Objective:To investigate the value of biparametric-MRI (bpMRI) based peritumoral radiomics for preoperative prediction of extraprostatic extension (EPE) in prostate cancer (PCa).Methods:In this cross-sectional study, consecutive bpMRI of patients undergoing prostatectomy for PCa were retrospectively collected from the First Medical Center (center 1) and the Third Medical Center (center 2) of Chinese PLA General Hospital. A total of 274 patients were finally enrolled. Patients at center 1 from January 2020 to December 2022 were randomly divided into a training set (149 cases) and an internal validation set (63 cases) by stratified random sampling. Patients at center 2 from January 2023 to March 2024 were assigned to the external test set (62 cases). Patients were categorized into EPE-positive group and EPE-negative group according to pathological assessment postoperatively. In the training set, there were 49 cases in EPE-positive group and 100 cases in EPE-negative group. In the internal validation set, there were 26 cases in EPE-positive group and 37 cases in EPE-negative group. In the external test set, there were 22 cases in EPE-positive group and 40 cases in EPE-negative group. Axial T 2WI and apparent diffusion coefficient (ADC) images were manually annotated to obtain index lesion regions of interest (ROIs), with the peritumoral ROIs subsequently delineated by semi-automatic segmentation technique. Radiomics features were extracted from intra-tumoral, peri-tumoral, and intra-tumoral plus peri-tumoral ROIs. The training set data was employed to select and optimize features to build the radiomics models. The logistic regression analysis was used to develop radiomics, clinical, and integrated models. The predictive performance was assessed by the area under the receiver operating characteristic curve (AUC) in the external test set, and compared by the DeLong test. The sensitivity and specificity were compared by the exact McNemar test. Results:In the external test set, the peri-tumoral radiomics model based on bpMRI showed the highest performance in evaluating EPE, with an AUC of 0.739 (95% CI 0.611-0.842), which was identified as the optimal radiomics model. EPE grade ( OR=6.151, 95% CI 3.371-11.226, P<0.001) was incorporated into the clinical model, with an AUC of 0.780 (95% CI 0.657-0.875) in the external test set. The integrated model had an AUC of 0.817 (95% CI 0.698-0.904) in the external test set. There was no statistically significant difference in comparisons of AUCs among the three models (all P>0.05). The sensitivity of the integrated model (68.2%) showed no significant difference from those of the clinical model and the optimal radiomics model (77.3% and 86.4%, respectively; P=0.500 and P=0.289). However, the specificity of the integrated model (85.0%) was significantly higher than those of the clinical model (67.5%, P=0.016) and the optimal radiomics model (50.0%, P<0.001). Conclusion:A bpMRI-based peritumoral radiomics integrating clinical model demonstrates high performance for preoperative prediction of EPE in PCa.

Acquired resistance to the proteasome inhibitor bortezomib(BTZ)poses a significant chal-lenge in the treatment of multiple myeloma(MM).During the acquisition of BTZ resistance,metabolic reprogramming is actively engaged in MM cells.However,the key regulatory genes and molecular mecha-nisms mediating bortezomib resistance through this metabolic rewiring have not been fully elucidated.This study aims to investigate the regulatory role of pyrimidine metabolites in drug resistance of MM and their underlying molecular mechanisms.Screening via CCK-8 assays demonstrated that the pyrimidine metabolite uridine is associated with BTZ resistance in MM(P＜0.05).In vitro experiments,including CCK-8 assays,Western blotting,and flow cytometry,demonstrated that uridine partially suppresses bort-ezomib-induced apoptosis in MM cells(P＜0.05).In vivo,experiments utilizing Vk*MYC mouse mod-els,subcutaneous tumor models,and intramedullary bone marrow transplantation models showed that the combination of BTZ and uridine significantly accelerated tumor growth,exacerbated bone destruction,and increased tumor cell infiltration in tumor-bearing mice(P＜0.05).RNA sequencing analysis re-vealed that uridine primarily affects mitochondrial translation in MM at the transcriptional level.Seahorse energy metabolism assays demonstrated that uridine enhances mitochondrial oxidative phosphorylation without significantly altering glycolysis.Transcriptomic analysis further identified a significant upregula-tion of cytochrome c oxidase subunit 5B(COX5B)transcription in uridine-treated groups(P＜0.05).Functional studies confirmed that COX5B is a key molecule mediating uridine's effects on mitochondrial function in MM cells.In conclusion,uridine promotes BTZ resistance in MM by upregulating COX5B transcription and protein expression,thereby enhancing cytochrome c oxidase activity and regulating mito-chondrial oxidative phosphorylation.This study delineates the role of uridine in the development of borte-zomib resistance in MM and elucidates its COX5B-mediated metabolic reprogramming mechanism,provi-ding a theoretical foundation for developing targeted therapies against relapsed/refractory MM.

BACKGROUND:The phosphatidylinositol 3-kinase/protein kinase(PI3K/AKT)signaling pathway plays a pivotal role in regulating osteoclast activation,which is essential for maintaining bone homeostasis.Bone destruction in osteoarticular tuberculosis is caused by aberrant osteoclastogenesis induced by Mycobacterium tuberculosis infection.However,the role of the PI3K signaling pathway in Mycobacterium tuberculosis-induced aberrant osteoclastogenesis remains unclear. OBJECTIVE:To investigate the effects and mechanisms of the PI3K/AKT signaling pathway inhibitor BYL-719 on aberrant osteoclastogenesis induced by Mycobacterium tuberculosis. METHODS:RAW264.7 cells were infected with bovine Mycobacterium tuberculosis bacillus calmette-cuerin vaccine,and Ag85B was used for cellular immunofluorescence staining.The cell counting kit-8 assay was employed to determine the safe concentration of BYL-719.There were four groups in the experiment:blank control group,BYL-719 group,BCG group,and BCG+BYL-719 group.Under the induction of receptor activator of nuclear factor kappa-B ligand,the effects of BYL-719 on post-infection osteoclast differentiation and fusion were explored through tartrate-resistant acid phosphatase staining and phalloidin staining.RT-PCR and western blot were used to detect the expression of osteoclast-related genes and proteins,and further investigate the mechanism of action. RESULTS AND CONCLUSION:Immunofluorescence staining showed that RAW264.7 cells phagocytosed Mycobacterium tuberculosis.Cell counting kit-8 data indicated that 40 nmol/L BYL-719 was non-toxic to cells.Tartrate-resistant acid phosphatase staining and phalloidin staining showed that BYL-719 inhibited the generation and fusion ability of osteoclasts following infection.RT-PCR and western blot results also indicated that BYL-719 suppressed the upregulation of osteoclast-specific genes(including c-Fos,NFATc1,matrix metalloproteinase 9,and CtsK)induced by Mycobacterium tuberculosis infection(P<0.05).Western blot and immunofluorescence staining revealed that BYL-719 inhibited excessive osteoclast differentiation induced by Mycobacterium tuberculosis by downregulating the expression of IκBα-p65.To conclude,BYL-719 inhibits aberrant osteoclastogenesis induced by Mycobacterium tuberculosis through the downregulation of IκBα/p65.Therefore,the IκBα/p65 signaling pathway is a potential therapeutic target for osteoarticular tuberculosis,and BYL-719 holds potential value for the preventing and amelioration of bone destruction in osteoarticular tuberculosis.BYL-719 has the potential to prevent and ameliorate bone destruction in osteoarticular tuberculosis.

Objective To establish a stable,reliable,and clinically relevant porcine model of endotoxin-induced acute respiratory distress syndrome(ARDS).Methods Ten 8-month-old male Bama minipigs were deeply sedated,followed by invasive mechanical ventilation and electrocardiographic monitoring.Lipopolysaccharide(LPS)was intravenously pumped at 600 μg/(kg·h)for 3 hours,then maintained at 15 μg/(kg·h)thereafter.Dynamic monitoring was performed at five time points after LPS injection(LPS 0,1,3,5,and 8 h),including arterial blood gas analysis and chest computed tomography(CT)scans.Pathological examination of lung tissues obtained via bronchoscopic biopsy(HE staining and transmission electron microscopy)was conducted.These indicators were comprehensively used to evaluate the success of the animal model.Results At 5 hours after LPS administration,8 minipigs developed symptoms such as skin cyanosis,elevated body temperature,and respiratory distress.The oxygenation index decreased to<300 mmHg.Chest CT scans showed diffuse pulmonary infiltrates.Histopathology revealed alveolar edema and hyaline membrane formation.Transmission electron microscopy demonstrated disruption of pulmonary blood-air barrier,depletion of lamellar bodies in type Ⅱ pneumocytes,inflammatory cell infiltration,and exudation of plasma proteins and fibrin.Compared with LPS 0 h,at LPS 8 h,the oxygenation index and arterial blood pH were significantly decreased(P<0.001),while blood lactic acid and serum potassium were significantly increased(P<0.05);serum calcium and base excess were significantly decreased(P<0.05),and the lung injury score based on HE-stained lung sections was significantly increased(P<0.01).Conclusion The porcine ARDS model established by continuous LPS injection can dynamically simulate the pathophysiological characteristics and typical pathological manifestations of clinical septic ARDS,making it an effective tool to study the pathogenesis,prevention,and treatment strategies of septic ARDS.

Objective:To evaluate the outcomes of intensive conservative treatment compared to conventional conservative treatment in patients with acute aortic syndrome(AAS).Methods:The study prospectively enrolled consecutive patients with AAS who were admitted to Beijing Anzhen Hospital, affiliated with Capital Medical University, and Beijing Dawanglu Emergency Rescue Hospital from January 2024 to December 2024. These patients with surgical contraindications or refused surgery for various reasons opted for conservative treatment. A total of 282 patients were included, and 15 patients with missing data or those who died without any treatment were excluded. Finally, 267 patients were enrolled, of whom 94 received intensive conservative treatment, and 173 received conventional conservative treatment, the inverse probability of treatment weighting (IPTW) was used to reduce the influence of confoundings. After adjusting of baseline datas via IPTW, the survival outcomes of the two groups were compared at 14 days, 30 days, and at the end of follow-up.Results:The results showed significant differences in acute phase survival rates between the enhanced conservative treatment group and the conventional conservative treatment group at 14 days(82.40%vs.53.20%, P<0.0001). Significant survival differences were also observed at 30 days and at 276-day mid-term follow-up (96.29% vs.51.60%, P<0.0001; 78.50% vs.48.50%, P<0.0001). In the subgroup analysis, for type A aortic dissection, the enhanced conservative treatment group had higher survival rates compared to the conventional conservative treatment group at 14, 30 and 276 days (63.46% vs.41.35%, P<0.05; 52.17% vs.37.90%, P<0.05; 50.00% vs. 31.97%, P<0.05). However, for type B aortic dissection, although the enhanced conservative treatment group had higher survival rates than the conventional conservative treatment group, no statistically significant differences were observed (96.29% vs. 80.00%, P=0.054; 95.65% vs.78.37%, P=0.067; 94.12% vs.74.20%, P=0.088). Conclusion:For patients diagnosed with AAS are forced to choose conservative treatment if emergency surgery is not possible in the first place, intensive conservative treatment strategies can significantly reduce the mortality in the acute phase compared with conventional conservative treatment. Mid-term follow-up, intensive conservative treatment still has a significant survival advantage.

The purpose of this survey was to understand the occurrence of hypocalcemia in dairy cows in large-scale pasture and its relationship with production performance,disease and culling.Eighty-one large-scale pastures were selected in China to carry out a questionnaire survey on the lactation performance,reproductive performance,disease status and culling situations of dairy cows,and analyzed the production data of dairy farms by SPSS software.The survey results show that the incidence of hypocalcemia in dairy cows in pasture was different,the subclinical type was nearly twice as high as the clinical type,and the incidence rate of hypocalcemia was higher in about 30％of pasture.Hypocalcemia has no obvious effect on the lactation performance of dairy cows on dairy farms.However,a high incidence rate can reduce the conception rate,increase the incidence of subclinical mastitis,ketosis,and other common internal diseases,and raise the annual culling rate and culling rate of adult cows.Clinical,subclinical and total incidence of hypocalcemia have differ-ent effects on reproduction and diseases such as mastitis and ketosis,but clinical hypocalcemia is more harmful.Hypocalcemia is still an important metabolic disease that harms the health and pro-duction of dairy cows in large-scale pastures in China.For farms with a high incidence rate,it is recommended to conduct regular monitoring of blood calcium levels in dairy cows before and after calving,and to conduct in-depth investigations into the related pathogenic factors.This will provide a scientific basis for improving the prevention measures for hypocalcemia,reducing the incidence of the disease,increasing reproductive efficiency,and reducing culling rates.

To clarify the current situation of ketosis in dairy cattle on large-scale pastures in China and provide new insights,a questionnaire survey was conducted to analyze the incidence,preven-tion,treatment methods,and associated costs of ketosis in 79 large-scale pastures.The results showed that the average incidence of ketosis in dairy cows was 3.97％,with a cure rate of 92.40％.The order of importance of methods for preventing and controlling ketosis was as follows:feed for-mulation optimization＞blood ketone monitoring＞negative energy balance monitoring＞feed in-take monitoring＞milk yield monitoring.The most important treatment methods are intravenous glucose＞propylene glycol butyl phosphate＞vitamins＞choline.The most important diagnostic methods are blood ketone testing＞milk ketone testing＞negative energy balance testing＞clinical symptoms＞blood glucose testing.Economic analysis revealed that treatment costs were lower on larger farms and higher milk yields farms.Continuous optimization of feeding management,preven-tion,and control measures should be implemented on large-scale farms in China to reduce the oc-currence of ketosis in dairy cows.Additionally,more effective diagnostic and treatment methods should be employed to improve the cure rate and overall farm income.

To clarify the current situation of ketosis in dairy cattle on large-scale pastures in China and provide new insights,a questionnaire survey was conducted to analyze the incidence,preven-tion,treatment methods,and associated costs of ketosis in 79 large-scale pastures.The results showed that the average incidence of ketosis in dairy cows was 3.97％,with a cure rate of 92.40％.The order of importance of methods for preventing and controlling ketosis was as follows:feed for-mulation optimization＞blood ketone monitoring＞negative energy balance monitoring＞feed in-take monitoring＞milk yield monitoring.The most important treatment methods are intravenous glucose＞propylene glycol butyl phosphate＞vitamins＞choline.The most important diagnostic methods are blood ketone testing＞milk ketone testing＞negative energy balance testing＞clinical symptoms＞blood glucose testing.Economic analysis revealed that treatment costs were lower on larger farms and higher milk yields farms.Continuous optimization of feeding management,preven-tion,and control measures should be implemented on large-scale farms in China to reduce the oc-currence of ketosis in dairy cows.Additionally,more effective diagnostic and treatment methods should be employed to improve the cure rate and overall farm income.

Acquired resistance to the proteasome inhibitor bortezomib(BTZ)poses a significant chal-lenge in the treatment of multiple myeloma(MM).During the acquisition of BTZ resistance,metabolic reprogramming is actively engaged in MM cells.However,the key regulatory genes and molecular mecha-nisms mediating bortezomib resistance through this metabolic rewiring have not been fully elucidated.This study aims to investigate the regulatory role of pyrimidine metabolites in drug resistance of MM and their underlying molecular mechanisms.Screening via CCK-8 assays demonstrated that the pyrimidine metabolite uridine is associated with BTZ resistance in MM(P＜0.05).In vitro experiments,including CCK-8 assays,Western blotting,and flow cytometry,demonstrated that uridine partially suppresses bort-ezomib-induced apoptosis in MM cells(P＜0.05).In vivo,experiments utilizing Vk*MYC mouse mod-els,subcutaneous tumor models,and intramedullary bone marrow transplantation models showed that the combination of BTZ and uridine significantly accelerated tumor growth,exacerbated bone destruction,and increased tumor cell infiltration in tumor-bearing mice(P＜0.05).RNA sequencing analysis re-vealed that uridine primarily affects mitochondrial translation in MM at the transcriptional level.Seahorse energy metabolism assays demonstrated that uridine enhances mitochondrial oxidative phosphorylation without significantly altering glycolysis.Transcriptomic analysis further identified a significant upregula-tion of cytochrome c oxidase subunit 5B(COX5B)transcription in uridine-treated groups(P＜0.05).Functional studies confirmed that COX5B is a key molecule mediating uridine's effects on mitochondrial function in MM cells.In conclusion,uridine promotes BTZ resistance in MM by upregulating COX5B transcription and protein expression,thereby enhancing cytochrome c oxidase activity and regulating mito-chondrial oxidative phosphorylation.This study delineates the role of uridine in the development of borte-zomib resistance in MM and elucidates its COX5B-mediated metabolic reprogramming mechanism,provi-ding a theoretical foundation for developing targeted therapies against relapsed/refractory MM.

The purpose of this survey was to understand the occurrence of hypocalcemia in dairy cows in large-scale pasture and its relationship with production performance,disease and culling.Eighty-one large-scale pastures were selected in China to carry out a questionnaire survey on the lactation performance,reproductive performance,disease status and culling situations of dairy cows,and analyzed the production data of dairy farms by SPSS software.The survey results show that the incidence of hypocalcemia in dairy cows in pasture was different,the subclinical type was nearly twice as high as the clinical type,and the incidence rate of hypocalcemia was higher in about 30％of pasture.Hypocalcemia has no obvious effect on the lactation performance of dairy cows on dairy farms.However,a high incidence rate can reduce the conception rate,increase the incidence of subclinical mastitis,ketosis,and other common internal diseases,and raise the annual culling rate and culling rate of adult cows.Clinical,subclinical and total incidence of hypocalcemia have differ-ent effects on reproduction and diseases such as mastitis and ketosis,but clinical hypocalcemia is more harmful.Hypocalcemia is still an important metabolic disease that harms the health and pro-duction of dairy cows in large-scale pastures in China.For farms with a high incidence rate,it is recommended to conduct regular monitoring of blood calcium levels in dairy cows before and after calving,and to conduct in-depth investigations into the related pathogenic factors.This will provide a scientific basis for improving the prevention measures for hypocalcemia,reducing the incidence of the disease,increasing reproductive efficiency,and reducing culling rates.