Objective To predict the invasion degree of subsolid nodule(SSN)lung adenocarcinoma using a combined model incorporating artificial intelligence(AI)quantitative parameters and imaging signs,and to validate the predictive efficacy of this model.Methods A total of 281 SSN lung adenocarcinoma CT images in 243 patients were retrospectively collected and randomly divided into training set(224 cases)and validation set(57 cases)in an 8∶2 ratio,with atypical adenomatous hyperplasia(A AH)+adenocarcinoma in situ(AIS)+minimally invasive adenocarcinoma(MIA)(191 cases)as the non-invasive adenocarcinoma(I AC)group and I AC(90 cases)as the IAC group.Multivariate logistic regression analysis was performed based on the AI quantitative parameters and CT signs in the training set to obtain independent predictors of IAC.A combined model and nomogram were then constructed and validated.The diagnostic efficacy and clinical applicability of the model were evaluated by the receiver operating characteristic(ROC)curve,calibration curve,and clinical decision curve analysis(DCA).Results Multivariate logistic regression analysis of the training set showed nodule type,spicule sign,vascular abnormality,long diameter＞11.5 mm,median CT value＞—426.25 HU,and mass＞391.5 mg were independent predictors of IAC(P＜0.05).The area under the curve(AUC)of the training set model,based on these independent predictive factors,was 0.915[95％confidence interval(CI)0.875-0.954],and the AUC of the validation set model was 0.903(95％CI 0.824-0.982),indicating both the training set and validation set models had high efficacy in distinguishing IAC.The nomogram model,which quantified these independent factors,demonstrated enhanced predictive power for IAC.The calibration curve indicated good fit of the prediction model,and the clinical DCA showed the model had good clinical applicability.Conclusion The model combining AI quantitative parameters and imaging signs has a higher ability to predict the risk of IAC,compared to a single indicator.It helps clinicians in determining the appropriate surgical timing,formulating surgical methods,and reducing overtreatment.

Objective To investigate the causal relationship between abnormal placental lipid metabolism and trophoblast dysfunction in patients with preeclampsia(PE),and to explore the regulatory effects of PPARγ on trophoblast function under hypoxic conditions.Methods Placental tissues were collected from 30 patients with PE and 30 individuals with normal pregnancies at the General Hospital of Ningxia Medical University between October 2020 and November 2021 for the analysis of lipid deposition.A rat model of PE was established,comprising a sham-operated(Sham)group and a reduced uterine perfusion pressure(Rupp)group,with six rats in each group(n=12 total).Human trophoblast cells(HTR-8/SVneo)were cultured in vitro and randomly assigned to four experimental groups:normoxic control,hypoxia,hypoxia+PPARγ agonist(Rosiglitazone),and hypoxia+PPARγ antagonist(T0070907).The expression levels of lipid metabolism-related genes and transcription factors(FASN,FABP4,PPARγ,LXRα)were assessed using RT-qPCR.Western blotting was performed to determine the protein expression levels of PPARγ.Cell migration and invasion capacities were evaluated using scratch wound healing and Transwell assays,respectively.Results Placental lipid deposition in the PE group was significantly higher than that in the control group,particularly in the Rupp model mice(P<0.001).Under hypoxic conditions,the expression levels of FASN and FABP4 were upregulated in trophoblast cells(P<0.001),whereas the expression of PPARγ and LXRα was downregulated(P<0.001).Furthermore,treatment with the PPARγ antagonist T0070907 exacerbated the inhibitory effects of hypoxia on cell function(P<0.001),significantly reducing cell invasion and migration capacity(P<0.001).Additional siRNA-mediated knockdown experiments confirmed that PPARγ deficiency further aggravated hypoxia-induced impairments in cell migration and invasion,and this detrimental effect could not be reversed by Rosiglitazone.Conclusions Abnormal placental lipid metabolism in PE is closely linked to PPARγ-mediated enhancement of lipid synthesis and metabolic dysregulation under hypoxic conditions,which may subsequently impair trophoblast invasion and migration.

Objective To predict the invasion degree of subsolid nodule(SSN)lung adenocarcinoma using a combined model incorporating artificial intelligence(AI)quantitative parameters and imaging signs,and to validate the predictive efficacy of this model.Methods A total of 281 SSN lung adenocarcinoma CT images in 243 patients were retrospectively collected and randomly divided into training set(224 cases)and validation set(57 cases)in an 8∶2 ratio,with atypical adenomatous hyperplasia(A AH)+adenocarcinoma in situ(AIS)+minimally invasive adenocarcinoma(MIA)(191 cases)as the non-invasive adenocarcinoma(I AC)group and I AC(90 cases)as the IAC group.Multivariate logistic regression analysis was performed based on the AI quantitative parameters and CT signs in the training set to obtain independent predictors of IAC.A combined model and nomogram were then constructed and validated.The diagnostic efficacy and clinical applicability of the model were evaluated by the receiver operating characteristic(ROC)curve,calibration curve,and clinical decision curve analysis(DCA).Results Multivariate logistic regression analysis of the training set showed nodule type,spicule sign,vascular abnormality,long diameter＞11.5 mm,median CT value＞—426.25 HU,and mass＞391.5 mg were independent predictors of IAC(P＜0.05).The area under the curve(AUC)of the training set model,based on these independent predictive factors,was 0.915[95％confidence interval(CI)0.875-0.954],and the AUC of the validation set model was 0.903(95％CI 0.824-0.982),indicating both the training set and validation set models had high efficacy in distinguishing IAC.The nomogram model,which quantified these independent factors,demonstrated enhanced predictive power for IAC.The calibration curve indicated good fit of the prediction model,and the clinical DCA showed the model had good clinical applicability.Conclusion The model combining AI quantitative parameters and imaging signs has a higher ability to predict the risk of IAC,compared to a single indicator.It helps clinicians in determining the appropriate surgical timing,formulating surgical methods,and reducing overtreatment.

Objective To investigate the causal relationship between abnormal placental lipid metabolism and trophoblast dysfunction in patients with preeclampsia(PE),and to explore the regulatory effects of PPARγ on trophoblast function under hypoxic conditions.Methods Placental tissues were collected from 30 patients with PE and 30 individuals with normal pregnancies at the General Hospital of Ningxia Medical University between October 2020 and November 2021 for the analysis of lipid deposition.A rat model of PE was established,comprising a sham-operated(Sham)group and a reduced uterine perfusion pressure(Rupp)group,with six rats in each group(n=12 total).Human trophoblast cells(HTR-8/SVneo)were cultured in vitro and randomly assigned to four experimental groups:normoxic control,hypoxia,hypoxia+PPARγ agonist(Rosiglitazone),and hypoxia+PPARγ antagonist(T0070907).The expression levels of lipid metabolism-related genes and transcription factors(FASN,FABP4,PPARγ,LXRα)were assessed using RT-qPCR.Western blotting was performed to determine the protein expression levels of PPARγ.Cell migration and invasion capacities were evaluated using scratch wound healing and Transwell assays,respectively.Results Placental lipid deposition in the PE group was significantly higher than that in the control group,particularly in the Rupp model mice(P<0.001).Under hypoxic conditions,the expression levels of FASN and FABP4 were upregulated in trophoblast cells(P<0.001),whereas the expression of PPARγ and LXRα was downregulated(P<0.001).Furthermore,treatment with the PPARγ antagonist T0070907 exacerbated the inhibitory effects of hypoxia on cell function(P<0.001),significantly reducing cell invasion and migration capacity(P<0.001).Additional siRNA-mediated knockdown experiments confirmed that PPARγ deficiency further aggravated hypoxia-induced impairments in cell migration and invasion,and this detrimental effect could not be reversed by Rosiglitazone.Conclusions Abnormal placental lipid metabolism in PE is closely linked to PPARγ-mediated enhancement of lipid synthesis and metabolic dysregulation under hypoxic conditions,which may subsequently impair trophoblast invasion and migration.

Objective:To evaluate the clinical efficacy of omalizumab in the treatment of patients with chronic spontaneous urticaria accompanied by other allergic diseases.Methods:Clinical data were retrospectively collected from 74 patients, who were clinically diagnosed with chronic spontaneous urticaria and other allergic diseases, and received subcutaneous injections of omalizumab in the Department of Allergy, Tianjin Medical University General Hospital from June 2020 to September 2022. Types of allergic diseases, serum total IgE (tIgE) and allergen-specific IgE (sIgE) levels before treatment, treatment outcomes and adverse drug reactions were analyzed. Differences before and after treatment were assessed using paired t-test and Wilcoxon signed-rank sum test. Results:A total of 74 patients with chronic spontaneous urticaria were involved, including 29 with complicated allergic asthma (39.2%) , 61 with complicated allergic rhinitis (82.4%) , 6 with complicated atopic dermatitis (8.1%) , and 4 with food allergy (5.4%) . Before treatment, elevated serum tIgE or sIgE levels were observed in 44 (59.5%) patients. After the first omalizumab treatment, the urticaria control test (UCT) score significantly increased compared with that before treatment (16.00 [13.0.0, 16.00] vs. 6.00 [5.75, 9.00], Z = 7.39, P < 0.001) ; after 4 sessions of the omalizumab treatment, 82.5% (33/40) of the patients achieved complete control of urticaria symptoms or showed complete response. After omalizumab treatment, asthmatic attacks were decreased in 29 patients with allergic asthma, and asthma control test (ACT) scores significantly increased compared with those before treatment (21.07 ± 2.88 points [after the first treatment] vs. 18.48 ± 3.20 points [before treatment], t = 8.87, P < 0.001) ; among 61 patients with allergic rhinitis, global rhinitis symptom-based visual analog scale (VAS) scores (before treatment: 5.89 ± 1.29 points; after the first treatment: 3.28 ±1.46 points) and rhinoconjunctivitis quality of life questionnaire (RQLQ) scores (before treatment: 60.10 ± 20.53 points; after the first treatment: 37.26 ± 18.83 points) both significantly decreased after the first treatment ( t = 15.04, 10.01, respectively, both P < 0.001) , and rhinitis symptoms were relieved at the same time; skin itching was relieved in 4 patients with atopic dermatitis, and allergic symptoms after contact with food allergens were also relieved in the 2 patients with food allergy after omalizumab treatment. During the treatment, only 1 patient experienced erythematous swelling, induration, and pain at the injection site. Conclusions:In the treatment of chronic spontaneous urticaria accompanied by allergic diseases, the use of omalizumab not only effectively improved urticaria symptoms, but also well controlled allergic diseases, with a good safety profile. Multiple benefits may be achieved by the use of omalizumabin in patients with chronic spontaneous urticaria accompanied by other allergic diseases.

With the coronavirus disease 2019(COVID-19)pandemic across the world, numerous variants have emerged.As a high-risk group for COVID-19, the elderly are prone to acute kidney injury(AKI), with atypical clinical features and high proportions of patients with critical illness.Its pathogenesis mainly includes direct damage to the kidney via the angiotensin-converting enzyme 2(ACE2)pathway, the extracellular matrix metalloproteinase inducer(CD147)pathway, and age-related renal dysfunction, inflammatory aging, immune aging and other non-specific mechanisms, which significantly increase the risk of adverse prognosis.Therefore, the establishment of an early warning system for AKI, increasing vaccination coverage, nutritional support, treatment of primary diseases, extracorporeal supportive therapy and other control measures are particularly important to prognosis improvement.This review summarized the pathogenesis, early prevention and treatment of AKI in elderly patients with COVID-19.

To construct a hypobaric hypoxia-induced cell injury model. Rat pheochromocytoma PC12 cells were randomly divided into control group, normobaric hypoxia group and hypobaric hypoxia group. The cells in control group were cultured at normal condition, while cells in other two groups were cultured in normobaric hypoxia and hypobaric hypoxia conditions, respectively. CCK-8 method was used to detect cell viability to determine the optimal modeling conditions like the oxygen concentration, atmospheric pressure and low-pressure hypoxia time. The contents of lactate dehydrogenase (LDH), superoxide dismutase (SOD) and malondialdehyde (MDA) were detected by microplate method. The apoptosis ratio and cell cycle were analyzed by flow cytometry. The hypobaric hypoxia-induced cell injury model can be established by culturing for 24 h at 1% oxygen concentration and 41 kPa atmospheric pressure. Compared with the control group and normobaric hypoxia group, the activity of LDH and the content of MDA in hypobaric hypoxia group were significantly increased, the activity of SOD was decreased, the percentage of apoptosis was increased (all <0.05), and the cell cycle was arrested in G0/G1 phase. A stable and reliable cell injury model induced by hypobaric hypoxia has been established with PC12 cells, which provides a suitable cell model for the experimental study on nerve injury induced by hypoxia at high altitude.
Animals ; Cell Hypoxia ; Hypoxia ; Malondialdehyde ; PC12 Cells ; Rats ; Superoxide Dismutase/metabolism*

Objective:To implement PRECEDE-PROCEED based intervention in community patients with type 2 diabetes mellitus (T2DM) and explore its effects on patients' diabetes knowledge and self-efficacy.Methods:Totally 86 T2DM patients treated in a community health service center in Hangzhou between May and October 2014 were selected using convenient sampling and divided into intervention group ( n=43) and control group ( n=43) . Patients in the intervention group received 6-month intervention based on PRECEDE-PROCEED, while patients in the control group received a regular community health education course once during the same period. The diabetes knowledge and self-efficacy scores were evaluated between the two groups before and 3 and 6 months after intervention. At last, a total of 40 patients in the intervention group and 42 patients in the control group completed the study. Results:Repeated measures analysis of variance showed that there were time-dependent, between-group and combined effects in diabetes knowledge and self-efficacy scores in the two groups ( P<0.05) . Pairwise comparison between the two groups revealed that there was no statistically significant difference in diabetes knowledge and self-efficacy scores between the two groups before intervention ( P>0.05) , but there were statistically significant differences in diabetes knowledge and self-efficacy scores between the two groups 3 and 6 months after intervention ( P<0.05) . Conclusions:The PRECEDE-PROCEED based intervention can effectively improve the diabetes knowledge and self-efficacy of T2DM patients, which is worth promoting in clinical practice.

OBJECTIVE: To investigate the effect of short-term rehabilitation therapy based on exercise on lung function in coal workers' with pneumoconiosis(CWP). METHODS: A total of 74 CWP patients were divided into control group(32) and treatment group(42) by random number table method. The control group received routine treatment only. The treatment group underwent 6 months of exercise-based rehabilitation treatment on the basis of routine treatment. The lung function was assessed in two groups to evaluate the treatment efficacy. RESULTS: Before rehabilitation treatment, the vital capacity(VC) and forced vital capacity(FVC) of patients in the treatment group were lower than that in the control group(P<0.05). But there was no significant difference in forced expiratory volume in first second(FEV_(1.0)) and FEV_(1.0)% between the two groups(P>0.05). After treatment, VC and FVC in the treatment group were higher than that before treatment in the same group(P<0.05). However, there was no significant difference in the four lung function indexes before and after treatment in the control group(P>0.05). The difference of VC and FVC before and after treatment in the treatment group was higher than those in the control group(P<0.01). However, there was no significant difference in FEV_(1.0 )and FEV_(1.0)% between the two groups before and after treatment(P>0.05). CONCLUSION: Exercise-based short-term rehabilitation therapy can improve lung ventilation of CWP patients.

Objective:To investigate the effects of sodium aescinate on endothelin ( ET ) and calcitonin gene -related peptide ( CGRP) contents in the gerbils with cerebral ischemia/reperfusion injury ( CI/R) . Methods:The gerbil model of CI/R was prepared by bilateral common carotid arteries ligation for 10 min followed by 2-hour reperfusion. Sodium aescinate (i. p. , 10, 20 and 40 mg· kg-1 ) was administered once a day for 3 days before the operation and once every 1 h after the operation, respectively. The levels of ET and CGRP in brain tissue homogenate were determined by a radioimmunoassay method. Results:Sodium aescinate significantly in-hibited the level of ET (28. 69-37. 03 ng·L-1) in the brain tissue of gerbils with CI/R compared with the model group (P<0. 05 or P<0. 01), while showed no evident influence on CGRP (P>0. 05). Conclusion:Sodium aescinate has obvious protective effects a-gainst CI/R in gerbils, which may be due to its inhibitory action on ET levels in brain tissue.