To review the clinical characteristics, short-term outcomes, and risk factors of patients with infective endocarditis(IE) who underwent surgical treatment at a single center, and to summarize treatment experience.

Objective:To evaluate the safety and effectiveness of rubber band-assisted endoscopic submucosal excavation (RB-ESE) for gastric submucosal tumors (SMT).Methods:A retrospective study was conducted on data of gastric SMT patients who underwent ESE in Affiliated Hospital of Yangzhou University from January 2017 to August 2022. A total of 48 patients were selected and divided into two groups: RB-ESE group ( n=20) and the conventional ESE (C-ESE) group ( n=28). The operation time, bleeding rate and perforation rate during operation, the retention rate of the mucosal cap, the number of clips, postoperative complications, and the hospitalization time were analyzed. Additionally, correlations between complications and tumor size/location and between bleeding and perforation were evaluated. Results:No significant difference was found in the general conditions between the two groups ( P>0.05). The operation time of RB-ESE group (14.82±2.31 min) was significantly shorter than that of C-ESE group (23.70±3.67 min) ( t=-9.539, P<0.001). The intraoperative bleeding rates were 20.0% (4/20) and 42.9% (12/28) in the RB-ESE group and C-ESE group respectively ( χ2=2.743, P=0.098), while the intraoperative perforation rates were 25.0% (5/20) and 46.4% (13/28) respectively ( χ2=2.286, P=0.131). Furthermore, the mucosal cap preservation rate was notably higher in the RB-ESE group at 60.0% (12/20) compared with 7.1% (2/28) in the C-ESE group ( χ2=15.777, P<0.001). The number of clips applied to close the wound was 8.05±1.40 and 10.43±1.96 in the RB-ESE group and C-ESE group respectively ( t=4.925, P<0.001). The postoperative hospital stays were 4.35±0.75 days and 5.00±0.86 days respectively in two groups ( t=2.724, P=0.009). No postoperative bleeding or perforation occurred in either group. The results showed that the occurrence of perforation and bleeding were associated with tumor diameter. Patients with tumor size ≥2 cm showed increased proportions of intraoperative bleeding [68.4% (13/19), P<0.001] and perforation [78.9% (15/19), P<0.001]. There was a correlation between intraoperative bleeding and perforation ( P<0.001). Conclusion:RB-ESE proves to be an effective and safe approach for managing gastric SMT, offering advantages such as reduced operation time and hospital stays, improved retention of the mucosal cap post-operation, and less clips use. The results suggest that RB-ESE could be widely adopted for treating SMT.

Central nervous system (CNS) injuries, including stroke, traumatic brain injury, and spinal cord injury, are leading causes of long-term disability. It is estimated that more than half of the survivors of severe unilateral injury are unable to use the denervated limb. Previous studies have focused on neuroprotective interventions in the affected hemisphere to limit brain lesions and neurorepair measures to promote recovery. However, the ability to increase plasticity in the injured brain is restricted and difficult to improve. Therefore, over several decades, researchers have been prompted to enhance the compensation by the unaffected hemisphere. Animal experiments have revealed that regrowth of ipsilateral descending fibers from the unaffected hemisphere to denervated motor neurons plays a significant role in the restoration of motor function. In addition, several clinical treatments have been designed to restore ipsilateral motor control, including brain stimulation, nerve transfer surgery, and brain-computer interface systems. Here, we comprehensively review the neural mechanisms as well as translational applications of ipsilateral motor control upon rehabilitation after CNS injuries.
Animals ; Spinal Cord Injuries/therapy* ; Motor Neurons/physiology* ; Brain ; Stroke ; Recovery of Function/physiology*

Objective:To explore the predictive values for mutation subtypes of epidermal growth factor receptor (EGFR) in patients with lung adenocarcinoma (LUAD) based on machine learning and 18F-fluorodeoxyglucose (FDG) PET/CT images. Methods:18F-FDG PET/CT images and pathological data of 238 patients with LUAD (126 patients (54 males, 72 females, median age 62 years) with EGFR mutation; 112 patients (68 males, 44 females, median age 61 years) with wild-type EGFR)) were retrospectively collected at Tianjin Medical University Cancer Institute and Hospital between April 2016 and May 2020. Volumes of interest (VOI) of PET and CT images were delineated respectively and three-dimensional-based and two-dimensional-based radiomics features were extracted from VOIs. Three machine learning classifiers of K-nearest neighbor (KNN), support vector machine (SVM) and Adaboost were trained in training set with CT, PET and fusion PET/CT radiomics features respectively. Well trained classifiers were tested in test set. Each predictive model was evaluated by using the receiver operating characteristic (ROC) curve. Results:A total of 126 patients were EGFR mutation including 3 patients with 18 exon mutation, 6 patients with 20 exon mutation, 42 patients with 19 exon mutation, and 75 patients with 21 exon mutation. Finally, patients with 18 exon mutation and 20 exon mutation were removed due to the scale was too small to be trained adequately by machine learning classifiers. Predictive performance of mean PET/CT feature-based model (Adaboost: area under curve (AUC)=0.87, 95% CI: 0.75-0.99) in EGFR mutation subtypes was better than PET feature-based model (Adaboost: AUC=0.64, 95% CI: 0.46-0.83; z=2.04, P<0.05) and CT feature-based model (Adaboost: AUC=0.64, 95% CI: 0.45-0.83; z=2.06, P<0.05). There was no statistical difference between predictive performance of mean PET/CT feature-based model (SVM: AUC=0.76, 95% CI: 0.56-0.96) and PET/CT concatenation feature-based model (SVM: AUC=0.75, 95% CI: 0.59-0.92; z=1.14, P>0.05). Conclusion:Machine learning and 18F-FDG PET/CT radiomics features can provide predictive value for EGFR mutation subtypes in patients with LUAD.

Lung cancer is a malignant tumor with the high morbidity and mortality in the world, and non-small cell lung cancer ( NSCLC) is the most common type. The emergence of epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI) in recent years has provided new treatment option for NSCLC patients. The efficacy of EGFR-TKI is closely related to the EGFR mutation status, but the current detection methods for gene mutation have certain limitations. As a non-invasive method, 18F-fluorodeoxyglucose (FDG) PET/CT shows a certain potential in the detection of EGFR gene mutation status. In this paper, the re-cent research and progress of PET/CT in predicting the mutation status of EGFR gene are reviewed.

Objective To evaluate and compare the radiation dose and image quality of the new generation of whole body mobile CT (BodyTom CT) with commonly used fixed CT.Methods The image quality was evaluated with CATPHAN 500 performance test body model.The radiation dose was measured by conventional 100 mm pen ionization chamber and PMMA body phantom and head phantom (head diameter 160 mm,phantom diameter 320 rm and width 140 mm).Results The spatial and contrast resolution of BodyTom CT images were similar to two kinds of fixed CT(P ＞ 0.05).The CNR of image with BodyTom CT decreased by about 20％:In head scan mode,significantly lower than that with Philps 64 slice CT and Toshiba 320 slice CT (with soft,t =-4.82,-6.98,P ＜ 0.05;with standard,t =-20.60,-20.09,P ＜0.05);in body scan mode,significantly lower than that with Philps 64 slice CT and Toshiba 320 slice CT (with soft,t =-5.67,-12.82,P ＜ 0.05;with standard,t =-3.39,-9.18,P ＜ 0.05;with sharp,t =-3.88,-3.21,P ＜0.05).The radiation dose with BodyTom CT was significantly higher than that with fixed CT:in body model,22.97％ than that with Philps 64(t=9.48,P＜0.05),29.6％ than that with Toshiba 320 slice CT(t =11.66,P ＜0.05);in head model,29.76％ than that with Philps 64 slice CT(t=23.44,P＜0.05),33.22％ than that with Toshiba 320 slice CT(t=23.11,P＜0.05).Conclusions The radiation dose with mobile CT was over 20％ higher than that with routine multi-row CT while with the similar image quality.

Objective To investigate the relationship between plasma homocysteine on admission and the outcome at discharge of acute ischemic stroke.Methods A non-concurrent cohort study was performed and a total of 1 3 1 9 patients with acute is-chemic stroke were continuously included in this study.According to tertile range of plasma homocysteine,patients were di-vided into three group.Logistic regression analysis was used to assess the independent association between plasma homocys-teine on admission and poor outcome at discharge of acute ischemic stroke.Results The difference of plasma homocysteine on admission between the poor outcome and those with good outcome had statistical significance (P<0.000 1).Without the adj ustment of multiple factors,when comparing to the first group,the second and third tertile seemed to have a tendency of increasing the risk of poor outcome at discharge,the OR (95%CI)was 2.111 (1.297~3.437,P<0.05),2.113 (1.361~3.279,P<0.05).After adjustment for multivariate,the second and third tertile also seemed to have a tendency of increasing the risk of poor outcome at discharge,the OR (95%CI)was 1.876 (1.160~3.036,P<0.05),2.396 (1.414~4.062,P<0.05).Conclusion The current study indicated that higher plasma homocysteine level was an independent risk factor for poor outcome at discharge in ischemic stroke patients.It would increase the risk of the outcome at discharge in patients with acute ischemic stroke,and suggests that there is a dose-response relationship between plasma homocysteine level on admis-sion and the poor outcome at discharge.

Objective To explore a method to culture human aortic valvular interstitial cells and identify the phenotypes,to establish the cell model which would be used to study aortic valve diseases in vitro.Methods Normal aortic valves of the patient with acute Stanford A aortic dissection in Peking Union Medical College Hospital were preserved during the surgical operation.Human aortic valvular interstitial cells were isolated and amplified in vitro by modified collagenase digestion method.The cell phenotype was identified by the immunofluorescent staining.Results Human aortic valvular interstitial cells could be successfully isolated and amplified in vitro by modified collagenase digestion method,identified by positive staining of Vimention and α-SMA.Conclusions The cell model of human aortic valvular interstitial ceils could be successfully established in vitro by modified collagenase digestion method.The cell phenotype identification proved to meet the experimental requirements.So it could provide cellular foundations for the study of pathogenesis of degenerative aortic valve disease.

Objective To explore the expression and significance of HDGF and ADAM9 in esophageal cancer.Methods HDGF and ADAM9 expression in 113 patients with esophageal cancer (78 males and 35 females) with ages ranging from 28 to 87 years,averaged (61.2 ± 8.6) years,were analyzed by SP immunohistoehemical staining.Results The positive rates of HDGF and ADAM9 in esophageal cancer (78.8％ and 68.1％ respectively) were significantly higher than those in normal tissue(all were 30％).ADAM expressions were not correlated with age,sex,tissue types,lymph nodes metastasis,location and tumor size (P ＞ 0.05) ;the positive expression rate of HDGF and ADAM9 was related to differentiation,PT stages,and 5-year survival rate (P ＜0.05).HDGF was correlated with PT stage.Conclusion The expressions of HDGF and ADAM9 in esophageal cancer tissues were more higher than normal esophageal tissues,this means they could promote the development of tumor cells transformation,multiple and moving,and may be an useful tool for providing information about the targeted therapy and prognosis.