Objective To explore the clinical value of artificial intelligence (AI) quantitative parameters in distinguishing pathological grades of stageⅠ invasive adenocarcinoma (IAC). Methods Clinical data of patients with clinical stageⅠ IAC admitted to Yantaishan Hospital Affiliated to Binzhou Medical University from October 2018 to May 2023 were retrospectively analyzed. Based on the 2021 WHO pathological grading criteria for lung adenocarcinoma, IAC was divided into gradeⅠ, grade Ⅱ, and grade Ⅲ. The differences in parameters among the groups were compared, and logistic regression analysis was used to evaluate the predictive efficacy of AI quantitative parameters for grade Ⅲ IAC patients. Parameters were screened using least absolute shrinkage and selection operator (LASSO) regression analysis. Three machine learning models were constructed based on these parameters to predict grade Ⅲ IAC and were internally validated to assess their efficacy. Nomograms were used for visualization. Results A total of 261 IAC patients were included, including 101 males and 160 females, with an average age of 27-88 (61.96±9.17) years. Six patients had dual primary lesions, and different lesions from the same patient were analyzed as independent samples. There were 48 patients of gradeⅠ IAC, 89 patients of grade Ⅱ IAC, and 130 patients of grade Ⅲ IAC. There were statitical differences in the AI quantitive parameters such as consolidation/tumor ratio (CTR), ect among the three goups. (P<0.05). Univariate analysis showed that the differences in all variables except age were statistically significant (P<0.05) between the group gradeⅠ+grade Ⅱand the group grade Ⅲ . Multivariate analysis suggested that CTR and CT standard deviation were independent risk factors for identifying grade Ⅲ IAC, and the two were negatively correlated. Grade Ⅲ IAC exhibited advanced TNM staging, more pathological high-risk factors, higher lymph node metastasis rate, and higher proportion of advanced structure. CTR was positively correlated with the proportion of advanced structures in all patients. This correlation was also observed in grade Ⅲ but not in gradeⅠand grade ⅡIAC. CTR and CT median value were selected by using LASSO regression. Logistic regression, random forest, and XGBoost models were constructed and validated, among which, the XGBoost model demonstrated the best predictive performance. Conclusion Cautious consideration should be given to grade Ⅲ IAC when CTR is higher than 39.48% and CT standard deviation is less than 122.75 HU. The XGBoost model based on combined CTR and CT median value has good predictive efficacy for grade Ⅲ IAC, aiding clinicians in making personalized clinical decisions.

Objective To analyze the distribution characteristics of traditional Chinese medicine(TCM)syndrome types in patients with osteoporosis and the distribution differences of clinical and serological indicators in TCM syndrome types.Meth-ods A total of 69 patients with osteoporosis were collected from the Third Affiliated Hospital of Guangzhou University of Chinese Medicine and Qifu Hospital Affiliated to Jinan University.The general information,bone mineral density T value,fasting periph-eral venous blood in the morning were collected.The expression of telomerase protective factor 1(POT1),telomerase reverse transcriptase(TERT),serum 8-hydroxy-2'-deoxyguanosine(8-OHdG)and superoxide dismutase 2(SOD2)were detected by ELISA.Finally,the above data were statistically analyzed.Results There were significant differences in body weight,height,bone mineral density,POT1,TERT,and 8-OHdG among the four syndromes(P＜0.05).In terms of correlation,the relation-ship between bone mineral density and each parameter in different syndrome types was explored.The bone mineral density of qi stagnation and blood stasis syndrome was positively correlated with SOD2 value.There is a positive correlation between bone min-eral density and 8-OHdG in patients with Yin deficiency of liver and kidney.TERT was positively correlated with qi stagnation and blood stasis syndrome.Liver and kidney Yin deficiency syndrome was positively correlated with weight and bone mineral den-sity,and negatively correlated with TERT value.Weight was negatively correlated with qi and blood stasis syndrome.Conclusion In TCM syndrome differentiation of osteoporosis,there were statistical differences in weight,height,bone mineral density,ser-um POT1,TERT and 8-OHdG among Qi-stagnation and blood stasis,spleen-kidney Yang deficiency,liver-kidney Yin deficiency and Qi-blood-peace syndrome.In different syndrome types,serum SOD2 and 8-OHdG were the influencing factors of bone miner-al density.Serum TERT and 8-OHdG are the main factors affecting the dialectical classification of osteoporosis.

Osteoporosis （OP） is a systemic metabolic bone disease. Amid population aging， OP has become a major health problem for the middle-aged and the elderly in China. Aging， iron load， and estrogen deficiency break the balance between oxidation and antioxidant systems， and the increase of reactive oxygen species mediates oxidative stress to damage DNA， lipids， proteins and other macromolecules， thus accelerating cell apoptosis and inducing OP， obesity， and neurodegenerative disorders. It has been found that oxidative stress is of great significance in the pathogenesis of OP. Oxidative stress regulates the signaling pathways， cytokines， and proteins related to the mesenchymal stem cells， osteoblasts， and osteoclasts， thereby weakening the osteogenic differentiation of mesenchymal stem cells， inhibiting osteoblast mineralization， and promoting the activation， proliferation， and maturation of osteoclasts. As a result， the dynamic imbalance between bone resorption and bone formation occurs， influencing bone remodeling and promoting the progression of OP. At the moment， anti-bone resorption drugs， bone formation-promoting drugs， and hormones are mainly used in clinical settings in western medicine. However， due to the long treatment cycle and the occurrence of serious gastrointestinal reactions， hypocalcemia， osteonecrosis， and others， patients show poor compliance and thus the effect is not as expected. Traditional Chinese medicine （TCM） demonstrates remarkable effect on OP attributing to the multi-pathway and multi-target characteristics. With low price and few adverse reactions， TCM is widely applied in clinical practice in comparison with western medicine. TCM has unique advantages in the treatment of OP by regulating oxidative stress. It exerts the therapeutic effect on OP by modulating different signaling pathways， providing new mindset for the treatment of this disease. Therefore， through literature research， this study summarized the research on mechanism of oxidative stress in OP and the treatment by TCM， which is expected to lay a foundation for further research.

【Objective】 To identify and propose blood transfusion suggestions for 3 children suspected to have red blood cell T polyagglutination. 【Methods】 According to the RBC reactions with phytohemagglutinin, adult serum and cord blood serum, aggregation test with polybrene reagent and MN antigen phenotype test were carried out on 3 children to confirm the presence of T polyagglutination. The donor serum with negative or weak reactions was selected by minor cross matching for the 3 children who needed therapeutic plasma exchange(TPE). 【Results】 Three cases of RBC T polyagglutination were caused by bacterial infection, with transient appearance of MN antigen; the samples were reactive to peanut agglutinin, soybean agglutinin, adult serum but nonreactive to cord blood serum, and didn′t aggregate after adding polybrene reagent. After receiving timely TPE, the T polyagglutination gradually disappeared. 【Conclusion】 Some bacteria, such as Streptococcus pneumoniae, may cause polyagglutination of red blood cells. The patients with suspected T polyagglutination should be diagnosed in time. For T polyagglutination patients, the minor matched plasma should be used for avoiding the random plasma with anti-T antibody transfusion.

Objective:To investigate the clinical effect of hearing aid combined with cognitive rehabilitation training in the treatment of dementia with hearing loss.Methods:Forty-six cases of dementia patients with hearing loss in Dalian Municipal Central Hospital Affiliated of Dalian Medical University from September 2019 to September 2020 were divided into two groups by random number table method. The treatment group received cognitive rehabilitation training assisted by sound amplifier, while the control group only received cognitive rehabilitation training for 7 weeks. Before and after treatment, questionnaires were used to evaluate the training effect of patients, including MMSE, HAMA, HAMD and ADL, and satisfaction questionnaire was used to evaluate the satisfaction of caregivers.Results:After treatment, the MMSE score of the treatment group was significantly higher than that of the control group: (20.22 ± 3.38) scores vs. (19.89 ± 3.10) scores ( P<0.05), and HAMA and HAMD were significantly lower than those of the control group: (11.43 ± 5.07) scores vs. (11.83 ± 4.79) scores, (8.39±3.37) scores vs. (9.67 ± 5.34) scores ( P<0.05); there was no difference in activities of daily living between the treatment group and the control group ( P>0.05); the caregiver satisfaction of the treatment group was significantly improved, compared with that of the control group ( P<0.05). Conclusions:Hearing assisted cognitive training can improve the cognitive function of patients with hearing-impaired dementia, promote mental and emotional stability, and improve the feelings of caregivers; we emphasize the importance of hearing evaluation for the elderly with dementia, and the importance of cognitive rehabilitation training with hearing assistance.

Objective:To study the application value of flexible endoscopic examination of swallowing(FEES) for the aspiration screening, the diagnosis of dysphagia and evaluation of the therapeutic effectin acute stroke patients with dysphagia.Methods:Three hundred and seventy-three patients with acute stroke who hospitalized from October 2015 to January 2020 in Dalian Municipal Central Hospital Affiliated of Dalian Medical University and underwent FEES for analyzing the characteristic performance were enrolled, and 11 cases of them were examined by video fluoroscopic swallowing study (VFSS). The results of the reliability of diagnosis dysphagia of the two methods were compared. The results of FEES for assessing the recovery effect after treatment were evaluated.Results:In 373 patients, the FEES revealed 268 cases(71.85%) of aspiration (99 cases) were recessive aspiration, which was better than that in water swallow test (50.94%, 190/373). Patients with potential cricopharyngeus achalasia got the same results through both of VFSS and FEES. FEES could provide more positive indicators and guide clinical rehabilitation treatment and objective assessment of rehabilitation effectiveness.Conclusions:Acute stroke patients with dysphagia have characteristic laryngeal performance. FEES is simple to operate and has high application value.

Objective:to investigate the efficacy of drugs in the treatment of laryngeal granuloma after hypothermic plasma radiofrequency surgery in early glottic carcinoma.Methods:Thirty-two cases of laryngeal granulomacoming from 289 patients with early glottic carcinoma treated by plasma radiofrequency surgery under endoscope-supported laryngoscopefrom January 2011 to January 2021 in Dalian Municipal Central Hospital were enrolled. All patients were given oral treatment of zinc gluconate tablets (70 grams per tablet, containing 10 grams of zinc). The usage was 3 tablets each time, twice a day. If the granulation was located in the vocal cord, 20 mg of esomeprazolec was added twice a day, and taken orally on an empty stomach. The total course of treatment was 6-12 weeks.Results:Follow-up and reexamination of electronic laryngoscope showed that the granulation of all patients began to become smaller after 3 weeks of drug treatment and gradually disappeared after 6-12 weeks. After the granulation disappeared, the drug was stopped, and there was no recurrence.Two patients developed nausea and epigastric discomfort after oral administration of zinc gluconate tablets for 3 weeks, and the discomfort disappeared after reducing the dose.Conclusions:Oral administration of zinc gluconate tablets alone or in combination with esomeprazoleis an effective, safe and low recurrence method for laryngeal granuloma after hypothermic plasma radiofrequency ablation in early glottic carcinoma.

Purpose: C5α receptor 1 (C5ΑR1) is associated with the development of various human cancers. However, whether it is involved in the development of hepatitis B virus (HBV)–related hepatocellular carcinoma (HCC) is poorly understood. We explored the expression, biological role, and associated mechanisms of C5AR1 in HBV-related hepatoma cells. Materials and Methods: The expression of C5ΑR1 mediated by HBV and HBV core protein (HBc) was detected in hepatoma cells. The function of nuclear factor кB (NF-κB) pathway in HBc-induced C5AR1 expression was assessed. The roles of C5ΑR1 in the activation of intracellular signal pathways, the upregulation of inflammatory cytokines, and the growth and migration of hepatoma cells mediated by HBc, were investigated. The effect of C5α in the development of HCC mediated by C5AR1 was also measured. Results: C5ΑR1 expression was increased in HBV-positive hepatoma cells. Dependent on HBc, HBV enhanced the expression of C5ΑR1 at the mRNA and protein levels. Besides, HBc could promote C5ΑR1 expression via the NF-κB pathway. Based on the C5ΑR1, HBc facilitated the activation of JNK and ERK pathways and the expression and secretion of interleukin-6 in hepatoma cells. Furthermore, C5ΑR1 was responsible for enhancing the growth and migration of hepatoma cells mediated by HBc. Except these, C5α could promote the malignant development of HBc-positive HCC via C5AR1. Conclusion We provide new insight into the mechanisms of hepatocarcinogenesis mediated by HBc. C5ΑR1 has a significant role in the functional abnormality of hepatoma cells mediated by HBc, and might be utilized as a potential therapeutic target for HBV-related HCC.

Purpose: C5α receptor 1 (C5ΑR1) is associated with the development of various human cancers. However, whether it is involved in the development of hepatitis B virus (HBV)–related hepatocellular carcinoma (HCC) is poorly understood. We explored the expression, biological role, and associated mechanisms of C5AR1 in HBV-related hepatoma cells. Materials and Methods: The expression of C5ΑR1 mediated by HBV and HBV core protein (HBc) was detected in hepatoma cells. The function of nuclear factor кB (NF-κB) pathway in HBc-induced C5AR1 expression was assessed. The roles of C5ΑR1 in the activation of intracellular signal pathways, the upregulation of inflammatory cytokines, and the growth and migration of hepatoma cells mediated by HBc, were investigated. The effect of C5α in the development of HCC mediated by C5AR1 was also measured. Results: C5ΑR1 expression was increased in HBV-positive hepatoma cells. Dependent on HBc, HBV enhanced the expression of C5ΑR1 at the mRNA and protein levels. Besides, HBc could promote C5ΑR1 expression via the NF-κB pathway. Based on the C5ΑR1, HBc facilitated the activation of JNK and ERK pathways and the expression and secretion of interleukin-6 in hepatoma cells. Furthermore, C5ΑR1 was responsible for enhancing the growth and migration of hepatoma cells mediated by HBc. Except these, C5α could promote the malignant development of HBc-positive HCC via C5AR1. Conclusion We provide new insight into the mechanisms of hepatocarcinogenesis mediated by HBc. C5ΑR1 has a significant role in the functional abnormality of hepatoma cells mediated by HBc, and might be utilized as a potential therapeutic target for HBV-related HCC.

The clinical application of biological immunotherapy such as chimeric antigen receptor T cells (CAR-T) and novel targeted therapy has explored a new therapy for multiple myeloma (MM) treatment. Targeting B-cell maturation antigen (BCMA), allogeneic CAR-T, antibody-drug conjugate (ADC) and bispecific antibody targeting BCMA have achieved remarkable efficacy and safety in many clinical studies. This article introduces the latest immunotherapy for MM at the 62nd American Society of Hematology (ASH) Annual Meeting.