Objective:To explore the construction of an evaluation model for aortic root anatomy and calcium burden in patients with bicuspid aortic valve (BAV) stenosis before transcatheter aortic valve replacement (TAVR) based on deep learning (DL) algorithms.Methods:A retrospective collection of 362 BAV stenosis patients who underwent TAVR from September 2023 to May 2024 was performed. All patients underwent cardiac CT angiography. The patients were divided into training group ( n=104), internal validation group ( n=206), and external validation group ( n=52). A DL model was trained on the training dataset to assess aortic root anatomy and calcification burden. The evaluation included the segmentation accuracy of the algorithm, the measurement performance of key anatomical structures (i.e., valve leaflets and type-1 and type-2 fusion raphe), and calcification burden, as well as the measurement efficiency. Overall segmentation performance was assessed using the average Dice coefficient (ADC). The fine-scale segmentation quality was validated by the 95th-percentile Hausdorff distance (HD-95) and the average symmetric surface distance (ASSD). The consistency of the measurement results was assessed using the Pearson correlation coefficient and the intraclass correlation coefficient ( ICC) with a two-way mixed model for absolute agreement. In addition, the total time and total mouse movement distance required for manual assessment versus the DL model on the validation datasets were recorded and compared. Results:The algorithm demonstrated excellent segmentation performance on aortic root anatomical targets, achieving outstanding consistency within both internal and external validation datasets (0.955

Objective To investigate the effect and underlying mechanism of bufalin regulating ferroptosis on extracellular matrix synthesis in renal tubular epithelial cells(RTECs)under high glucose(HG)conditions.Methods RTECs were cultured in vitro and exposed to HG.The experimental groups included:the control group,the HG group,the HG+dimethyl sulfoxide(DMSO)group,the HG+bufalin group,the HG+ferrostatin-1(Fer-1)group,the HG+bufalin+DMSO group and HG+bufalin+erastin group.The expression levels of fibronectin(FN),type Ⅰ collagen(Col Ⅰ),acyl-CoA synthetase long-chain family member 4(ACSL4),solute carrier family 7 member 11(SLC7A11)and glutathione peroxidase 4(GPX4)were detected using Western blot assay and quantitative real-time PCR(qRT-PCR).The potential molecular targets of bufalin were predicted using SwissTargetPrediction,and functional enrichment analysis was conducted using Metascape.FerrDb was employed to analyze ferroptosis-related gene sets.The levels of ferrous ions(Fe2+),malondialdehyde(MDA)and glutathione(GSH)were measured using micro-methods to evaluate the occurrence of ferroptosis.Results Compared with the control group,the mRNA and protein relative expression levels of FN,Col Ⅰand ACSL4 were increased in the HG group,while the mRNA and protein expression levels of GPX4 and SLC7A11 were decreased(P＜0.05).Compared with the HG+DMSO group,the mRNA and protein expression levels of FN,Col Ⅰand ACSL4,as well as levels of Fe2+and MDA were decreased in the HG+bufalin group,while the mRNA and protein expression levels of GPX4 and SLC7A11,and the level of GSH were increased(P＜0.05).In the HG+Fer-1 group,the mRNA and protein expression levels of GPX4 and SLC7A11 were increased,while the mRNA and protein expression levels of ACSL4,FN and Col Ⅰ were decreased(P＜0.05).The SwissTargetPrediction database and Metascape analysis function showed that the downstream functions of bufalin were closely related to lipid metabolism,inflammatory response,programmed cell death and ferroptosis-related pathways.The FerrDb analysis results indicated that the target sites of bufalin were closely related to ferroptosis markers.Compared with the HG+bufalin+DMSO group,the mRNA and protein expression levels of GPX4 and SLC7A11 were decreased in the HG+bufalin+Erastin group,while the mRNA and protein expression levels of ACSL4,FN and Col Ⅰ were increased(P＜0.05).Conclusion Bufalin attenuates extracellular matrix synthesis in HG-induced RTECs by inhibiting ferroptosis.

Objective To investigate the value of the combined detection of neutrophil CD64(nCD64),C-reactive protein(CRP)and lactate dehydrogenase(LDH)in the diagnosis of refractory Mycoplasma pneumoniae pneumonia(RMPP)in children.Methods A total of 147 children with Mycoplasma pneumoniae infection were enrolled and divided into the RMPP group(n=70)and the general Mycoplasma pneumoniae pneumonia group(GMPP,n=77)based on disease severity and treatment response.The age,gender,white blood cell count(WBC)within 24 hours of admission,serum procalcitonin(PCT),C-reactive protein(CRP)and lactate dehydrogenase(LDH)levels were collected in the study participants.The expression level of nCD64 in peripheral blood was measured using flow cytometry.Multivariate Logistic regression analysis was conducted to identify the independent risk factors associated with RMPP in children.Additionally,a receiver operating characteristic(ROC)curve was constructed to assess the diagnostic performance of the combined detection of nCD64,CRP and LDH for RMPP in children.Results The RMPP group had a longer hospital stay than the GMPP group(P＜0.05).Levels of nCD64,CRP and LDH were significantly higher in the RMPP group compared to those of the GMPP group(P＜0.05),and there were no significant differences in WBC and PCT levels between the two groups.Multivariate Logistic regression analysis showed that elevated nCD64,CRP and LDH were risk factors for RMPP in children(P＜0.05).ROC curve analysis revealed that the areas under the curve(AUC)for nCD64,CRP and LDH in diagnosing RMPP were 0.817,0.863 and 0.805,respectively.The combined detection of three indicators for AUC was 0.948.Conclusion The levels of nCD64,CRP and LDH in blood of children with RMPP are higher than those of children with GMPP.The combined detection of the three indicators has a high diagnostic value for RMPP in children with Mycoplasma pneumoniae pneumonia.

Objective To investigate the value of the combined detection of neutrophil CD64(nCD64),C-reactive protein(CRP)and lactate dehydrogenase(LDH)in the diagnosis of refractory Mycoplasma pneumoniae pneumonia(RMPP)in children.Methods A total of 147 children with Mycoplasma pneumoniae infection were enrolled and divided into the RMPP group(n=70)and the general Mycoplasma pneumoniae pneumonia group(GMPP,n=77)based on disease severity and treatment response.The age,gender,white blood cell count(WBC)within 24 hours of admission,serum procalcitonin(PCT),C-reactive protein(CRP)and lactate dehydrogenase(LDH)levels were collected in the study participants.The expression level of nCD64 in peripheral blood was measured using flow cytometry.Multivariate Logistic regression analysis was conducted to identify the independent risk factors associated with RMPP in children.Additionally,a receiver operating characteristic(ROC)curve was constructed to assess the diagnostic performance of the combined detection of nCD64,CRP and LDH for RMPP in children.Results The RMPP group had a longer hospital stay than the GMPP group(P＜0.05).Levels of nCD64,CRP and LDH were significantly higher in the RMPP group compared to those of the GMPP group(P＜0.05),and there were no significant differences in WBC and PCT levels between the two groups.Multivariate Logistic regression analysis showed that elevated nCD64,CRP and LDH were risk factors for RMPP in children(P＜0.05).ROC curve analysis revealed that the areas under the curve(AUC)for nCD64,CRP and LDH in diagnosing RMPP were 0.817,0.863 and 0.805,respectively.The combined detection of three indicators for AUC was 0.948.Conclusion The levels of nCD64,CRP and LDH in blood of children with RMPP are higher than those of children with GMPP.The combined detection of the three indicators has a high diagnostic value for RMPP in children with Mycoplasma pneumoniae pneumonia.

Objective:To explore the construction of an evaluation model for aortic root anatomy and calcium burden in patients with bicuspid aortic valve (BAV) stenosis before transcatheter aortic valve replacement (TAVR) based on deep learning (DL) algorithms.Methods:A retrospective collection of 362 BAV stenosis patients who underwent TAVR from September 2023 to May 2024 was performed. All patients underwent cardiac CT angiography. The patients were divided into training group ( n=104), internal validation group ( n=206), and external validation group ( n=52). A DL model was trained on the training dataset to assess aortic root anatomy and calcification burden. The evaluation included the segmentation accuracy of the algorithm, the measurement performance of key anatomical structures (i.e., valve leaflets and type-1 and type-2 fusion raphe), and calcification burden, as well as the measurement efficiency. Overall segmentation performance was assessed using the average Dice coefficient (ADC). The fine-scale segmentation quality was validated by the 95th-percentile Hausdorff distance (HD-95) and the average symmetric surface distance (ASSD). The consistency of the measurement results was assessed using the Pearson correlation coefficient and the intraclass correlation coefficient ( ICC) with a two-way mixed model for absolute agreement. In addition, the total time and total mouse movement distance required for manual assessment versus the DL model on the validation datasets were recorded and compared. Results:The algorithm demonstrated excellent segmentation performance on aortic root anatomical targets, achieving outstanding consistency within both internal and external validation datasets (0.955

Objective To investigate the effect and underlying mechanism of bufalin regulating ferroptosis on extracellular matrix synthesis in renal tubular epithelial cells(RTECs)under high glucose(HG)conditions.Methods RTECs were cultured in vitro and exposed to HG.The experimental groups included:the control group,the HG group,the HG+dimethyl sulfoxide(DMSO)group,the HG+bufalin group,the HG+ferrostatin-1(Fer-1)group,the HG+bufalin+DMSO group and HG+bufalin+erastin group.The expression levels of fibronectin(FN),type Ⅰ collagen(Col Ⅰ),acyl-CoA synthetase long-chain family member 4(ACSL4),solute carrier family 7 member 11(SLC7A11)and glutathione peroxidase 4(GPX4)were detected using Western blot assay and quantitative real-time PCR(qRT-PCR).The potential molecular targets of bufalin were predicted using SwissTargetPrediction,and functional enrichment analysis was conducted using Metascape.FerrDb was employed to analyze ferroptosis-related gene sets.The levels of ferrous ions(Fe2+),malondialdehyde(MDA)and glutathione(GSH)were measured using micro-methods to evaluate the occurrence of ferroptosis.Results Compared with the control group,the mRNA and protein relative expression levels of FN,Col Ⅰand ACSL4 were increased in the HG group,while the mRNA and protein expression levels of GPX4 and SLC7A11 were decreased(P＜0.05).Compared with the HG+DMSO group,the mRNA and protein expression levels of FN,Col Ⅰand ACSL4,as well as levels of Fe2+and MDA were decreased in the HG+bufalin group,while the mRNA and protein expression levels of GPX4 and SLC7A11,and the level of GSH were increased(P＜0.05).In the HG+Fer-1 group,the mRNA and protein expression levels of GPX4 and SLC7A11 were increased,while the mRNA and protein expression levels of ACSL4,FN and Col Ⅰ were decreased(P＜0.05).The SwissTargetPrediction database and Metascape analysis function showed that the downstream functions of bufalin were closely related to lipid metabolism,inflammatory response,programmed cell death and ferroptosis-related pathways.The FerrDb analysis results indicated that the target sites of bufalin were closely related to ferroptosis markers.Compared with the HG+bufalin+DMSO group,the mRNA and protein expression levels of GPX4 and SLC7A11 were decreased in the HG+bufalin+Erastin group,while the mRNA and protein expression levels of ACSL4,FN and Col Ⅰ were increased(P＜0.05).Conclusion Bufalin attenuates extracellular matrix synthesis in HG-induced RTECs by inhibiting ferroptosis.

Objective To investigate the effect and possible mechanism of microRNA-26a(miR-26a)on the syn-thesis of extracellular matrix(ECM)induced by high glucose(HG)in renal tubular epithelial cells(RTECs).Methods A model of diabetic kidney disease(DKD)was constructed by inducing RTECs with HG.MiR-26a was overexpressed in HG-induced RTECs,and RT-qPCR and Western blot were used to assess the effects of miR-26a on ECM synthesis and ferroptosis-related markers in HG-treated RTECs.Ferrostatin(Fer-1)was used to inhibit ferroptosis in the DKD model,and its impact on ECM synthesis was evaluated.RT-qPCR and Western blot were performed to measure ferroptosis-related markers,and fluorescence microscopy was used to observe the intensity of reactive oxygen species(ROS).Results Compared with the control group,the expression of miR-26a decreased in HG-treated cells,while the expression levels of ECM synthesis-related indexes fibronectin and collagen Ⅰ in-creased.After overexpressing miR-26a,the HG+miR-26a group showed a significant increase in miR-26a expres-sion and a decrease in fibronectin and collagen Ⅰ expression compared to the HG group.In terms of ferroptosis,the protein and mRNA expression of SLC7A11 and GPX4 significantly decreased,the expression of TFR-1 and AC-SL4 significantly increased,and the fluorescence intensity of ROS was significantly enhanced in the HG group com-pared with the control group.Inhibition of ferroptosis in the HG+Fer-1 group resulted in significant changes in fer-roptosis and ECM synthesis-related indicators expression levels compared to the HG group.Furthermore,re-expres-sion of miR-26a in the HG+miR-26a led to significant changes in ferroptosis-related indicators expression levels and decreased ROS fluorescence intensity compared to the HG group.Conclusions In HG-induced RTECs,miR-26a inhibits the occurrence of ferroptosis,thus reducing ECM synthesis.