites of miR-145-5p with lncRNA KCNQ1OT1 and ROCK1 were predicted by bioinformatics website,and their targeting relationships were verified by dual-luciferase reporter assay.Results Compared with the control group,the expression of lncRNA KCNQ1OT1,the expression of ROCK1 mRNA and protein,the apoptosis rate,and the levels of IL-6,TNF-α,and IL-1β in cells were all increased,and the level of miR-145-5p and cell survival rate were all decreased in the OGD/R group(P<0.05).Compared with the OGD/R group and the sh-NC group,the expression of lncRNA KCNQ1OT1,the expression of ROCK1 mRNA and protein,the apoptosis rate,and the levels of IL-6,TNF-α,and IL-1β in cells were all decreased,and the level of miR-145-5p and cell survival rate were all increased in the sh-KCNQ1OT1 group,with significant differences(P<0.05).Compared with the sh-KCNQ1OT1+inhibitor NC group,the expression of ROCK1 mRNA and protein,the apoptosis rate,and the levels of IL-6,TNF-α,and IL-1β in cells were all increased,and the expression of miR-145-5p and cell survival rate were all decreased in the sh-KCNQ1OT1+miR-145-5p inhibitor group,with significant differences(P<0.05).Bioinformatics website showed that miR-145-5p had targeted action sites with lncRNA KCNQ1OT1 and ROCK1,and dual-luciferase reporter assay confirmed that miR-145-5p had targeting relationships with lncRNA KCNQ1OT1 and ROCK1(P<0.05).Conclusion Silencing lncRNA KCNQ1OT1 can alleviate OGD/R-induced microglia injury via upregulating the expression of miR-145-5p and targeting the down-regulation of ROCK1 expression.

Objective:To investigate the application of 18F-FDG PET/MR and its derived parameters in the diagnosis and staging of bladder cancer. Methods:Forty patients (32 males, 8 females; age (66.8±11.2) years) with suspected bladder cancer between December 2019 and March 2022 were retrospectively included and underwent 18F-FDG PET/MR in Nanjing First Hospital. Parameters including SUV max, SUV mean, maximum tumor diameter and mean of apparent diffusion coefficient (ADC mean) were obtained, and bladder cancer muscle invasiveness and lymph node involvement were determined. The efficacy of 18F-FDG PET/MR and its derived parameters for tumor diagnosis and staging was analyzed using transurethral resection of bladder tumor (TUR-BT) or radical cystectomy (RC) and extended pelvic lymph node dissection (ePLND) histopathology as the " gold standard". Independent-sample t test, Mann-Whitney U test or χ2 test was used to analyze the data, and Delong test was used to compare different AUCs. Results:Of 40 patients, 8 were non-muscle invasive bladder cancer (NMIBC), 32 were muscle invasive bladder cancer (MIBC), and 5 were pathologically confirmed to have lymph node metastasis. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of 18F-FDG PET/MR for identifying MIBC were 96.9%(31/32), 7/8, 96.9%(31/32), 7/8, 95.0%(38/40), respectively, and those for lymph node metastasis were 4/5, 90.0%(18/20), 4/6, 18/19, 88.0%(22/25), respectively. For pathological tumor (pT) staging, significant differences were observed between pT2-3 and pT1 groups in maximum tumor diameter ( t=-2.37, P=0.024), SUV mean( Z=-2.11, P=0.035), and ADC mean( t=2.91, P=0.006). The AUCs of maximum tumor diameter, SUV mean and ADC mean in distinguishing MIBC were 0.781, 0.746, and 0.825, respectively. The sensitivity, specificity, PPV, NPV, and accuracy of MRI alone in identifying MIBC were 87.5%(28/32), 1/8, 80.0%(28/35), 1/5 and 72.5%(29/40), respectively, with the AUC of 0.500. The AUC of 18F-FDG PET/MR in identifying MIBC was 0.796, which was better than MRI alone ( Z=5.54, P<0.001), and the accuracy of PET/MR was also higher than MRI alone ( χ2=7.44, P=0.006). Conclusion:Compared with MRI alone, 18F-FDG PET/MR significantly improves the diagnostic efficacy of bladder cancer and the accuracy of pT staging.

Objective:To investigate the impact of immunosuppressive therapy on the severity of SARS-CoV-2 infection and cytokine levels in pediatric patients with kidney diseases.Methods:A retrospective analysis was conducted on the clinical data of 40 hospitalized pediatric patients who were diagnosed with SARS-CoV-2 infection at the 900th Hospital of PLA Joint Logistic Support Force from December 2022 to February 2023. Based on their immunosuppressive status prior to SARS-CoV-2 infection, these patients were categorized into immunosuppressive group and non-immunosuppressive group. Independent sample t-tests, Mann-Whitney U tests, and χ2 test were employed to compare the clinical baseline characteristics and laboratory data, the severity of SARS-CoV-2 infection, and the levels of cytokines between the 2 groups. Results:Among the 40 patients, 11 were in the immunosuppressive group (aged 13 (8, 14) years, 9 males and 2 females) and 29 in the non-immunosuppressive group (aged 2 (1, 4) years, 15 males and 14 females). In the immunosuppressive group, 2 were asymptomatic cases, 8 were mild cases, and 1 was moderate case, and there was no severe or critical cases. In the non-immunosuppressive group, 8 were mild cases, 5 were moderate, 15 were severe cases, 1 was critical case, and no asymptomatic cases. The underlying diseases in the immunosuppressive group included nephrotic syndrome (6 cases), IgA vasculitis nephritis (2 cases), lupus nephritis (1 case), post-renal transplantation (1 case), and renal failure (1 case), with a mean total immunosuppression score (TIS) of (3.6±1.4) points. In the non-immunosuppressive group, 2 patients had a history of epilepsy, and the remaining 27 cases had no underlying conditions, all with TIS scores of 0. Compared to the children in the non-immunosuppressive group, those in the immunosuppressive group were more likely to exhibit asymptomatic or mild infection, with lower risks of severe disease, cytokine storm, fever, and cough, but a higher risk of fatigue ( OR=1.22, 2.66, 0.48, 0.12, 0.12, 0.13, 1.22; 95% CI 0.93-1.62, 0.99-7.15, 0.33-0.70, 0.03-0.57, 0.03-0.57, 0.03-0.65, 0.93-1.62; all P<0.05). The levels of cytokine IL-6, interferon-α and interferon-γ in the immunosuppressive group were all lower than those in the non-immunosuppressive group ( Z=2.23, 2.51, 2.92, respectively; all P<0.05). Conclusion:Pediatric patients with kidney diseases receiving appropriate immunosuppressive therapy may mitigate the severity of SARS-CoV-2 infection by suppressing the expression of cytokines.

OBJECTIVE: To explore the early efficacy and safety of hip arthroscopy in the treatment of patients with borderline developmental dysplasia of the hip(BDDH). METHODS: A total of 111 patients diagnosed with BDDH from January 2020 to December 2022 were selected and divided into two groups according to the surgical method. Among them, 63 patients who underwent arthroscopy were assigned to the arthroscopy group, including 22 males and 41 females with an average age of (35.67±6.83) years;48 patients who underwent periacetabular osteotomy were assigned to the PAO group, including 18 males and 30 females with an average age of (36.85±7.10) years. The operation time, hospital stay, blood loss, rehabilitation time, complication rate, and reoperation rate were recorded in both groups. Imaging indicators of the two groups were measured and recorded. The modified Harris hip score (mHHS), nonarthritic hip score (NAHS), and hip outcome score-activity of daily living scale (HOS-ADL) were used to evaluate hip function and quality of life before and after surgery. RESULTS: All patients were followed up for 12 months. The operation time (90.43±9.85) min, hospital stay(4.32±0.56) days, rehabilitation time (15.22±2.15) weeks, blood loss (25.69±6.57) ml, and number of complications (15 cases) in the arthroscopy group were all lower than those in the PAO group (117.25±15.83) min, (5.81±0.92) days, (21.10±3.74) weeks, (358.52±126.73) ml, 30 cases, with statistically significant differences (P<0.05). At the last follow-up after treatment, the lateral center edge angle (LCEA) (19.82±1.90)° and anterior center edge angle (ACEA) (20.01±1.85)° in the arthroscopy group decreased compared with those before treatment (21.43±2.10)°, (21.54±2.05)°, while in the PAO group, the LCEA (33.03±3.45)° and ACEA (33.48±4.22)° at the last follow-up after treatment increased compared with those before treatment, with statistically significant differences (P<0.05). The T?nnis angle in the arthroscopy group after treatment (11.05±1.83)° increased compared with that before treatment, while in the PAO group, the T?nnis angle at the last follow-up after treatment (2.98±0.75)° decreased compared with that before treatment, with statistically significant differences (P<0.05). In the arthroscopy group, the extrusion index (30.68±2.85) and T?nnis grade after treatment increased compared with those before treatment, while the α angle after treatment (38.79±4.27)° significantly decreased compared with that before treatment, with statistically significant differences (P<0.05);in the PAO group, the extrusion index (15.03±2.18) and α angle (53.58±6.02)° after treatment significantly decreased compared with those before treatment, with statistically significant differences (P<0.05). The mHHS score at the last follow-up after treatment in the arthroscopy group (86.41±7.33) was higher than that in the PAO group (81.02±6.49), with a statistically significant difference (P<0.05). At 6 months after treatment, the NAHS (69.83±6.53) and HOS-ADL scores (78.84±7.39) in the arthroscopy group were higher than those in the PAO group (64.10±6.02), (75.31±7.01), with statistically significant differences (P<0.01);at the last follow-up after treatment, the NAHS (87.63±7.60) and HOS-ADL scores (88.94±8.11) in the arthroscopy group were higher than those in the PAO group (81.63±7.03), (83.63±7.92), with statistically significant differences (P<0.05). CONCLUSION Compared with PAO, hip arthroscopy shows better early to mid-term clinical efficacy in the treatment of BDDH patients. However, PAO has more advantages in improving acetabular imaging indicators of BDDH patients, while hip arthroscopy only improves the α angle of patients. Meanwhile, hip arthroscopy causes less trauma to patients, reduces blood loss, and is more conducive to the subsequent recovery of patients.
Humans ; Female ; Male ; Arthroscopy/methods* ; Adult ; Developmental Dysplasia of the Hip/physiopathology* ; Middle Aged ; Treatment Outcome

OBJECTIVE: To analyze the effect of COVID-19 infection on the mobilization and collection of autologous peripheral blood stem cells in patients with multiple myeloma. METHODS: The general baseline data, treatment factors before mobilization collection, collection status, and treatment overview after collection of autologous peripheral blood stem cells at Beijing Chaoyang Hospital affiliated with Capital Medical University from January 1, 2020 to July 15, 2023 were analyzed. RESULTS: 269 patients underwent mobilization and collection of autologous peripheral blood stem cells. Among them, 32 cases with COVID-19 infection history (COVID-19 group) and 237 cases without COVID-19 infection history (non-COVID-19 group). In the COVID-19 group, 17 cases were treated with chemotherapy (etoposide)+G-CSF, and 15 cases were treated with plerixafor +G-CSF. In the non-COVID-19 group, 214 cases were treated with chemotherapy +G-CSF, 17 cases were treated with plerixafor +G-CSF, and 6 cases were treated with chemotherapy + plerixafor +G-CSF. The number of CD34⁺ cells, collection success rate, and excellence rate in the COVID-19 group and the non-COVID-19 group were ［5.52 (0.94-26.87) vs 4.80 (0.53-37.20)］×10⁶/kg (P =0.610), (93.8% vs 85.2%) (P =0.275), (62.5% vs 49.4%) (P =0.190), respectively. Among 113 patients mobilized with etoposide +G-CSF, the number of CD34⁺ cells, success rate, and excellence rate collected from COVID-19 infection (17 cases) and non-COVID-19 infection (96 cases) were ［7.54 (2.66-26.87) vs 7.78 (2.26-37.20)］×10⁶/kg (P =0.847), (100.0% vs 100.0%) (no P value), (82.4% vs 86.5%) (P =0.655), respectively. Among 32 patients mobilized by plerixafor +G-CSF, the number of CD34⁺ cells, success rate and excellence rate of COVID-19 infection (15 cases) and non-COVID-19 infection (17 cases) were ［3.82 (0.94-7.27) vs 4.11 (0.53-9.05)］×10⁶/kg (P =0.821), (86.7% vs 88.2%) (P =0.893), (40.0% vs 35.3%) (P =0.784), respectively. In 32 patients with COVID-19 infection, the number of CD34⁺ cells collected by etoposide +G-CSF (17 cases) and plerixafor +G-CSF (15 cases), as well as the success rate and excellence rate were ［7.54 (2.66-26.87) vs 3.82(0.94-7.27)］×10⁶/kg (P =0.004), (100.0% vs 86.7%) (P =0.120), (82.4% vs 40.0%) (P =0.014), respectively. By 2023.7.31, 232 patients (86.2%, 232/269) had received transplantation, including 24 patients in the COVID-19 group and 208 patients in the non-COVID-19 group. The median number of CD34⁺ cells infused in the two groups was ［3.67 (2.50-13.44) vs 3.11(1.12-19.89)］×10⁶/kg (P =0.058), the median days of neutrophil engraftment ［11(9-13) vs 11(9-17)］ (P =0.674), the median days of platelet engraftment ［11(0-23), 12(0-43)］ (P =0.279), respectively. CONCLUSION The history of COVID-19 infection did not affect the PBSC mobilization, collection and transplantation of patients with myeloma. In patients with COVID-19 infection, the results of chemotherapy mobilization with etoposide seems to be better than that of plerixafor mobilization, but further research is needed to clarify.
Humans ; COVID-19/complications* ; Multiple Myeloma/complications* ; Hematopoietic Stem Cell Mobilization ; Transplantation, Autologous ; Granulocyte Colony-Stimulating Factor/therapeutic use* ; Peripheral Blood Stem Cell Transplantation ; SARS-CoV-2 ; Middle Aged ; Peripheral Blood Stem Cells ; Male ; Female ; Cyclams ; Benzylamines

OBJECTIVE: To evaluate the clinical effect and safety of acupuncture manipulation on treatment of intractable facial paralysis (IFP), and verify the practicality and precision of the Anzhong Facial Paralysis Precision Scale (Eyelid Closure Grading Scale, AFPPS-ECGS). METHODS: A multicentre, single-blind, randomized controlled trial was conducted from October 2022 to June 2024. Eighty-nine IFP participants were randomly assigned to an ordinary acupuncture group (OAG, 45 cases) and a characteristic acupuncture group (CAG, 44 cases) using a random number table method. The main acupoints selected included Yangbai (GB 14), Quanliao (SI 18), Yingxiang (LI 20), Shuigou (GV 26), Dicang (ST 4), Chengjiang (CV 24), Taiyang (EX-HN 5), Jiache (ST 6), Fengchi (GB 20), and Hegu (LI 4). The OAG patients received ordinary acupuncture manipulation, while the CAG received characteristic acupuncture manipulation. Both groups received acupuncture treatment 3 times a week, with 10 times per course, lasting for 10 weeks. Facial recovery was assessed at baseline and after the 1st, 2nd and 3rd treatment course by AFPPS-ECGS and the House-Brackmann (H-B) Grading Scale. Infrared thermography technology was used to observe the temperature difference between healthy and affected sides in various facial regions. Adverse events and laboratory test abnormalities were recorded. The correlation between the scores of the two scales was analyzed using Pearson correlation coefficient. RESULTS: After the 2nd treatment course, the two groups showed statistically significant differences in AFPPS-ECGS scores (P<0.05), with even greater significance after the 3rd course (P<0.01). Similarly, H-B Grading Scale scores demonstrated significant differences between groups following the 3rd treatment course (P<0.05). Regarding temperature measurements, significant differences in temperatures of frontal and ocular areas were observed after the 2nd course (P<0.05), becoming more pronounced after the 3rd course (P<0.01). Additionally, mouth corner temperature differences reached statistical significance by the 3rd course (P<0.05). No safety-related incidents were observed during the study. Correlation analysis revealed that the AFPPS-ECGS and the H-B Grading Scale were strongly correlated (r=0.86, 0.91, 0.93, and 0.91 at baseline, and after 1st, 2nd, and 3rd treatment course, respectively, all P<0.01). CONCLUSIONS Acupuncture is an effective treatment for IFP, and the characteristic acupuncture manipulation enhances the therapeutic effect. The use of the AFPPS-ECGS can more accurately reflect the recovery status of patients with IFP. (Trial registration No. ChiCTR2200065442).
Humans ; Acupuncture Therapy/methods* ; Facial Paralysis/therapy* ; Female ; Male ; Middle Aged ; Adult ; Treatment Outcome ; Acupuncture Points ; Aged