Objective To observe the value of machine learning(ML)models based on CT angiography(CTA)morphology combined with blood inflammation indicators for predicting rupture of intracranial aneurysms(IA).Methods Totally 286 IA patients were enrolled,including 143 cases in ruptured group and 143 case in unruptured group.Among them 200 cases(100 in ruptured subgroup and 100 in unruptured subgroup)were taken as training set,while 86 cases(43 in ruptured subgroup and 43 in unruptured subgroup)were taken as validation set.CTA morphological parameters and blood inflammation indicators were compared between subgroups in training set,and the impact factors of IA ruptured among univariate variables were screened using stepwise logistic regression analysis.Logistic regression(LR),classification and regression tree(CART)and backpropagation neural network(BPNN)models were constructed based on the above impact factors,respectively.Receiver operating characteristic curves were drawn,the area under the curves(AUC)were calculated to evaluate the efficacy of these models for predicting IA rupture.Results Neutrophil,neutrophil-lymphocyte ratio,interleukin-10,tumor necrosis factor-α,transforming growth factor-β,as well as tumor width,height and size ratio(SR)were all impact factors of IA rupture(all P＜0.05),and collinearity diagnosis suggested that no covariate relationship existed among these factors.LR,CART and BPNN models had good efficacy for predicting IA rupture in both training and validation sets with AUC of 0.878-0.993,and BPNN model had the best predictive efficacy(AUC of 0.993,0.976).Conclusion ML models based on CTA morphology combined with blood inflammation indicators could be used to predict IA rupture effectively,among which BPNN model had the best efficacy.

Objective To compare the effects of remimazolam and propofol on postoperative nausea and vomiting(PONV)after pancreatic extracorporeal shock wave lithotripsy(P-ESWL),with the aim of optimizing the anesthesia regimen for this procedure.Methods Clinical data were retrospectively collected from patients who underwent P-ESWL for pancreatic stones under general anesthesia at The First Affiliated Hospital of Xi'an Jiaotong University from January 2021 to December 2024.A total of 307 patients were recruited,with 103 in the remimazolam group and 204 in the propofol group.Inverse probability of treatment weighting(IPTW)based on propensity scores was used to balance baseline characteristics and confounding factors between the two groups.The incidence of PONV and anesthesia recovery time were compared between the two groups.Results Before IPTW,there were statistically significant differences between the remimazolam and propofol groups in gender[male/female:51/52 vs.155/49],smoking history(27.2％vs.42.6％),intraoperative sufentanil use[25(10)μg vs.30(10)μg],remifentanil use[429.00(177)μg vs.480.50(209)μg],rocuronium use[36(6)mg vs.38(7)mg],and intraoperative dexamethasone use(62.1％vs.49.0％)(all P＜0.05).After IPTW,the baseline characteristics and confounding factors were balanced and comparable between the two groups(P＞0.05).Before IPTW,the incidence of PONV was higher in the remimazolam group than in the propofol group(24.3％vs.14.7％,P=0.039).After IPTW,the two groups did not significantly differ in the incidence of PONV(21.5％vs.17.5％,P=0.215),and the anesthesia recovery time was significantly shorter in the remimazolam group than in the propofol group[3(3)min vs.9(4)min,P＜0.001].Conclusion Compared to propofol anesthesia,remimazolam does not increase the incidence of PONV in patients undergoing P-ESWL for pancreatic stones and can effectively reduce anesthesia recovery time.

Objective:To assess the cytotoxicity of self-adhesive resin cement RelyXTM U200 on human periodontal ligament fibro-blasts(HPDLFs)under different light treatment modes.Methods:The self-adhesive resin cement RelyXTM U200 was cured by immediate light(A),intermittent light(B),delayed light(C)and no light(D)treatment respectively.The HPDLFs were cultured with the specimen extracts under different light modes.The proliferation ability and apoptosis level of the cells in the groups were detected by CCK-8 test and flow cytometry apoptosis test.SPSS 20.0 software was used to analyze the cytotoxicity of specimens to HPDLFs.Results:At 24 h after light treatment the cytoxicity(grade)of group A,B,C and D was 1,2,3 and 4,at 72 h 1,2,2 and 3,respectively.At 72 h,the apoptosis index(％)of the cells in A,B,C and D groups was 6.38％±0.94％,16.34％±1.67％,24.13％±1.43％and 38.34％±2.75％respecitvely.Conclusion:The cytotoxicity of self-adhesive resin cement is the greatest under no light treatment mode and the least under immediate light treatment mode.

Objective:To assess the cytotoxicity of self-adhesive resin cement RelyXTM U200 on human periodontal ligament fibro-blasts(HPDLFs)under different light treatment modes.Methods:The self-adhesive resin cement RelyXTM U200 was cured by immediate light(A),intermittent light(B),delayed light(C)and no light(D)treatment respectively.The HPDLFs were cultured with the specimen extracts under different light modes.The proliferation ability and apoptosis level of the cells in the groups were detected by CCK-8 test and flow cytometry apoptosis test.SPSS 20.0 software was used to analyze the cytotoxicity of specimens to HPDLFs.Results:At 24 h after light treatment the cytoxicity(grade)of group A,B,C and D was 1,2,3 and 4,at 72 h 1,2,2 and 3,respectively.At 72 h,the apoptosis index(％)of the cells in A,B,C and D groups was 6.38％±0.94％,16.34％±1.67％,24.13％±1.43％and 38.34％±2.75％respecitvely.Conclusion:The cytotoxicity of self-adhesive resin cement is the greatest under no light treatment mode and the least under immediate light treatment mode.

Objective To compare the effects of remimazolam and propofol on postoperative nausea and vomiting(PONV)after pancreatic extracorporeal shock wave lithotripsy(P-ESWL),with the aim of optimizing the anesthesia regimen for this procedure.Methods Clinical data were retrospectively collected from patients who underwent P-ESWL for pancreatic stones under general anesthesia at The First Affiliated Hospital of Xi'an Jiaotong University from January 2021 to December 2024.A total of 307 patients were recruited,with 103 in the remimazolam group and 204 in the propofol group.Inverse probability of treatment weighting(IPTW)based on propensity scores was used to balance baseline characteristics and confounding factors between the two groups.The incidence of PONV and anesthesia recovery time were compared between the two groups.Results Before IPTW,there were statistically significant differences between the remimazolam and propofol groups in gender[male/female:51/52 vs.155/49],smoking history(27.2％vs.42.6％),intraoperative sufentanil use[25(10)μg vs.30(10)μg],remifentanil use[429.00(177)μg vs.480.50(209)μg],rocuronium use[36(6)mg vs.38(7)mg],and intraoperative dexamethasone use(62.1％vs.49.0％)(all P＜0.05).After IPTW,the baseline characteristics and confounding factors were balanced and comparable between the two groups(P＞0.05).Before IPTW,the incidence of PONV was higher in the remimazolam group than in the propofol group(24.3％vs.14.7％,P=0.039).After IPTW,the two groups did not significantly differ in the incidence of PONV(21.5％vs.17.5％,P=0.215),and the anesthesia recovery time was significantly shorter in the remimazolam group than in the propofol group[3(3)min vs.9(4)min,P＜0.001].Conclusion Compared to propofol anesthesia,remimazolam does not increase the incidence of PONV in patients undergoing P-ESWL for pancreatic stones and can effectively reduce anesthesia recovery time.

Objective To observe the value of machine learning(ML)models based on CT angiography(CTA)morphology combined with blood inflammation indicators for predicting rupture of intracranial aneurysms(IA).Methods Totally 286 IA patients were enrolled,including 143 cases in ruptured group and 143 case in unruptured group.Among them 200 cases(100 in ruptured subgroup and 100 in unruptured subgroup)were taken as training set,while 86 cases(43 in ruptured subgroup and 43 in unruptured subgroup)were taken as validation set.CTA morphological parameters and blood inflammation indicators were compared between subgroups in training set,and the impact factors of IA ruptured among univariate variables were screened using stepwise logistic regression analysis.Logistic regression(LR),classification and regression tree(CART)and backpropagation neural network(BPNN)models were constructed based on the above impact factors,respectively.Receiver operating characteristic curves were drawn,the area under the curves(AUC)were calculated to evaluate the efficacy of these models for predicting IA rupture.Results Neutrophil,neutrophil-lymphocyte ratio,interleukin-10,tumor necrosis factor-α,transforming growth factor-β,as well as tumor width,height and size ratio(SR)were all impact factors of IA rupture(all P＜0.05),and collinearity diagnosis suggested that no covariate relationship existed among these factors.LR,CART and BPNN models had good efficacy for predicting IA rupture in both training and validation sets with AUC of 0.878-0.993,and BPNN model had the best predictive efficacy(AUC of 0.993,0.976).Conclusion ML models based on CTA morphology combined with blood inflammation indicators could be used to predict IA rupture effectively,among which BPNN model had the best efficacy.

Objective:To investigate the correlation of relative cross-sectional area of lumbar paravertebral muscle and psoas with lumbar curvature and its clinical significance.Methods:This study was conducted as a retrospective cross-sectional study. Among the patients treated at the Department of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January to April 2023, 107 middle-aged and young patients with changes in lumbar physiological curvature or no apparent abnormalities were included in this study based on MRI findings. The relative cross-sectional area (RCSA) values of the left and right paravertebral muscles and psoas were measured at the lower margin of the L3 vertebral body and at the L3/L4, L4/L5, and L5/S1 intervertebral discs. Furthermore, the correlation between these RCSA values and lumbar curvature was analyzed.Results:The 107 patients were (30.51 ± 4.64) years old, and the proportion of females accounted for 71.96%. There were differences in RCSA between the lower margin of L3, L3/L4, L4/L5, and L5/S1 intervertebral discs (left psoas F = 30.21, P < 0.001; right psoas F = 31.63, P < 0.001; left paravertebral muscle F = 31.04, P < 0.001; right paravertebral muscle F = 26.55, P < 0.001). From L3 to S1, the RCSA of the psoas increased, while the RCSA of the paravertebral muscle decreased. The RCSA values of the total paravertebral muscle/RCSA values of the total psoas major muscle were positively correlated with lumbar curvature at the lower margin of the L3 vertebral body ( r = 0.40, P < 0.001). This correlation could be seen at both L3/L4 ( r = 0.31, P = 0.001) and L4/L5 ( r = 0.24, P = 0.012). However, after considering the influence of left and right muscle groups on lumbar curvature, there was no correlation between the muscle cross-sectional area at the L5/S1 disc position and lumbar curvature ( P > 0.05). Nevertheless, there was still a correlation between the muscle cross-sectional area at other lumbar segments ( P < 0.05). Conclusion:An increase in the RCSA of the psoas relative to the paraspinal muscle may lead to straightening of the lumbar spine curvature, whereas an increase in the RCSA of the paraspinal muscle relative to the psoas may result in an increase in lumbar spine curvature. Improving the quality of the paraspinal muscle may restore the physiological curvature of the lumbar spine, which holds clinical application value.

Macropinocytosis, an evolutionarily conserved, actin-dependent form of endocytosis, is involved in various physiological processes, including nutrient absorption, antigen presentation, and cell signaling transduction and migration. Oncogene activation and tumor suppressor inactivation induce macropinocytosis in tumors in the digestive system, involved in tumorigenesis and progression, whereas the inhibition of macropinocytosis slows the aggressive phenotype of digestive system tumors and improves the efficacy of anti-tumor drugs. Macropinocytosis can also be used as a delivery route for anti-tumor drugs. Therefore, macropinocytosis has been widely studied to develop new methods for the treatment of digestive system tumors.This paper reviews the role of macropinocytosis in the body, the regulation of macropinocytosis-related signaling pathway, as well as the mechanism of macropinocytosis in colorectal cancer, pancreatic ductal adenocarcinoma, liver cancer and other digestive system tumors, to provide reference for related researches.

Objective To observe the effects of Banxia Xiexin Decoction on intestinal microbes and 5-HT in ulcerative colitis(UC)model mice induced by drinking sodium dextran sulfate(DSS),and to analyze the mechanism of Banxia Xiexin Decoction in treating UC from the perspective of brain-gut axis.Methods 40 male C57BL6/J mice were randomly divided into control group,model group,positive drug(mesalazine)group and Banxia Xiexin decoction group.All mice except control group were induced by 2.5%DSS solution for 7 days to establish UC model.From the 8th day,mice in the above groups were given intragastric administration of sterilized water,mesalazine aqueous solution and Banxia Xiexin decoction aqueous solution.HE staining was used to observe histopathological changes of colon,ELISA to detect 5-HT content in serum,colon and brain tissues,and 16S rRNA sequencing to further detect the changes of fecal flora in model mice.Results Compared with model group,DAI index of experimental mice model group was significantly decreased after Banxia Xiexin Decoction intervention(P<0.05);IL-2,IL-4 and IFN-γ were significantly recovered(P<0.05).The histopathological score of proximal and distal colon was significantly decreased(P<0.01).Moreover,the peripheral 5-HT level was significantly decreased(P<0.05),but the central had an increasing trend.Results of intestinal flora showed that the relative abundance of Clostridium_sensu_stricto_1,unclassified_p__Firmicutes increased(P<0.05),while Lachnospiraceae_NK4A136_group,Lachnoclostridium,norank_f__Oscillospiraceae and Eubacterium_xylanophilum_group decreased(P<0.05).It was also found that there were significant correlations between intestinal microflora and peripheral and central 5-HT levels.Conclusion Banxia Xiexin Decoction could play a role in treating ulcerative colitis by improving the intestinal microbial composition structure of UC mice to reduce peripheral 5-HT levels and increase central 5-HT levels,thereby improving intestinal inflammatory response and relieving anxiety.

Objective:To investigate the effect of hyperbaric oxygen（HBO）combined with rosuvastatin on the levels of D-dimer（D-D），lipoprotein-associated phospholipase A2（Lp-PLA2），and high-sensitivity C-reactive protein（hs-CRP）in patients with type 2 diabetes mellitus（T2DM）combined with coronary heart disease（CHD）.Method:The clinical data of 167 T2DM patients combined with CHD admitted to Linyi Central Hospital from July 2019 to July 2021 were retrospectively analyzed. They were divided into two groups according to different treatment methods. The control group（ n=78）was given conventional treatment and oral rosuvastatin，and the study group（ n=89）was treated with HBO on the basis of the treatment in the control group. The effective rate，blood viscosity，and the levels of D-D，Lp-PLA2，and hs-CRP were compared between the two groups. Results:After treatment，the effective rate in the study group［93.23%（83/89）］was significantly higher than that of the control group［82.05%（64/78）］，and the difference was statistically significant（ P<0.05 or P<0.01）；the serum levels of D-D，Lp-PLA2，hs-CRP，and blood viscosity in the study group were significantly lower than those of the control group，and the differences were statistically significant（ P<0.05 or P<0.01）. Conclusion:HBO combined with rosuvastatin in the treatment of T2DM patients combined with CHD can be more effective than using rosuvastatin alone in reducing D-D，Lp-PLA2，hs-CRP levels，and blood viscosity，thus achieving better clinical efficacy.