Objective·To detect the expression level of Fas-associated protein with death domain(FADD)in head and neck squamous cell carcinoma(HNSCC)and to explore the molecular mechanisms by which FADD promotes the proliferation of HNSCC cells.Methods·The GEPIA 2 database was utilized to analyze the expression level of FADD in tumor tissues and to evaluate its association with prognosis.Immunohistochemistry staining(IHC)was performed on HNSCC tissues to investigate the changes in FADD expression levels in normal,dysplastic,and tumor tissues.Stable FADD-knockdown Fadu and HSC3 cell lines were constructed and validated using Western blotting and quantitative real-time PCR(qRT-PCR).The regulatory effect of FADD on the proliferation of HNSCC cells was explored using the LiveCyte live-cell tracking system,colony formation assay,and cell viability assay.Proteins interacting with FADD were identified by co-immunoprecipitation mass spectrometry(Co-IP/MS),and further mechanistic studies were conducted using CRISPR/Cas9 technology,LiveCyte live-cell tracking system,and Western blotting.Results·Analysis of the GEPIA2 database indicated that FADD was significantly overexpressed in head and neck cancer and was associated with poor prognosis.IHC staining showed that FADD expression levels progressively increased from normal to dysplastic to tumor tissues in HNSCC patients.Knockdown of FADD in HNSCC cells resulted in significantly reduced proliferation and colony formation compared to the control group.Co-IP/MS results showed that FADD interacted with the CUX1 protein,and FADD knockdown led to increased CUX1 expression.Moreover,CUX1 knockdown significantly promoted HNSCC cell proliferation and reversed the anti-proliferative phenotype caused by FADD knockdown.Conclusion·FADD plays a significant pro-carcinogenic role in HNSCC and is associated with poor prognosis.FADD can further regulate tumor cell proliferation by interacting with CUX1 and suppressing its expression level.

Object:To explore the feasibility of using artificial intelligence for quality control of echocardiographic images.Methods:Retrospectively，5 000 two-dimensional echocardiographic video images within the period from 2021 to 2023 were randomly retrieved from the echocardiography database of Nanjing Drum Tower Hospital，Affiliated Hospital of Medical School，Nanjing University. Among these selected images，1 559 of them were apical views. The physician team formulated the scoring rules，which specifically included four scoring criteria：gain，scaling ratio，cardiac axis angle，and structure. Subsequently，the data were labeled with view classification and image quality scores. The labeled data were further partitioned into the training set（ n = 643），the validation set（ n = 276），and the test set（ n = 640）. The training and validation sets were utilized for constructing the models for view classification and quality assessment，while the test set was employed to verify the models' effectiveness. The view classification module was implemented using the SlowFast model，and the quality assessment module involved algorithms such as ResNet，Video Swin Transformer，SSD，and U-Net. Results:The average accuracy，precision，recall rate and F1 score of the classification model in identifying each apical view were 0.987 1，0.983 0，0.987 1 and 0.984 9 respectively，and the inference time was（333.4 ± 105.4）ms. The average accuracies of the quality assessment module in terms of gain，scaling ratio，cardiac axis angle and display of main structures were 0.915 1，0.928 2，0.938 7 and 0.965 6 respectively，and the overall scoring accuracy was 0.912 7.Conclusions:The echocardiogram quality control system developed in this research can effectively classify and evaluate the quality of two-dimensional images of the apical views in echocardiograms. Moreover，it guarantees the objectivity，timeliness and high-efficiency of quality control，which has reference value for the establishment of the echocardiogram quality control system.

This case report presents a 16-year-old male patient with deficiency of adenosine deaminase 2(DADA2). The patient had a history of Raynaud′s phenomenon with digital ulcers since childhood. As the disease progressed, the patient developed retinal vasculitis, intracranial hemorrhage, skin necrosis, severe malnutrition, refractory hypertension, and gastrointestinal bleeding. Genetic testing revealed compound heterozygous mutations in the ADA2 gene (paternal c.1072G > A pathogenic mutation + maternal c.1065C > A variant of unknown clinical significance). ADA2 enzyme activity was significantly reduced (0.1 U/L). A multidisciplinary treatment team developed an individualized plan to address key issues, including nutritional support, blood pressure control, rehabilitation, pain management, and balancing anticoagulation/bleeding risks. After systematic intervention, the patient′s condition showed partial improvement. This case reveals clinical challenges such as anticoagulation decisions and nutritional support of DADA2. It also emphasizes the importance of early molecular diagnosis, tumor necrosis factor-α inhibitor targeted therapy, and multidisciplinary collaboration in management, underlining the core value of precision medicine in rare disease management.

Objective·To detect the expression level of Fas-associated protein with death domain(FADD)in head and neck squamous cell carcinoma(HNSCC)and to explore the molecular mechanisms by which FADD promotes the proliferation of HNSCC cells.Methods·The GEPIA 2 database was utilized to analyze the expression level of FADD in tumor tissues and to evaluate its association with prognosis.Immunohistochemistry staining(IHC)was performed on HNSCC tissues to investigate the changes in FADD expression levels in normal,dysplastic,and tumor tissues.Stable FADD-knockdown Fadu and HSC3 cell lines were constructed and validated using Western blotting and quantitative real-time PCR(qRT-PCR).The regulatory effect of FADD on the proliferation of HNSCC cells was explored using the LiveCyte live-cell tracking system,colony formation assay,and cell viability assay.Proteins interacting with FADD were identified by co-immunoprecipitation mass spectrometry(Co-IP/MS),and further mechanistic studies were conducted using CRISPR/Cas9 technology,LiveCyte live-cell tracking system,and Western blotting.Results·Analysis of the GEPIA2 database indicated that FADD was significantly overexpressed in head and neck cancer and was associated with poor prognosis.IHC staining showed that FADD expression levels progressively increased from normal to dysplastic to tumor tissues in HNSCC patients.Knockdown of FADD in HNSCC cells resulted in significantly reduced proliferation and colony formation compared to the control group.Co-IP/MS results showed that FADD interacted with the CUX1 protein,and FADD knockdown led to increased CUX1 expression.Moreover,CUX1 knockdown significantly promoted HNSCC cell proliferation and reversed the anti-proliferative phenotype caused by FADD knockdown.Conclusion·FADD plays a significant pro-carcinogenic role in HNSCC and is associated with poor prognosis.FADD can further regulate tumor cell proliferation by interacting with CUX1 and suppressing its expression level.

Objective Constructing a transitional care program for critically ill children in the ICU and exploring the effects of its application on the relocation stress and caregiving abilities of parents of children to improve their caregiving experience.Methods Convenience sampling method was used to select 150 children and their families transferred from PICU to the general ward of a tertiary pediatric hospital in Shanghai from January to September 2023 as research subjects.Subjects enrolled from June to September 2023 were selected as an experimental group,and were applied with the ICU transitional care program for critically ill children.Those enrolled from January to April 2023 were selected as a control group,and received routine ICU transitional care.Family Relocation Stress Scale and Family Caregiver Task Inventory were used to evaluate children's families at 24h before,24h after,and 72h after children's transition from ICU.The incidence of unplanned readmission to ICU within 48h and adverse events were compared between 2 groups of children.Results Eventually 74 pairs in the experimental group and 75 pairs in the control group completed the study.The Family Caregiver Task Inventory scores in the experimental group were lower than that in the control group(P=0.046).Generalized estimation equation showed that,there were significant differences on the intervention effect,the time effect,and the interaction effect of the Family Relocation Stress Scale scores in 2 groups(P＜0.05).Conclusion The ICU transitional care program for critically ill children constructed in this study can effectively improve the level of migration stress and caregiving ability of parents of critically ill children,and optimize the quality of transitional care for critically ill children.

Objective Constructing a transitional care program for critically ill children in the ICU and exploring the effects of its application on the relocation stress and caregiving abilities of parents of children to improve their caregiving experience.Methods Convenience sampling method was used to select 150 children and their families transferred from PICU to the general ward of a tertiary pediatric hospital in Shanghai from January to September 2023 as research subjects.Subjects enrolled from June to September 2023 were selected as an experimental group,and were applied with the ICU transitional care program for critically ill children.Those enrolled from January to April 2023 were selected as a control group,and received routine ICU transitional care.Family Relocation Stress Scale and Family Caregiver Task Inventory were used to evaluate children's families at 24h before,24h after,and 72h after children's transition from ICU.The incidence of unplanned readmission to ICU within 48h and adverse events were compared between 2 groups of children.Results Eventually 74 pairs in the experimental group and 75 pairs in the control group completed the study.The Family Caregiver Task Inventory scores in the experimental group were lower than that in the control group(P=0.046).Generalized estimation equation showed that,there were significant differences on the intervention effect,the time effect,and the interaction effect of the Family Relocation Stress Scale scores in 2 groups(P＜0.05).Conclusion The ICU transitional care program for critically ill children constructed in this study can effectively improve the level of migration stress and caregiving ability of parents of critically ill children,and optimize the quality of transitional care for critically ill children.

Object:To explore the feasibility of using artificial intelligence for quality control of echocardiographic images.Methods:Retrospectively，5 000 two-dimensional echocardiographic video images within the period from 2021 to 2023 were randomly retrieved from the echocardiography database of Nanjing Drum Tower Hospital，Affiliated Hospital of Medical School，Nanjing University. Among these selected images，1 559 of them were apical views. The physician team formulated the scoring rules，which specifically included four scoring criteria：gain，scaling ratio，cardiac axis angle，and structure. Subsequently，the data were labeled with view classification and image quality scores. The labeled data were further partitioned into the training set（ n = 643），the validation set（ n = 276），and the test set（ n = 640）. The training and validation sets were utilized for constructing the models for view classification and quality assessment，while the test set was employed to verify the models' effectiveness. The view classification module was implemented using the SlowFast model，and the quality assessment module involved algorithms such as ResNet，Video Swin Transformer，SSD，and U-Net. Results:The average accuracy，precision，recall rate and F1 score of the classification model in identifying each apical view were 0.987 1，0.983 0，0.987 1 and 0.984 9 respectively，and the inference time was（333.4 ± 105.4）ms. The average accuracies of the quality assessment module in terms of gain，scaling ratio，cardiac axis angle and display of main structures were 0.915 1，0.928 2，0.938 7 and 0.965 6 respectively，and the overall scoring accuracy was 0.912 7.Conclusions:The echocardiogram quality control system developed in this research can effectively classify and evaluate the quality of two-dimensional images of the apical views in echocardiograms. Moreover，it guarantees the objectivity，timeliness and high-efficiency of quality control，which has reference value for the establishment of the echocardiogram quality control system.

OBJECTIVE To investigate the inhibitory effects of Ginkgo biloba extract （GBE） on renal inflammation in diabetic nephropathy （DN） model mice， and its potential mechanism. METHODS KK/Ay mice were fed with high fat and high sugar to induce DN model. They were divided into model group， positive control group [metformin 200 mg/（kg·d）]， GBE low-dose and high-dose groups [100， 200 mg/（kg·d）]， with 6 mice in each group. Six C57BL/6J mice were fed with a regular diet as the control group. Administration groups were given relevant liquid intragastrically， control group and model group were given constant volume of normal saline intragastrically， once a day， for 8 consecutive weeks. The body weight， fasting blood glucose， 24-hour food intake， 24-hour urine output， monocyte chemoattractant protein-1 （MCP-1）， interleukin-12 （IL-12）， IL-10， advanced glycation end products （AGEs）， blood urea nitrogen （BUN） and serum creatinine （Scr） of mice were measured， and the ratio of bilateral kidneys to body weight was also calculated. The pathological injury and fibrotic changes of the renal cortex were observed， and the expressions of macrophage polarization marker proteins [type M1： inducible nitric oxide synthase （iNOS）； type M2： arginase-1 （Arg-1）] and AGEs-the receptor of advanced glycation end products （RAGE）/Ras homolog gene pharm_chenjing@163.com family member A （RhoA）/Rho-associated coiled-coil forming protein kinase （ROCK） signaling pathway-related proteins were determined in renal cortex. RESULTS Compared with the model group， the symptoms such as renal cortical hyperplasia， vacuoles， infiltration of inflammatory cells， and renal cortical fibrosis had been improved in GBE low-dose and high-dose groups； body weight， serum level of IL-10， the expression of Arg-1 in the renal cortex were significantly higher than model group （P＜ 0.01）； fasting blood glucose， 24-hour food intake， 24-hour urine output， serum levels of MCP-1， IL-12， BUN， Scr and AGEs， the ratio of bilateral kidneys to body weight， renal injury score， the proportion of renal interstitial fibrosis， the protein expressions of iNOS， RAGE， RhoA and ROCK1 （except for GBE low-dose group） in renal cortex were significantly lower than model group （P＜0.01）. CONCLUSIONS GBE could improve kidney damage and alleviate inflammatory response in DN model mice， the mechanism of which may be related to inhibiting the AGEs-RAGE/RhoA/ROCK signaling pathway and regulating macrophage polarization.

Objective To assess the predictive value of the model combined conventional metabolic parameters and radiomics fea-tures from 18F-FDG PET/CT for predicting HER-2 expression status in gastric cancer.Methods A retrospective analysis included 110 gastric cancer patients from The Second Hospital Lanzhou University and The Gansu Provincial People's Hospital.All patients under-went 18 F-FDG PET/CT before treatment.The Lanzhou cases were randomly divided into a 7∶3 training set(n=61)and an internal vali-dation set(n=26),while data from Gansu Provincial People's Hospital(n=23)served as an external validation set.LASSO regression and 10-fold cross-validation were employed to select PET parameters and radiomics features in the training set.Logistic regression was used to create PET,radiomics,and combined model.Evaluation included ROC curves and the DeLong test for model comparison.Clinical utility was assessed using decision curve analysis,and model consistency was observed through calibration curves.Results Models based on 3,2 and 5 selected features for the PET,radiomics,and combined model.ROC curves demonstrated strong predictive performance for all models.The DeLong test showed a significant difference between the combined model and radiomics model in the training set(P＜0.05),with no statistical difference between the PET model and radiomics model(P＞0.05).Internal and external validation sets showed no statistical differences among the three models(P＞0.05).Calibration curves indicated good fitting effects for each model,and decision curve analysis revealed higher clinical utility for the combined model compared to the other two models.Conclusion The combined model provides a robust predictive tool for determining HER-2 expression status in gastric cancer patients.

Objective:To compare the safety of radial artery puncture in elderly patients aged 75 years and older who are undergoing neurointerventional procedures.Methods:A single-center retrospective study was conducted, involving 350 elderly patients aged 75 years and older who received neurointerventional treatment at Beijing Tiantan Hospital, Capital Medical University, from June to December 2022.The participants were divided into two groups based on the puncture site: femoral artery puncture and radial artery puncture.The safety indicators compared between the two groups included puncture failure, changes in puncture site, general puncture complications(such as subcutaneous bleeding, puncture site hematoma, and vasospasm), severe puncture complications(including distal limb ischemia and pseudoaneurysm), and lower limb venous thrombosis.Multivariate Logistic regression analysis was conducted to evaluate the impact of different puncture methods on the occurrence of complications.Results:Among the 350 patients, 280 underwent femoral artery puncture, while 70 underwent radial artery puncture.There were no statistically significant differences in baseline characteristics between the two groups(all P>0.05).The proportions of patients using antiplatelet drugs prior to surgery, puncture failure rates, rates of change in puncture sites, and the incidence of severe complications-including distal limb ischemia and pseudoaneurysm-were not significantly different between the two groups( χ2=2.051, 0.075, 0.588, 3.175; P=0.152, 0.784, 0.443, 0.075).In the femoral artery puncture group, 20.4%(57 cases)of patients experienced general puncture complications(including subcutaneous bleeding, puncture site hematoma, and vasospasm), whereas only 8.6%(6 cases)in the radial artery puncture group experienced such complications, revealing a statistically significant difference between the two groups( χ2=5.720, P=0.022).Multivariate Logistic regression analysis indicated that, compared to femoral artery puncture, radial artery puncture was associated with a reduced risk of all complications( OR=0.272, 95% CI: 0.139-0.532, P<0.001), general puncture complications( OR=0.375, 95% CI: 0.153-0.919, P=0.032)and lower limb venous thrombosis( OR=0.219, 95% CI: 0.050-0.954, P=0.043). Conclusions:In elderly patients aged 75 years and older who are undergoing neurointerventional procedures, radial artery puncture is associated with a reduced incidence of general puncture complications and lower limb venous thrombosis when compared to femoral artery puncture, indicating a superior safety profile.