ObjectiveTo evaluate a novel nomogram based on contrast-enhanced MRI radiomics combined with clinical variables for the preoperative prediction of perineural invasion （PNI） in intrahepatic cholangiocarcinoma （ICC）. MethodsThe clinical data of 59 ICC patients were retrospectively collected. According to postoperative pathology reports， the patients were divided into the non-PNI group （n = 33） and the PNI group （n = 26）. Regions of interest （ROI） were delineated from five MRI sequences. Radiomics features were then extracted and filtered to select those with the strongest discriminative power for PNI identification. These selected features were used to construct a radiomics model， which subsequently generated a quantitative radiomics score （radiomics score， Radscore）. Univariate analysis was applied to identify clinical variables associated with PNI， and the glm function was subsequently used to construct clinical and combined models. Finally， the models were evaluated using receiver operating characteristic （ROC） curves， calibration curves， and decision curve analysis （DCA）. The combined model was then visualized as a nomogram. ResultsThe clinical model included age， carbohydrate antigen 19-9 （CA19-9）， red blood cell distribution width， and albumin， whereas the Radscore included five radiomic features. The areas under the ROC curves （AUCs） for the clinical and radiomics models were 0.717 （95%CI： 0.586-0.848） and 0.896 （95%CI： 0.820-0.973）， respectively， whereas the combined model further improved its AUC to 0.917 （95% CI：0.848-0.987）. The calibration curves and DCA showed that the nomogram was well calibrated and provided the greatest net clinical benefit. ConclusionThe novel nomogram may serve as a basis for preoperative prediction of PNI status， thereby assisting clinical decision-making and guiding personalized treatment.

Objective:To explore the clinical application value of press-needle assisted sedation therapy in sedation treatment of intensive care unit (ICU) under bispectral index (BIS) monitoring.Methods:A total of 30 critically ill patients admitted to the ICU of the China-Japan Friendship Hospital from July 2024 to January 2025 were selected. A prospective self before-after control method was used. On the basis of conventional analgesic and sedative drug treatment, traditional Chinese medicine press-needles were combined to stimulate the head emotion area, Yintang (GV29), Hegu (LI4), Neiguan (PC6), and Zusanli (ST36). The BIS, dosages of remifentanil and propofol, respiratory and circulatory functions, and lactate levels before and after treatment were compared.Results:The BIS value dropped to stability (21.90±13.67)min after press-needle treatment, with a decrease of (5.73±1.42) ( P<0.05). The dosage of propofol within 8 h after press-needle treatment was reduced by (1.08±0.33)mg/kg compared with that before treatment ( P<0.05). There were no significant differences in heart rate, blood pressure, oxygenation index, and lactate level before and after treatment (all P>0.05). Conclusions:Press-needle assisted sedation therapy can improve the sedative effect, reduce the dosage of propofol sedatives, and has good safety.

Objective To investigate the value of combined detection of serum interleukin-25(IL-25),interleukin-33(IL-33),C-C motif chemokine ligand 2(CCL-2)and C-C motif chemokine ligand 17(CCL-17)in children with bronchial asthma.Methods A total of 91 children diagnosed with bronchial asthma were enrolled into asthma group,and 46 healthy children undergoing routine physical examinations during the same period were included in control group.General clinical data,airway inflammatory markers[fractional exhaled nitric oxide(FeNO)and immunoglobulin E(IgE)]and pulmonary function parameters[forced vital capacity(FVC),forced expiratory volume in one second(FEV1),peak expiratory flow(PEF),minute resting ventilation(VE)and specific airway resistance(Raw)]were comparedbetween the two groups.The levels of serum IL-25,IL-33,CCL-2 and CCL-17 were compared between the two groups.According to the severity of asthma,the patients were further divided into severe asthma subgroup(n=31)and non-severe asthma subgroup(n=60).Spearman correlation analysis was performed to evaluate the association between serum levels of IL-25,IL-33,CCL-2 as well as CCL-17 and the severity of asthma.Multivariate logistic regression analysis was used to identify independent risk factors for severe exacerbation in children with bronchial asthma.The predictive value of serum IL-25,IL-33,CCL-2 and CCL-17 for severe at-tacks of bronchial asthma was analyzed by using the receiver operating characteristic(ROC)curve.Results The levels of FeNO,IgE,IL-25,IL-33,CCL-2 CCL-17 and VE in the asthma group were significantly higher than those in the healthy group,while the levels of FVC,FEV1,PEF and Raw were significantly lower than those in the healthy group(P＜0.05).The levels of FeNO,IgE,IL-25,IL-33,CCL-2,CCL-17 and VE in the severe group were significantly higher than those in the non-severe group,while the levels of FVC,FEV1,PEF and Raw were significantly lower than those in the non-severe group(P＜0.05).The levels of serum IL-25,IL-33,CCL-2 and CCL-17 in children of the asthma group were positively correlated with the severity of asthma(r=0.382,0.416,0.475,0.501,P＜0.05).The levels of serum IL-25,IL-33,CCL-2 and CCL-17 were in-dependent influencing factors for severe asthma.The area under the receiver operating characteristic curve for the combined detection of IL-25,IL-33,CCL-2 and CCL-17 was greater than that obtained from each individual biomarker.Conclusion The combined prediction of serum IL-25,IL-33,CCL-2 and CCL-17 has relatively high value in predicting the development of severe asthma in chil-dren with bronchial asthma.

Objective:To explore the clinical application value of press-needle assisted sedation therapy in sedation treatment of intensive care unit (ICU) under bispectral index (BIS) monitoring.Methods:A total of 30 critically ill patients admitted to the ICU of the China-Japan Friendship Hospital from July 2024 to January 2025 were selected. A prospective self before-after control method was used. On the basis of conventional analgesic and sedative drug treatment, traditional Chinese medicine press-needles were combined to stimulate the head emotion area, Yintang (GV29), Hegu (LI4), Neiguan (PC6), and Zusanli (ST36). The BIS, dosages of remifentanil and propofol, respiratory and circulatory functions, and lactate levels before and after treatment were compared.Results:The BIS value dropped to stability (21.90±13.67)min after press-needle treatment, with a decrease of (5.73±1.42) ( P<0.05). The dosage of propofol within 8 h after press-needle treatment was reduced by (1.08±0.33)mg/kg compared with that before treatment ( P<0.05). There were no significant differences in heart rate, blood pressure, oxygenation index, and lactate level before and after treatment (all P>0.05). Conclusions:Press-needle assisted sedation therapy can improve the sedative effect, reduce the dosage of propofol sedatives, and has good safety.

Objective:To understand the clinical characteristics of Pneumocystis carinii pneumonia (PCP) in immunocompromised patients. Methods:Clinical data of 15 patients with PCP hospitalized in Shanghai East Hospital, Tongji University from March 2018 to March 2019 were retrospectively analyzed. Clinical manifestations, laboratory index examinations, imaging characteristics, comorbidities, treatment and outcome were observed.Results:Among the 15 cases, 11 were cases with hematological malignancies and four cases received allogenetic hematopoietic stem cell transplantation (AHSCT). The onset time was (5.82±2.33) months after transplantation. Chest computed tomography (CT) of all 15 patients showed diffuse ground glass-like exudation of the lungs surrounding hilar. Peripheral blood CD4 + T cell count decreased to (135.17±74.83)/μL and oxygenation index to (188.47±41.03) mmHg(1 mmHg=0.133 kPa), while lactic acid dehydrogenase (LDH) elevated to (576.18±228.01) U/L.Levels of 1, 3-β-D-glucan in serum and bronchoalveolar lavage fluid (BALF) increased to (1 862.81±157.73) ng/L and (1 216.97±957.16) ng/L, respectively. Metagenomic next-generation sequencing (mNGS) of BALF showed that the numbers of sequence of Pneumocystis carinii were 120 to 14 383. There were nine patients co-infected with cytomegalovirus (CMV), four patients with Epstein-Barr virus, and two patients with gram-negative bacilli. All the patients received compound sulfamethoxazole and caspofungin treatment, and 13 cases improved and two died. Conclusions:Patients with hematological malignancies and AHSCT are at high-risk of PCP. Serum counts of CD4 + T cells decrease, while serum levels of LDH and 1, 3-β- D-glucan increase.mNGS is valuable for early diagnosis.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cell Culture Techniques ; methods ; Child ; Female ; Humans ; Induced Pluripotent Stem Cells ; cytology ; metabolism ; Male ; Middle Aged

Background Influence of weightlessness on visual function has been a hot topic in aerospace medicine field.Electroretinography (ERG) is valuable tool of evaluating visual function.Objective This study aims to observe the influence of head down tilt simulated weightlessness on ERG.MethodHead down tilt for 6° was adopted in 6 healthy volunteers.Flash ERG,including rod response,maxium response,cone response,oscillatory potentials (OPs) and 30 Hz flicker was recorded,and the latency and amplitude from each wave were analyzed before,two days and five days after trial.The record procedure followed the ISCEV standard for full field clinical electroretinography (2008 update).Oral informed consent was obtained from all the subjects prior to the trail.Results No significant differences were detected in the latencies and amplitudes of a,b waves of cone response and 30 Hz flicker among various time points(P＞0.05).The latencies were significantly prolonged in b wave of rod and a,b waves of maxim responses(P＜0.01),but no obvious change was found in amplitudes (P＞0.05).Both the latency and amplitude of all of the wavelets of OPs were considerably among the different time points(P＜0.05-0.01),and the ∑OPs was evidently different among the different time points(P＜0.05).Conclusion Head down tilt simulated weightlessness induce the abnormality of visual function in the early stage.

Objective To observe the influence of head-down tilt on visual evoked potential.Methods Six healthy volunteers were exposed to-6? head-down tilt.The visual evoked potential were measured before the test,the second day and the fifth day of the test under different space frequency.Results No significant difference was found in the latency of P100 before and after the test.The amplitude of P100 had significant change under high space frequency.But not the same happened on middle and low space frequency.Conclusion head-down tilt can induce the change of visual evoked potential under high space frequency,which means the weightlessness may influent the visual function.