Objective:To explore the value of the vesical imaging-reporting and data system (VI-RADS) score based on multiparametric MRI (mpMRI) combined with quantitative tumor MRI parameters in assessing the muscle invasion of bladder cancer.Methods:The study was a case-control study. The data of 87 bladder cancer patients confirmed by pathology who underwent mpMRI of the bladder were retrospectively collected from the First Medical Center of Chinese PLA General Hospital between January 2019 and April 2023 The pathological findings were used as the gold standard to categorize them into the muscle invasive bladder cancer (MIBC) group (29 cases) and non-muscle invasive bladder cancer (NMIBC) group (58 cases). Quantitative parameters were measured based on preoperative mpMRI images, including the length of tumor bladder wall contact, the perpendicular distance between the bladder tumor and the tangent of the bladder wall, the maximal diameter of the bladder tumor, and the volume of the bladder tumor. Bladder cancer was classified according to the VI-RADS scoring criteria. The Mann-Whitney U test was used for intergroup comparisons. Multivariate logistic regression analysis was performed to obtain the independent risk factors related to muscle invasion of bladder cancer and to establish the model. The receiver operating characteristic curves were analyzed for MRI quantitative parameters and logistic regression models, and area under the curve (AUC) comparisons were performed using the DeLong test. Results:The differences in tumor bladder wall contact length, perpendicular distance from the tumor to the tangent line of the bladder wall, maximum diameter, bladder tumor volume, and the VI-RADS scores were statistically significant between the MIBC group and the NMIBC group ( P<0.05). Multifactorial logistic regression analysis showed that tumor bladder wall contact length ( OR=21.07, 95% CI 3.56-124.89, P=0.001) and VI-RADS score ( OR=11.90, 95% CI 3.53-40.12, P<0.001) were the independent risk factors for evaluating the muscle invasion of bladder cancer. The difference between the VI-RADS score and the tumor bladder wall contact length for assessing muscular infiltration of bladder cancer had AUCs of 0.802 (95% CI 0.704-0.899) and 0.759 (95% CI 0.652-0.865). The combined model of VI-RADS score combined with tumor bladder wall contact length had an AUC of 0.891 (95% CI 0.812-0.970), which was higher than the diagnostic efficacy of applying tumor bladder wall contact length or VI-RADS score alone ( Z=3.05, 2.37, P=0.002, 0.018). Conclusion:Tumor contact length with the bladder wall is an independent risk factor for assessing muscle invasion of bladder cancer and the combination of VI-RADS score may enhances diagnostic accuracy.

Objective:To explore the value of the vesical imaging-reporting and data system (VI-RADS) score based on multiparametric MRI (mpMRI) combined with quantitative tumor MRI parameters in assessing the muscle invasion of bladder cancer.Methods:The study was a case-control study. The data of 87 bladder cancer patients confirmed by pathology who underwent mpMRI of the bladder were retrospectively collected from the First Medical Center of Chinese PLA General Hospital between January 2019 and April 2023 The pathological findings were used as the gold standard to categorize them into the muscle invasive bladder cancer (MIBC) group (29 cases) and non-muscle invasive bladder cancer (NMIBC) group (58 cases). Quantitative parameters were measured based on preoperative mpMRI images, including the length of tumor bladder wall contact, the perpendicular distance between the bladder tumor and the tangent of the bladder wall, the maximal diameter of the bladder tumor, and the volume of the bladder tumor. Bladder cancer was classified according to the VI-RADS scoring criteria. The Mann-Whitney U test was used for intergroup comparisons. Multivariate logistic regression analysis was performed to obtain the independent risk factors related to muscle invasion of bladder cancer and to establish the model. The receiver operating characteristic curves were analyzed for MRI quantitative parameters and logistic regression models, and area under the curve (AUC) comparisons were performed using the DeLong test. Results:The differences in tumor bladder wall contact length, perpendicular distance from the tumor to the tangent line of the bladder wall, maximum diameter, bladder tumor volume, and the VI-RADS scores were statistically significant between the MIBC group and the NMIBC group ( P<0.05). Multifactorial logistic regression analysis showed that tumor bladder wall contact length ( OR=21.07, 95% CI 3.56-124.89, P=0.001) and VI-RADS score ( OR=11.90, 95% CI 3.53-40.12, P<0.001) were the independent risk factors for evaluating the muscle invasion of bladder cancer. The difference between the VI-RADS score and the tumor bladder wall contact length for assessing muscular infiltration of bladder cancer had AUCs of 0.802 (95% CI 0.704-0.899) and 0.759 (95% CI 0.652-0.865). The combined model of VI-RADS score combined with tumor bladder wall contact length had an AUC of 0.891 (95% CI 0.812-0.970), which was higher than the diagnostic efficacy of applying tumor bladder wall contact length or VI-RADS score alone ( Z=3.05, 2.37, P=0.002, 0.018). Conclusion:Tumor contact length with the bladder wall is an independent risk factor for assessing muscle invasion of bladder cancer and the combination of VI-RADS score may enhances diagnostic accuracy.

Objective:To evaluate the diagnostic efficacy and practicality of the Jaundice color card (JCard) as a screening tool for neonatal jaundice.Methods:Following the standards for reporting of diagnostic accuracy studies (STARD) statement, a multicenter prospective study was conducted in 9 hospitals in China from October 2019 to September 2021. A total of 845 newborns who were admitted to the hospital or outpatient department for liver function testing due to their own diseases. The inclusion criteria were a gestational age of ≥35 weeks, a birth weight of ≥2 000 g, and an age of ≤28 days. The neonate′s parents used the JCard to measure jaundice at the neonate′s cheek. Within 2 hours of the JCard measurement, transcutaneous bilirubin (TcB) was measured with a JH20-1B device and total serum bilirubin (TSB) was detected. The Pearson′s correlation analysis, Bland-Altman plots and the receiver operating characteristic (ROC) curve were used for statistic analysis.Results:Out of the 854 newborns, 445 were male and 409 were female; 46 were born at 35-36 weeks of gestational age and 808 were born at ≥37 weeks of gestational age. Additionally, 432 cases were aged 0-3 days, 236 cases were aged 4-7 days, and 186 cases were aged 8-28 days. The TSB level was (227.4±89.6) μmol/L, with a range of 23.7-717.0 μmol/L. The JCard level was (221.4±77.0) μmol/L and the TcB level was (252.5±76.0) μmol/L. Both the JCard and TcB values showed good correlation ( r=0.77 and 0.80, respectively) and agreements (96.0% (820/854) and 95.2% (813/854) of samples fell within the 95% limits of agreement, respectively) with TSB. The JCard value of 12 had a sensitivity of 0.93 and specificity of 0.75 for identifying a TSB ≥205.2?μmol/L, and a sensitivity of 1.00 and specificity of 0.35 for identifying a TSB ≥342.0?μmol/L. The TcB value of 205.2?μmol/L had a sensitivity of 0.97 and specificity of 0.60 for identifying TSB levels of 205.2 μmol/L, and a sensitivity of 1.00 and specificity of 0.26 for identifying TSB levels of 342.0 μmol/L. The areas under the ROC curve (AUC) of JCard for identifying TSB levels of 153.9, 205.2, 256.5, and 342.0 μmol/L were 0.96, 0.92, 0.83, and 0.83, respectively. The AUC of TcB were 0.94, 0.91, 0.86, and 0.87, respectively. There were both no significant differences between the AUC of JCard and TcB in identifying TSB levels of 153.9 and 205.2 μmol/L (both P>0.05). However, the AUC of JCard were both lower than those of TcB in identifying TSB levels of 256.5 and 342.0 μmol/L (both P<0.05). Conclusions:JCard can be used to classify different levels of bilirubin, but its diagnostic efficacy decreases with increasing bilirubin levels. When TSB level are ≤205.2 μmol/L, its diagnostic efficacy is equivalent to that of the JH20-1B. To prevent the misdiagnosis of severe jaundice, it is recommended that parents use a low JCard score, such as 12, to identify severe hyperbilirubinemia (TSB ≥342.0 μmol/L).

OBJECTIVE To study the effects of Dianxianqing granules on the tau protein in P301S mice by regulating mitophagy. METHODS Totally 36 P301S mice were randomly divided into model group， Dianxianqing granule group （12.48 g/kg）， donepezil hydrochloride group （positive control， 1.3 mg/kg）， with 12 mice in each group； another 10 C57BL6 mice were selected as control group. Administration groups were given relevant drug solutions intragastrically， and control group and model group were given constant volume of water intragastrically. The gavage volume was 20 mL/kg， once a day， for consecutive 5 months. During the experiment， the general condition of mice was observed in each group. After the last medication， the learning and memory ability was determined by Y maze test and Morris water maze test； HE staining was used to observe the morphological changes in brain tissue， and Nissl staining was used to observe the structure of neural cells and the number of Nissl bodies in cerebral tissue. Immunohistochemistry was used to detect the expressions of phospho-tau serine 202/threonine 205 （abbreviated as AT8） in brain tissue. Western blot assay was used to determine the expressions of mitophagy-associated proteins [PTEN-induced putative kinase-1 （PINK1）， Parkin， microtubule-associated protein 1 light chain 3B （LC3B）， p62]， synaptic-associated proteins [postsynaptic density protein-95 （PSD-95）， synaptophysin （SYP）， and growth-associated protein-43 （GAP-43）] and the phosphorylation of tau protein [expressed by the phosphorylation levels of serine 199 （Ser199） and Ser202] in brain tissue. RESULTS The mice in E-mail：lnzyxyqy2003@163.com model group showed symptoms such as white hair， decreased body mass， and lower limb paralysis， with incomplete hippocampal structures in their brain tissue， as well as incomplete cell membrane edges and cell structures； the spontaneous alternating response rate， the times of crossing platform， the number of Nissl bodies， the protein expressions of PINK1， Parkin， LC3B， SYP， GAP-43， and PSD-95 were decreased significantly， compared with control group； swimming latency （fourth and fifth day）， the protein expressions of AT8 and p62，the phosphorylation levels of Ser199 and Ser202 were increased or lengthened significantly， compared with control group （P＜0.05 or P＜0.01）. Compared with model group， the above symptoms and indexes of mice were improved significantly in administration groups （P＜0.05 or P＜0.01）. CONCLUSIONS Dianxianqing granules can effectively improve cognitive impairment in P301S mice，the mechanism of which may be associated with inducing mitochondrial autophagy， reducing the hyperphosphorylation of tau protein， up-regulating the expression of synaptic-associated proteins in brain tissue，and repairing damaged neural cells.

Objective:To investigate applications of nonconsecutive aerobic resistance training among women with gestational diabetes mellitus, to provide reference for pregnancy health care.Methods:The convenient sampling method was adopted, a total of 110 gestational diabetes mellitus pregnant women were selected who established card and regular obstetric check-up in Zhongshan City People's Hospital from June 2019 to June 2020 as the study subjects. They were divided into experimental group and control group according to the random number table method, each group contained 55 cases. Both groups were given routine pregnancy health care, based on this, the control group received aerobic walking for 6 times a week, and the experimental group was implemented nonconsecutive aerobic resistance training for 6 times a week. The fasting blood glucose and 2 h postprandial blood glucose levels of the two groups were compared at the time of enrollment, the 4th week, the 8th week and the 12th week of intervention, childbirth outcome was also compared between two groups.Results:At the 8th week and the 12th week of intervention, the levels of fasting blood glucose were (5.15 ± 0.48), (4.85 ± 0.37) mmol/L in the experimental group, lower than (5.36 ± 0.46), (5.18 ± 0.48) mmol/L in the control group; at the 4th, 8th and 12th week of intervention, 2 h postprandial blood glucose levels were (6.45 ± 0.52), (6.34 ± 0.44), (6.21 ± 0.40) mmol/L in the experimental group, lower than (6.73 ± 0.56), (6.74 ± 0.48), (6.49 ± 0.45) mmol/L in the control group, the difference was statistically significant ( t values were 2.19-4.30, P<0.05). The natural delivery rate in the experimental group was 85.7% (42/49), which was higher than 69.2% (36/52) in the control group; the incidence of perineal injury and respiratory distress were 12.2% (6/49) and 2.0% (1/49) in the experimental group, lower than 28.9% (15/52) and 15.4% (8/52) in the control group, the difference was statistically significant ( χ2 = 3.89, 4.22, P<0.05). Conclusions:Nonconsecutive aerobic resistance training can effectively control blood glucose, increase the natutal delivery rate and improve delivery outcomes of women with gestational diabetes mellitus.

Objective:To explore the effect of discharge preparation service strategy in hospital-community chronic disease management of patients with liver cirrhosis.Methods:From January 2018 to May 2019, the convenience sampling was used to select 162 patients with compensatory cirrhosis hospitalized in the Department of Infectious Diseases, Puyang People's Hospital of Henan Province. Patients were randomly divided into observation group and control group, with 81 cases in each group. Control group used routine management, and observation group carried out the discharge preparation service strategy. We compared the differences in re-admission rate and laboratory indicators between two groups after discharge.Results:Within 6 months after discharge, the re-admission rates of patients in observation group and control group were 4.94% (4/81) and 20.99% (17/81) respectively, and the difference was statistically significant (χ 2=9.246, P<0.05) . Six months after discharge, prealbumin of observation group was (226.48±27.52) mg/L higher than that of control group, and alanine aminotransferase of observation group was (90.26±6.72) U/L lower than that of control group, and differences were statistically significant ( t=5.482, -6.834; P<0.05) . Conclusions:Discharge preparation service strategy can reduce the re-admission rate of patients with liver cirrhosis and delay the progression of the disease, which is worthy of clinical application.

Hepatocellular carcinoma (HCC) is highly heterogeneous in nature and has been one of the most common cancer types worldwide. To ensure repeatability of identified gene expression patterns and comprehensively annotate the transcriptomes of HCC, we carefully curated 15 public HCC expression datasets that cover around 4000 clinical samples and developed the database HCCDB to serve as a one-stop online resource for exploring HCC gene expression with user-friendly interfaces. The global differential gene expression landscape of HCC was established by analyzing the consistently differentially expressed genes across multiple datasets. Moreover, a 4D metric was proposed to fully characterize the expression pattern of each gene by integrating data from The Cancer Genome Atlas (TCGA) and Genotype-Tissue Expression (GTEx). To facilitate a comprehensive understanding of gene expression patterns in HCC, HCCDB also provides links to third-party databases on drug, proteomics, and literatures, and graphically displays the results from computational analyses, including differential expression analysis, tissue-specific and tumor-specific expression analysis, survival analysis, and co-expression analysis. HCCDB is freely accessible at http://lifeome.net/database/hccdb.
Carcinoma, Hepatocellular ; genetics ; Databases, Genetic ; Gene Expression Profiling ; Gene Expression Regulation, Neoplastic ; Humans ; Liver Neoplasms ; genetics

Objective To investigate the diagnostic criteria for HBV-related acute-on-chronic pre-liver failure (pre-ACLF) which can effectively predict the risk of liver failure.Methods A total of 1279 patients with severe icteric chronic hepatitis B (CHB) and/or severe acute exacerbation of CHB were enrolled.The influence of serum levels of alanine aminotransferase (ALT),aspartate aminotransferase (AST),and total bilirubin (TBil),international normalized ratio (INR) of prothrombin time,sex,and age on the incidence rate of acute-on-chronic liver failure (ACLF) was analyzed,the diagnostic criteria for pre-ACLF and predictive model for ACLF were developed.The chi-square test was used for comparison of categorical variables,and the independent samples t-test was used for continuous data;multivariate logistic regression analysis was performed to evaluate the risk of liver failure.Results The baseline serum levels ofALT,AST,and TBil,and INR were independent risk factors for liver failure (P ＜ 0.05).The diagnostic criteria for pre-ACLF were as follows:(1) INR ≥ 1.30;(2) AST ≥ 10×upper limit of normal (ULN) and obvious jaundice (TBil ≥ 51.3 μmol/L),or TBil ≥ 342.0 μmol/L.These criteria had a positive predictive value of 45.9％,a negative predictive value of 89.8％,a sensitivity of 69.1％,and a specificity of 76.9％.The predictive model for the risk of ACLF was PY =1=eX/(1+ex) (PY represented positive results of logistic regression analysis),X =-10.245+0.026×AST(ULN)-0.025×AST(ULN)+0.046×TBil(mg/d1) + 4.642×INR+0.049×age(years).The patients with higher PY values tended to have a higher incidence rate of ACLE The incidence rate of ACLF was 75.3％ in patients with PY ≥ 0.60,more than 50％ in patients with a PY value of 0.40-0.59,and 1.8％ in patients with PY ＜ 0.10 (P ＜ 0.01).Conclusion The diagnostic criteria for pre-ACLF and predictive model can effectively evaluate the risk of HBV-related ACLF.

OBJECTIVETo assess the correlation of primary colorectal cancer (CRC) lesions' maximum standardized uptake value (SUVmax) and tumor to normal tissue SUVmax ratio (T/N ratio) detected by ¹⁸F-deoxyglucose positron emission computed tomography (¹⁸F-FDG PET-CT) imaging with the postoperative prognosis.

METHODSClinicopathological data of 92 CRC patients who underwent curative resection after the PET-CT examination and received ¹⁸F-FDG PET-CT examination from January 2009 to December 2013 in the First Affiliated Hospital of Sun Yat-sen University were reviewed retrospectively. The correlation of SUVmax and T/N ratio in primary lesions with clinicopathological factors was analyzed. The optimal cutoff point of disease-free survival time of SUVmax, T/N ratio and the maximum tumor diameter were investigated by using ROC curve analysis. Association of clinicopathological factors and prognosis was examined and the Cox proportional hazard regression model was used in the multivariate analysis.

RESULTSPrimary SUVmax was associated with tumor TNM staging, location, differentiation degree and the maximum tumor diameter, while T/N ratio was only associated with pathological type (all P<0.05). The optimal cutoff point of disease-free survival time of SUVmax, T/N ratio and the maximum tumor diameter were 12.2 (sensitivity 67.6%, specificity 63.6% ), 6.9 (sensitivity 51.4%, specificity 74.5%) and 4.3 cm (sensitivity 56.8%, specificity 80.0%) respectively. Univariate analysis showed that age, TNM staging, tumor location, differentiation degree, the maximum tumor diameter, T/N ratio and CA125 level were significant predictors of survival. Multivariate analysis demonstrated that TNM staging (P=0.000, OR=3.98, 95% CI:2.12-7.45), tumor location (P=0.009, OR=0.43, 95% CI:0.23-0.81), tumor differentiation degree (P=0.001, OR=7.52, 95% CI:2.12-25.9) and T/N ratio (P=0.008, OR=2.92, 95% CI:1.33-6.411) were independent predictors of survival. However, SUVmax was not independent predictor of disease-free survival.

CONCLUSIONFor postoperative prognosis of colorectal cancer patients, T/N ratio is more valuable than the of primary tumor SUVmax.

Colorectal Neoplasms ; Disease-Free Survival ; Fluorodeoxyglucose F18 ; Humans ; Multimodal Imaging ; Neoplasm Staging ; Positron-Emission Tomography ; Postoperative Period ; Prognosis ; Proportional Hazards Models ; ROC Curve ; Retrospective Studies ; Tomography, X-Ray Computed

Objective To assess the correlation of primary colorectal cancer (CRC) lesions′maximum standardized uptake value (SUVmax) and tumor to normal tissue SUVmax ratio (T/N ratio) detected by 18F-deoxyglucose positron emission computed tomography (18F-FDG PET-CT) imaging with the postoperative prognosis. Methods Clinicopathological data of 92 CRC patients who underwent curative resection after the PET-CT examination and received 18F-FDG PET-CT examination from January 2009 to December 2013 in the First Affiliated Hospital of Sun Yat-sen University were reviewed retrospectively. The correlation of SUVmax and T/N ratio in primary lesions with clinicopathological factors was analyzed. The optimal cutoff point of disease-free survival time of SUVmax, T/N ratio and the maximum tumor diameter were investigated by using ROC curve analysis. Association of clinicopathological factors and prognosis was examined and the Cox proportional hazard regression model was used in the multivariate analysis. Results Primary SUVmax was associated with tumor TNM staging, location, differentiation degree and the maximum tumor diameter, while T/N ratio was only associated with pathological type (all P<0.05). The optimal cutoff point of disease-free survival time of SUVmax, T/N ratio and the maximum tumor diameter were 12.2 (sensitivity 67.6%, specificity 63.6% ), 6.9 (sensitivity 51.4%, specificity 74.5%) and 4.3 cm (sensitivity 56.8%, specificity 80.0%) respectively. Univariate analysis showed that age, TNM staging, tumor location, differentiation degree, the maximum tumor diameter, T/N ratio and CA125 level were significant predictors of survival. Multivariate analysis demonstrated that TNM staging (P=0.000, OR=3.98, 95% CI:2.12-7.45), tumor location (P=0.009, OR=0.43, 95% CI:0.23-0.81), tumor differentiation degree (P=0.001, OR=7.52, 95% CI:2.12-25.9) and T/N ratio (P=0.008, OR=2.92, 95% CI:1.33-6.411) were independent predictors of survival. However, SUVmax was not independent predictor of disease-free survival. Conclusion For postoperative prognosis of colorectal cancer patients, T/N ratio is more valuable than the of primary tumor SUVmax.