Objective To analyze the application effects of artificial intelligence (AI) software and Mimics software in preoperative three-dimensional (3D) reconstruction for thoracoscopic anatomical pulmonary segmentectomy. Methods A retrospective analysis was conducted on patients who underwent thoracoscopic pulmonary segmentectomy at the Second People's Hospital of Huai'an from October 2019 to March 2024. Patients who underwent AI 3D reconstruction were included in the AI group, those who underwent Mimics 3D reconstruction were included in the Mimics group, and those who did not undergo 3D reconstruction were included in the control group. Perioperative related indicators of each group were compared. Results A total of 168 patients were included, including 73 males and 95 females, aged 25-81 (61.61±10.55) years. There were 79 patients in the AI group, 53 patients in the Mimics group, and 36 patients in the control group. There were no statistical differences in gender, age, smoking history, nodule size, number of lymph node dissection groups, postoperative pathological results, or postoperative complications among the three groups (P>0.05). There were statistical differences in operation time (P<0.001), extubation time (P<0.001), drainage volume (P<0.001), bleeding volume (P<0.001), and postoperative hospital stay (P=0.001) among the three groups. There were no statistical differences in operation time, extubation time, bleeding volume, or postoperative hospital stay between the AI group and the Mimics group (P>0.05). There was no statistical difference in drainage volume between the AI group and the control group (P=0.494), while there were statistical differences in operation time, drainage tube retention time, bleeding volume, and postoperative hospital stay (P<0.05). Conclusion For patients requiring thoracoscopic anatomical pulmonary segmentectomy, preoperative 3D reconstruction and preoperative planning based on 3D images can shorten the operation time, postoperative extubation time and hospital stay, and reduce intraoperative bleeding and postoperative drainage volume compared with reading CT images only. The use of AI software for 3D reconstruction is not inferior to Mimics manual 3D reconstruction in terms of surgical guidance and postoperative recovery, which can reduce the workload of clinicians and is worth promoting.

BACKGROUND: Previous studies have reported that early computed tomography (CT) findings significantly contribute to the outcomes of cardiac arrest (CA) patients. This study aims to evaluate the association between chest CT features and prognosis in CA patients treated with extracorporeal cardiopulmonary resuscitation (ECPR). METHODS: A retrospective observational study was conducted on adult CA patients treated with ECPR in a tertiary hospital between March 2015 and June 2023. All the patients underwent a whole-body CT scan within 1 h of ECPR. Data regarding demographic and clinical characteristics were collected from electronic medical records. The presence of gravity-dependent distribution and CT scores based on chest CT scans were determined for each patient. The primary outcome was 28-day survival. Receiver operating characteristic (ROC) curves were used to evaluate the ability of chest CT features (gravity-dependent distribution and CT scores) to predict poor outcomes. The cut-off value of the CT score was determined. Kaplan-Meier curves were used to compare 28-day survival between the low- and high-CT score groups, which were classified using the estimated cut-off value. RESULTS: Among the 100 patients included, 74 were non-survivors. The non-survivor patients showed a higher presence of gravity-dependent distribution and higher CT scores than survivors (P<0.05). Patients with gravity-dependent distribution had significantly higher CT scores than those with non-gravity-dependent distribution (P<0.05). The combination of CT score and gravity-dependent distribution predicted poor outcomes better than considering the features individually, demonstrating moderate performance (AUC: 0.693, 95% CI: 0.568-0.801). According to the survival analysis, the risk of death increased as the CT score rose, with an estimated cut-off value of ≥ 11 (P=0.016). CONCLUSION: Chest CT features were associated with poor outcomes in CA patients following ECPR.

Objective To evaluate whether Vibrio vulnificus secreted exotoxin-hemolysin (VVH) can activate platelet, an important blood immune cell, and to explore the possible molecular mechanism of platelet activation by VVH. Methods Transcriptomics and immunohistochemistry were used to analyze whether Vibrio vulnificus infection caused platelet activation in mice. Then, flow cytometry was used to identify whether VVH was the main stimulator of platelet activation. Naturally expressed VVH toxin was purified and prepared. The effects of extracellular and intracellular Ca²⁺ signal inhibitors on VVH activated platelets were evaluated by flow cytometry and Western blotting. The immune activation effect of VVH in the early stage of Vibrio vulnificus infection was analyzed in vivo. Results VVH was the main stimulator of platelet activation in Vibrio vulnificus culture supernatant. Natural VVH can induce the increase of P-selectin (CD62P) on platelet surface, the formation of platelet-neutrophil complex (PNC), and the release of platelet microvesicles. The activation mechanism may be related to the VVH pore-dependent Ca²⁺-calmodulin (CaM) -myosin light chain kinase (MLCK) signaling pathway, which led to the release of platelet alpha particles and cascade activation of platelets. In a mouse model of ALD infected by Vibrio vulnificus gavage, VVH was strongly associated with platelet activation. Conclusion This study shows that VVH is an important platelet activating molecule in the early stage of Vibrio vulnificus infection, and its induction of platelet activation may be related to the pathogenic process.
Animals ; Platelet Activation/drug effects* ; Hemolysin Proteins/pharmacology* ; Vibrio vulnificus/metabolism* ; Mice ; Blood Platelets/drug effects* ; Vibrio Infections/immunology* ; P-Selectin/metabolism* ; Bacterial Proteins ; Female

OBJECTIVE: To explore the effects of hydroxychloroquine (HCQ) on immune mediators dysregulation in severe infection after chemotherapy in acute myeloid leukemia (AML) and its molecular mechanism. METHODS: Bone marrow or peripheral blood samples of 36 AML patients with severe infection (AML-SI) and 29 AML patients without infection (AML-NI) after chemotherapy were collected from the First Affiliated Hospital of Gannan Medical University from August 2022 to June 2023. In addition, the peripheral blood of 21 healthy subjects from the same period in our hospital was selected as the control group. The mRNA expressions of CXCL12, CXCR4 and CXCR7 were detected by RT-qPCR technology, and the levels of IL-6, IL-8 and TNF-α were detected by ELISA. Leukemia-derived THP-1 cells were selected and constructed as AML disease model. At the same time, bone marrow mesenchymal stem cells (BM-MSCs) from AML-SI patients were co-cultured with THP-1 cells and divided into Mono group and Co-culture group. THP-1 cells were treated with different concentration gradients of HCQ. The cell proliferation activity was subsequently detected by CCK-8 method and apoptosis was detected by Annexin V/PI double staining flow cytometry. ELISA was used to detect the changes of IL-6, IL-8 and TNF-α levels in the supernatant of the cell co-culture system, RT-qPCR was used to detect the mRNA expression changes of the core members of the CXCL12-CXCR4/7 regulatory axis, and Western blot was used to detect the expressions of apoptosis regulatory molecules and related signaling pathway proteins. RESULTS: CXCL12, CXCR4, CXCR7, as well as IL-6, IL-8, and TNF-α were all abnormally increased in AML patients, and the increases were more significant in AML-SI patients (P <0.01). Furthermore, there were statistically significant differences between AML-NI patients and AML-SI patients (all P <0.05). HCQ could inhibit the proliferation and induce the apoptosis of THP-1 cells, but the low concentration of HCQ had no significant effect on the killing of THP-1 cells. When THP-1 cells were co-cultured with BM-MSCs of AML patients, the levels of IL-6, IL-8 and TNF-α in the supernatance of Co-culture group were significantly higher than those of Mono group (all P <0.01). After HCQ intervention, the levels of IL-6, IL-8 and TNF-α in cell culture supernatant of Mono group were significantly decreased compared with those before intervention (all P <0.01). Similarly, those of Co-culture group were also significantly decreased (all P <0.001). However, the expression of the core members of the CXCL12-CXCR4/7 regulatory axis was weakly affected by HCQ. HCQ could up-regulate the expression of pro-apoptotic protein Bax, down-regulate the expression of anti-apoptotic protein Bcl-2, as well as simultaneously promote the hydrolytic activation of Caspase-3 when inhibiting the activation level of TLR4/NF-κB pathway, then induce the programmed death of THP-1 cells after intervention. CONCLUSION The core members of CXCL12-CXCR4/7 axis and related cytokines may be important mediators of severe infectious immune disorders in AML patients. HCQ can inhibit cytokine levels to reverse immune mediators dysregulation and suppress malignant biological characteristics of leukemia cells. The mechanisms may be related to regulating the expression of Bcl-2 family proteins, hydrolytically activating Caspase-3 and inhibiting the activation of TLR4/NF-κB signaling pathway.
Humans ; Leukemia, Myeloid, Acute/immunology* ; Hydroxychloroquine/pharmacology* ; Receptors, CXCR4/metabolism* ; Apoptosis/drug effects* ; Tumor Necrosis Factor-alpha/metabolism* ; Chemokine CXCL12/metabolism* ; Interleukin-8/metabolism* ; Interleukin-6/metabolism* ; Receptors, CXCR/metabolism* ; Mesenchymal Stem Cells ; THP-1 Cells

Objective: To investigate the prevalence of abnormal foot arch morphology and its associated factors among primary and secondary school students in Ganzhou City, so as to provide evidence for the prevention of such abnormalities. Methods: From November 2023 to May 2024, a questionnaire was conducted among 1 013 primary and secondary school students, who were selected from one primary school and one nine year continuous school with stratified cluster random sampling method. Professional equipment, including 2D foot scanning and plantar pressure plates, was utilized to screen pupils for abnormal foot arch morphology (including flatfoot and high arched foot). The Chi square was employed for intergroup comparisons, whilst multifactorial Logistic regression analysis was utilized to investigate the associated factors for the occurrence of foot morphological abnormality of arch among students. Results: The prevalence rate of flatfoot among primary and secondary school students at 61.1%, with bilateral cases accounting for 37.5% and unilateral cases for 23.6%; the prevalence of high arched foot was 8.0%, comprising 3.9% in both feet and 4.0% in one foot. The prevalence rates of flatfoot among boys and girls were 68.7% and 53.6% respectively. Multivariate Logistic regression analysis revealed that boys had a 1.45 times higher risk of developing flatfoot compared to girls ( OR =1.45, 95% CI = 1.05- 2.02), primary and secondary students aged 6-8 and 9-10 had 4.00, 3.81 times higher risk of flatfoot respectively compared to those aged 15-16 ( OR =4.00, 3.81, 95% CI =2.18-7.36, 2.08-6.99) (all P <0.05). Compared to girls, boys had a lower risk of developing high arched foot ( OR=0.52, 95%CI =0.28-0.95), primary and secondary students who frequently corrected their sitting and standing posture also had a lower risk of high arched foot ( OR = 0.30, 95% CI =0.10-0.88) (both P <0.05). Conclusions The prevalence of abnormal foot arch morphology among primary and secondary school students is relatively high, with exercise habits, and postural behaviour identified as associated factors. It is recommended to enhance early screening and behavioural interventions for key populations, thereby advancing the prevention and correction of foot morphological abnormality of arch.

Objective: To investigate the prevalence and associated factors of sexting among college students in Jiangxi Province, so as to provide a reference for sexual education interventions in colleges. Methods: A combined method of random cluster sampling and convenience sampling was used to conduct an anonymous questionnaire survey on 13 042 students from 14 colleges in Jiangxi Province in October 2023. A self designed questionnaire was used to collect data on sexting among students, and Chi square tests and binary Logistic regression analysis were conducted to explore the factors associated with sexting among college students in Jiangxi Province. Results: The reported rate of sexting among college students in Jiangxi Province was 11.5%. Binary Logistic regression analysis showed that female students, non only children, and those who do not view pornographic novels/videos/films had a lower likelihood of engaging in sexting ( OR =0.72, 0.83, 0.23, P <0.05). Students who identified as homosexual, lacked knowledge about AIDS, did not mind premarital sex, and had indifferent attitudes towards multiple sexual partners were more likely to engage in sexting ( OR =1.66, 1.53, 1.25, 2.26, 1.78, P <0.05). Students who smoke, drink, and report a history of high risk sexual behavior were more likely to engage in sexting behavior ( OR=1.38-12.20, P <0.05); night owls showed a negative correlation with sexting behavior ( OR=0.24-0.58, P <0.05). Conclusions A significant proportion of college students in Jiangxi Province engage in sexting. It is recommended that colleges and universities strengthen their sexual education efforts and focus on cultivating internet literacy to promote the physical and mental health development of college students.

Ribosomopathies encompass a spectrum of disorders arising from impaired ribosome biogenesis and reduced functionality.Mutation or dysexpression of the genes that disturb any finely regulated steps of ribosome biogenesis can result in different types of ribosomopathies in clinic,collectively known as ribosomopathy genes.Emerging data suggest that ribosomopathy patients exhibit a significantly heightened susceptibility to cancer.Abnormal ribosome biogenesis and dysregulation of some ribo-somopathy genes have also been found to be intimately associated with cancer development.The cor-relation between ribosome biogenesis or ribosomopathy and the development of malignancies has been well established.This work aims to review the recent advances in the research of ribosomopathy genes among human cancers and meanwhile,to excavate the potential role of these genes,which have not or rarely been reported in cancer,in the disease development across cancers.We plan to establish a theoretical framework between the ribosomopathy gene and cancer development,to further facilitate the potential of these genes as diagnostic biomarker as well as pharmaceutical targets for cancer treatment.

Objective:To evaluate the prognostic value of coagulofibrinolytic changes in survivors of adult extracorporeal cardiopulmonary resuscitation (ECPR) in Chinese.Methods:133 cardiac arrest (CA) patients whose blood samples were collected after establishment of extracorporeal membrane oxygenation between January 2018 and April 2023 in Emergency Department of the First Affiliated Hospital of Nangjing Medical University were enrolled in this single-center study. The following were examined: platelet counts (PLT), prothrombin time (PT), activated partial thrombin time (APTT), thrombin time (TT), fibrinogen (Fib), and D-dimer (D-D). The prognostic values of these coagulation-related indicators in predicting poor outcomes (Cerebral Performance Category 3-5) were analyzed.Results:Among the 133 patients involved, 96 (72.2%) had poor outcomes after ECPR treatment. In the poor-outcome group, PLT and Fib were significantly decreased, while PT and APTT were significantly prolonged (all P < 0.05). ECPR survivors had a significantly higher risk of poor neurological outcomes in the high-level group than those in the low-level group for PT ( HR=1.87, 95% CI:1.17-2.99, P=0.009), APTT ( HR=1.95, 95% CI:1.26-3.00, P=0.003), and D-D levels ( HR=5.18, 95% CI:2.06-13.03, P<0.001). The risk of poor neurological outcomes was significantly lower in the high-level group for PLT ( HR=0.55, 95%CI:0.35-0.84, P=0.007). Conclusion:Coagulofibrinolytic changes can be promising tools to assess poor neurological outcomes in adult ECPR survivors.