Objective:To analyze the application value of ultrasound Thyroid Imaging Reporting and Data System (TI-RADS) classification in the differential diagnosis of thyroid nodules and its correlation with patients' midkine, thymidine kinase 1, and thyroid function indicators.Methods:This study was a prospective study. A total of 108 patients with thyroid nodules (120 nodules) who visited Jinan 2 nd People's Hospital from December 2022 to February 2024 were included. Ultrasound examinations were conducted to complete the TI-RADS classification, and serum levels of midkine (MK) and thymidine kinase 1 (TK1), as well as thyroid function indicators, were measured. Based on the patients' pathological results, the consistency between the TI-RADS diagnostic results and the pathological findings was analyzed. The diagnostic efficacy of TI-RADS classification was calculated. The incidence of malignant nodules across various TI-RADS categories was assessed, and the differences in serum levels of MK, TK1, and thyroid function indicators between patients with benign and malignant nodules were compared. Additionally, a correlation analysis was performed to analyze the correlation between the TI-RADS classification of thyroid nodules and the serum levels of MK, TK1, and thyroid function indicators. Results:Pathological examination results revealed 38 malignant nodules and 82 benign nodules. The consistency between ultrasound TI-RADS classification diagnoses and pathological results was good ( Kappa = 0.90, P < 0.001), with diagnostic sensitivity, specificity, and accuracy of 86.84% (33/38), 97.56% (80/82), and 94.17% (113/120), respectively. Among the ultrasound TI-RADS classifications, the malignant rates for category Ⅳb and category Ⅴ thyroid nodules were the highest, at 92.00% (23/25) and 100.00% (10/10), respectively. Serum levels of MK, TK1, and thyroid-stimulating hormone (TSH) were significantly higher in patients with malignant thyroid nodules than in those with benign thyroid nodules (all P < 0.05). Correlation analysis indicated that TI-RADS classification was positively correlated with serum levels of MK, TK1, and TSH ( r = 0.56, 0.60, 0.52, all P < 0.05). Conclusions:Ultrasound TI-RADS classification can be used to differentiate the nature of thyroid nodules, demonstrating high accuracy with low risks of missed or misdiagnoses. It is also closely related to indicators such as MK, TK1, and TSH, providing a basis for the detection of thyroid cancer.

Objective To explore the characteristics and influencing factors of complicated intra-abdominal infection in ICU patients after abdominal surgery.Methods A retrospective study was performed on ICU patients(n=92,observation group)developing complicated intra-abdominal infection after abdominal surgery versus patients(n=104,control group)without complicated intra-abdominal infection after abdominal surgery in our hospital from January 2020 to December 2023.The characteristics of patients who developed complicated intra-abdominal infections were analyzed and the relevant influencing factors were identified using multivariate Logistic regression analysis.Results A total of 124 strains of pathogenic bacteria were isolated and identified in 92 infected patients,with 64.52％(80/124)of Gram-negative strains comprising mainly 29.03％(36/124)of Escherichia coli,25.81％(32/124)of Gram-positive strains comprising mainly 12.90％(16/124)of Enterococcus faecalis,and 9.68％(12/124)of fungi comprising mainly 6.45％(8/124)of Candida albicans.Multivariate Logistic regression results showed that preoperative underlying disease,surgical methods,duration of surgery,invasive procedures,antibiotic use,and length of ICU stay,enteral nutrition were the influencing factors of complicated intra-abdominal infection in ICU patients after abdominal surgery(P＜0.0 5).Conclusion Patients with complicated intra-abdominal infection are infected with a variety of pathogenic bacteria,predominantly Gram-negative.The patient's preoperative underlying disease,surgical approach,duration of surgery,invasive procedures,use of antibiotics,length of ICU stay,and early enteral nutrition all affect the risk of complicated intra-abdominal infection in ICU patients after abdominal surgery.

AIM To explore the clinical effects of Tongfu Jiangzhuo Formula on ICU delirium patients with Internal Accumulation of Turbid Toxins.METHODS Based on Turbid Toxins theory,two hundred and ten patients were randomly assigned into control group(105 cases)for intervention of conventional treatment,and observation group(105 cases)for intervention of both Tongfu Jiangzhuo Formula and conventional treatment.The changes in clinical effects,delirium scores(CAM-ICU,ICDSC),TCM syndrome score,inflammatory factors(IL-1β,IL-6,IL-8),Raf-1,MEK-2,ERK-1 mRNA and incidence of adverse reactions were detected.RESULTS The observation group demonstrated higher total effective rate than the control group(P＜0.05).After the treatment,the two groups displayed decreased delirium scores,TCM syndrome score,inflammatory factors and Raf-1,MEK-2,ERK-1 mRNA(P＜0.05),especially for the observation group(P＜0.05).No significant difference in incidence of adverse reactions was found between the two groups(P＞0.05).CONCLUSION For the patients with ICU delirium due to Internal Accumulation of Turbid Toxins,Tongfu Jiangzhuo Formula can safely and effectively improve symptoms,and reduce inflammation levels and Raf-1,MEK-2,ERK-1 mRNA expressions.

This review is based on the research progress and challenges of immune checkpoint inhibitors (ICIs) in the treatment of hepatocellular carcinoma (HCC). ICIs block the PD-1/PD-L1 and CTLA-4 pathways; thereby reactivate the body’s anti-tumor immune response, providing a new therapeutic option for patients with advanced HCC. However, the effect of ICIs is still compromised by factors such as primary and acquired resistance, immune-related adverse events and tumor microenvironment inhibition. This reveiw deeply analyzes these key mechanisms that affect the efficacy of ICIs, and proposes strategies to optimize the treatment, including combination with targeted therapy, chemotherapy and radiotherapy, modulation of tumor microenvironment, and the development of novel biomarkers. Future research should focus on personalized treatment that integrates the molecular and immunological characteristics of patients to enhance the precision and efficacy of ICIs therapy for patients with HCC.

This study assessed the role and mechanism of the recombinant Bacillus Calmette-Gue?rin vaccine(rBCG)with c-di-AMP adjuvant in regulating metabolism and immunity in epididymal white adipose(eWAT)in mice.Male C57BL/6 mice were intravenously immunized with BCG and rBCG,and their body weights were monitored.eWAT was isolated from the mice,and the stromal vascular fractions(SVFs)cell number was counted with a hemocytometer.Sections of mouse adipose tissue were prepared,and the size,number,and morphology of eWAT adipocytes and crown-like structure(CLS)formation were compared under a microscope after HE staining.The transcription levels of lipid metabolism-associated factors,cytokines and aging-associated genes in each group were determined with qRT-PCR.The body weights of mice gradually increased after immunization with BCG and rBCG.The proportions of eWAT increased,and the SVFs cell number decreased,in rBCG immunized mice.HE staining indicated that BCG immunization promoted hyperplasia,whereas rBCG immunization promoted hypertrophy of eWAT adipocytes;moreover,both BCG and rBCG immunization induced CLS formation in eWAT.The qRT-PCR results indicated that rBCG immunization inhibited the expression of genes associated with lipolysis and energy expenditure in eWAT.BCG immunization had little effect on cytokine transcription,whereas rBCG significantly induced the transcription of IFN-γ and IL-1Ra,and inhibited that of IL-15 and IL-2,but did not induce the expression of aging-associated genes.Thus,rBCG immunization induced eWAT adipocyte hypertrophy,which was associated with the inhibition of eWAT lipolysis and the regulation of cytokine expression.

Objective:To explore the experience of emotion management and program needs of patients with vasovagal syncope (VVS) from the doctor-nurse-patient perspective.Methods:This study was a phenomenological study in qualitative research. Using purposive sampling method, four medical specialists, four nursing specialists, and 10 patients with VVS from the Syncope Center of Shanghai East Hospital, Tongji University were selected from March to May 2024 for semi-structured interviews. Colaizzi's phenomenological data analysis was used to analyze the data.Results:Theme 1 was the initial perception and experience of emotion management, in which the doctor-nurse perspective included two sub-themes of emotion management met the actual needs of clinical patients and the management program was too specialized and unknown, and the patient perspective included three sub-themes of differences in the ability of individuals to recognize their own emotional state, lack of knowledge related to emotion management, and lack of social support. Theme 2 was the need for emotion management programs, in which the doctor-nurse perspective involved two sub-themes of multidisciplinary cooperation, suitable for clinical operation and follow-up, and the combination of online and offline, and in-hospital and out-of-hospital linkage, and the patient perspective involved two sub-themes of the need for healthcare guidance, easy to operate, and the diversification of forms, personalization, and meeting the needs of different populations.Conclusions:The content of emotion management is relatively unknown to doctors, nurses and patients, and even more so to patients. VVS emotion management work is still in its infancy, and emotion management as a branch of rehabilitation needs to be emphasized for its development, and psychological assessment and intervention work should be incorporated into the routine of syncope rehabilitation.

Objective:To investigate the expression of LINC01088 in breast cancer and its effects on cell prolifera-tion,migration,and invasion.Methods:GEPIA and bc-GenExMiner were used to analyze the correlation between LINC01088 expression levels and clinical characteristics as well as prognosis.The expression of LINC01088 in MCF10A and MDA-MB-231,BT-549,MCF7 were detected by Real-time PCR.The effect of LINC01088 on the biological func-tion of breast cancer cells was examined by overexpressing LINC01088 in breast cancer cells.Cell proliferation was as-sessed using the Incucyte assay,while cell migration and invasion were evaluated using Transwell assays.Western blot-ting was employed to detect the expression of proteins associated with cell proliferation and metastasis.Results:LINC01088 expression was significantly lower in breast cancer tissues compared to normal breast tissues(P<0.05).Data from the bc-GenExMiner database revealed higher LINC01088 expression in HER2 positive patients(P<0.0001),corre-lating with longer overall survival(P=0.0006)and disease-free survival(P=0.0002).The mRNA expression level of LINC01088 in normal breast epithelial cell line was higher than that in breast cancer cell lines(P<0.05).Overexpression of LINC01088 significantly reduced proliferation,migration,and invasion in three breast cancer cell lines(P<0.01).Addi-tionally,LINC01088 upregulated p21 and p27(P<0.01),while downregulating Snail,Slug,PI3K,and phosphorylated Akt(P<0.05).Conclusion:LINC01088 expression was significantly reduced in human breast cancer.In vitro,LINC01088 in-hibited the proliferation,migration,and invasion of breast cancer cells.This effect may be attributed to its role in sup-pressing the PI3K-AKT pathway and epithelial-mesenchymal transition.

Objective:To explore the mechanism of curcumin (Cur) in intervening leukemia based on transcriptomics and network pharmacology.Methods:(1) Cell proliferation experiment: Leukemia MV-4-11 cells were cultured in vitro and divided into the control group (DMSO), 15 μmol/L curcumin group (Cur 15 μmol/L), and 20 μmol/L curcumin group (Cur 20 μmol/L). The CFSE method by flow cytometry was used to determine the inhibitory effect of curcumin on the growth of leukemia MV-4-11 cells at 0, 24, and 48 hours. (2) Network pharmacology analysis: the Smiles number of curcumin was obtained using the PubChem database. The targets of curcumin were retrieved from SwissTargetPrediction, SEA, TTD, and CTD platforms. Leukemia-related targets were screened using Genecards, OMIM, TTD, and CTD databases, and the intersection targets of curcumin-leukemia were further collected. (3) Transcriptomics and network pharmacology analysis: RNA from MV-4-11 cells in the control group and Cur group was collected, transcriptome sequencing was performed, and the common targets of differential genes in network pharmacology and transcriptomics were collected. The STRING website and Cytoscape software were used to construct a protein-protein interaction (PPI) network for the intersection targets. The David database and micro-bioinformatics were used for enrichment analysis based on gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) databases. Finally, the core targets and main pathways of curcumin in anti-leukemia were screened out.Results:(1) Compared with the control group, 15 μmol/L and 20 μmol/L curcumin significantly inhibited the proliferation of MV-4-11 cells (all P<0.05). (2) Network pharmacology analysis showed 1 209 curcumin drug targets and 7 702 leukemia-related targets, with 901 intersection targets for curcumin′s anti-leukemia effect. (3) Transcriptome sequencing showed 14 714 genes expressed in the curcumin group and 13 689 genes in the control group, with a total of 3 064 differentially expressed genes, including 2 189 up-regulated genes and 875 down-regulated genes. There were 182 intersection targets between network pharmacology and transcriptomics. KEGG enrichment results indicated that the anti-leukemia targets of curcumin were mainly related to cancer signaling pathways, phosphatidylinositol-3-kinase signaling pathway (PI3K-Akt) signaling pathway, and mitogen-activated protein kinase (MAPK) signaling pathway. Conclusions:This study obtained the gene expression profile of curcumin acting on leukemia and elaborated the molecular mechanism of inhibiting leukemia cell proliferation, which is mainly involved in cancer signaling pathways, PI3K-Akt signaling pathway, MAPK signaling pathway, etc., indicating that the inhibitory effect of curcumin on leukemia is multi-faceted and multi-level.

Objective:To identify the nucleotide sequence of a novel HLA-DRB1*12: 106 allele. Methods:A blood donor who was joined into the database for platelet matching transfusion at the Blood Center of Zhejiang Province in 2023 was selected as the study subject. HLA genotyping was carried out through next-generation sequencing based on AllType NGS 11 locus, AllType FASTPlex NGS reagents, and Sanger sequencing method. The HLA genotype of the donor by Sanger sequencing and next generation sequencing were assigned by using uTYPE 7.3 and TypeStream Visual 3.0 software, respectively. This study was approved by Medical Ethics Committee of the Zhejiang Blood Center (Ethics No. Provincial Blood Center Ethics Review 2022 Research No. 001). Results:A novel HLA-DRB1*12 allele has been identified, and the full coding sequence has been submitted to the GenBank database (No. OR101190), and the length of submitted sequence was 801 bp, which was officially named as HLA-DRB1*12: 106 by the WHO Nomenclature Committee for Factors of the HLA System (submission No. HWS10066755). Compared with the sequence of the highest homology ( HLA-DRB1*12: 01: 01: 01 allele), a single nucleotide change was identified at position 344 T>G in the exon 2 of the HLA-DRB1*12: 106, which has resulted in replacement of Valine by Glycine at residue 86. The HLA genotype of the proband was determined as HLA-A*02: 01, 11: 01; -B*13: 02, 40: 01; -C*01: 02, 03: 03; -DRB1*07: 01, 12: 106; -DRB3*01: 01; -DRB4*01: 03; -DQA1*02: 01, 04: 01; -DQB1*02: 02, 04: 02; -DPA1*01: 03, 01: 03; -DPB1*02: 01: 02G, 04: 01: 01G. Conclusion:A novel HLA-DRB1 allele has been identified in the Chinese population. The mutated amino acid, located in the peptide binding region of the β chain, may affect the binding characteristics of antigen peptides.

This review delves into the pivotal role of necrotic apoptosis in Alzheimer's disease(AD),with a focus on treatment strategies,drug development,prospects,and challenges,highlighting its significance in the progression of the disease.Firstly,necrotic apoptosis plays a crucial role in the pathogenesis of AD,particularly in association with the abnormal metabolism of β-amyloid(Aβ)and Tau proteins.The primary focus of drug design is to regulate the metabolism pathways of these two proteins to slow down or inhibit the progression of necrotic apoptosis.Secondly,the progress in drug development further emphasizes the importance of necrotic apoptosis in treating AD.Current research mainly focuses on drugs that affect the metabolism of Aβ and Tau proteins,such as lecanemab.Still,inconsistent result underscore the necessity for a more comprehensive understanding of the molecular mechanisms of necrotic apoptosis.Finally,the prospects and challenges of necrotic apoptosis research in AD are thoroughly discussed.A deeper understanding of necrotic apoptosis contributes to a better comprehension of the pathological mechanisms of AD but also may reveal new therapeutic targets.However,challenges such as multifactorial influences and the selection of treatment timing necessitate further in-depth research in the future.In conclusion,this review advocates for future research to deepen the understanding of the molecular mechanisms of necrotic apoptosis,enhance research on treatment strategies,gain a deeper understanding of its cross-regulation with other cell death pathways,and promote collaboration between basic research and clinical practice to advance the comprehensive understanding and treatment of Alzheimer's disease and necrotic apoptosis.