1.Study on the safety and efficacy of micro-perfusion device for preserving isolated porcine limbs
Pengkai LI ; Zhaodi MI ; Shen LI ; Man YUAN ; Xiwei PENG ; Jia LÜ ; Sice WANG ; Zhibo JIA ; Xiangyu SONG ; Yixuan ZHU ; Chonghui LI ; Moling XIAO ; Wenjing XU ; Jiang PENG
Organ Transplantation 2026;17(3):422-431
Objective To evaluate the safety and efficacy of a self-developed micro-normothermic machine perfusion (NMP) system (micro-perfusion device) for preserving isolated porcine limbs. Methods Five healthy Landrace pigs were selected, and their left and right forelimbs were randomly divided into the NMP group and static cold storage (SCS) group. The NMP group was perfused with the self-developed micro-perfusion device and polymerized hemoglobin perfusate for 32 hours at normothermia, while the SCS group was preserved at 4 ℃. Hemodynamic parameters such as perfusion pressure and flow were monitored. The pH value, partial pressure of oxygen (PO2), lactic acid (Lac), creatine kinase (CK) and lactate dehydrogenase (LDH) in the perfusate were measured. Hematoxylin-eosin staining was used to assess the muscle tissue structure, terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling was employed to evaluate muscle cell apoptosis, and immunohistochemistry staining was applied to detect the expressions of tumor necrosis factor (TNF)-α and interleukin (IL)-6. A mixed-effects model was used to analyze the effects of time and treatment methods on tissue structure, cell apoptosis and inflammatory factors. Results The device could stably maintain a perfusion pressure of (69±15) mmHg and a flow rate of (117±42) mL/min. The pH value and electrolytes of the perfusate were generally stable, with PO2 maintained at a high level. Lac was maintained at 5.38(3.81, 6.45) mmol/L, while CK and LDH increased over time. After 32 hours of perfusion in the NMP group, both the myocyte spacing and apoptosis rate were better than those in the SCS group. Mixed-effects model analysis showed that there were statistically significant differences in the effects of NMP treatment and SCS treatment on myocyte spacing and apoptosis rate per unit time (both P < 0.05). There were no statistically significant differences in TNF-α and IL-6 between the two groups, and mixed-effects model analysis showed no statistically significant differences in the effects of NMP treatment and SCS treatment on TNF-α and IL-6 per unit time (both P > 0.05). Conclusions The micro-perfusion device used in this study may achieve 32-hour normothermic preservation in a porcine limb amputation model, maintain basic metabolism and ionic homeostasis, reduce muscle structural damage and cell apoptosis without inducing additional inflammatory responses. This technology is expected to significantly extend the time window for replantation of amputated limbs in disaster rescue and long-distance transportation, providing an important technical basis for clinical translation and subsequent replantation research.
2.Mechanistic study of Tripterygium wilfordii multiglucoside in improving nephrotic syndrome via regulating the HIF-1α/miR-155-5p/Nrf2 pathway
Yifan TAO ; Chundong SONG ; Xu WANG ; Chong ZHANG ; Ying SU ; Xidong JIA ; Haoran JIANG
China Pharmacy 2026;37(5):602-606
OBJECTIVE To study the improvement effect and mechanism of Tripterygium wilfordii multiglucoside (TWM) on nephrotic syndrome in rats. METHODS The nephrotic syndrome model was established by intravenous injection of adriamycin via the tail vein. The modeling rats were randomly divided into the model group (distilled water), prednisone group (10 mg/kg), and TWM high- and low-dose groups (10 and 5 mg/kg, respectively). Additionally, blank group (distilled water) without model induction was established. Each group consisted of 9 rats. Rats in each group were administered the corresponding drugs or distilled water by gavage, once a day, for 6 consecutive weeks. The histopathological morphology of kidney tissues in rats was observed; the levels of 24-hour urinary protein (24 h-UTP) and serum biochemical indicators [albumin (ALB), blood urea nitrogen (BUN), serum creatinine (SCr), cholesterol (CHOL), and triglyceride (TG)] in rats were determined; the levels of oxidative stress indicators [superoxide dismutase (SOD), malondialdehyde (MDA)] in kidney tissue of rats were determined; expressions of hypoxia-inducible factor-1α (HIF-1α)/microRNA-155-5p (miR-155-5p)/nuclear factor erythriod 2- related factor 2 (Nrf2) signaling pathway-related mRNA and protein in the renal tissues of rats were detected. RESULTS Compared with the blank group, the rats in the model group exhibited disordered renal tissue structure, with a small amount of glomerular necrosis and edema of the renal tubular epithelial cells. 24 h-UTP, serum levels of SCr, BUN, CHOL and TG, MDA content, mRNA and protein expressions of HIF-1α and Keap1 as well as the expression of miR-155-5p in renal tissues were increased significantly ( P <0.05). Serum level of ALB, SOD level in renal tissue as well as mRNA and protein expressions of Nrf2 were decreased significantly ( P <0.05). Compared with the model group, TWM high-dose and low-dose groups exhibited significant improvements in renal injury, with notable reversals in the levels of the above quantitative indicators ( P <0.05). CONCLUSIONS TWM can alleviate oxidative stress-induced damage and thereby improve nephrotic syndrome in rats by regulating the HIF-1α/miR-155-5p/Nrf2 signaling pathway.
3.Effect and Mechanism of Liangyi Paste on Hepatic Lipid Deposition in Naturally Aged Mice with High-fat Diet via Cuproptosis/Oxidative Stress Pathway
Meiling ZHANG ; Yuanguang DONG ; Xiaofei SUN ; Jiaxin WANG ; Yu LIU ; Jingxuan ZHU ; Qun WANG ; Nan SONG ; Guoyuan SUI ; Lianqun JIA
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(9):91-99
ObjectiveTaking the cuproptosis/oxidative stress pathway as the entry point, this study investigated the effect and mechanism of Liangyi Paste on hepatic lipid deposition in naturally aged mice fed with a high-fat diet. MethodsAfter adaptive feeding, 80 ten-week-old male C57BL/6 mice were used. Thirty of them were randomly divided into three groups (10 mice per group): The 12-month-old control group (12MCON), the 15-month-old control group (15MCON), and the 15-month-old group with a high-fat diet (15MHFD). The 12MCON and 15MCON groups were continuously fed a standard diet, while the 15MHFD group started receiving a high-fat diet at 12 months of age. Tissue samples were collected at the corresponding time points for each group. The remaining 50 mice were randomly divided into five groups (10 mice per group): the 20-month-old control group (20MCON), the model group, and the low-, medium-, and high-dose Liangyi Paste groups (2.91 , 5.82 , 11.64 g·kg-1·d-1, respectively). The 20MCON group was continuously fed a standard diet, while the other groups started receiving a high-fat diet at 15 months of age. At 18 months of age, the Liangyi Paste groups were administered the corresponding doses of Liangyi Paste by gavage, while the 20MCON and model groups were given an equal volume of saline by gavage. After 8 weeks of continuous gavage (when the mice reached 20 months of age), tissue samples were collected. Hepatic TG levels were measured using assay kits; liver histology and lipid deposition were observed via hematoxylin-eosin (HE) and oil red O staining; reactive oxygen species (ROS) were detected by enzyme-linked immunosorbent assay (ELISA); Cu2+, superoxide dismutase (SOD), and malondialdehyde (MDA) levels were measured by colorimetry; mRNA and protein expression of genes related to cuproptosis and oxidative stress pathways were analyzed by Real-time polymerase chain reaction(Real-time PCR) and Wes automated protein expression system. ResultsCompared with 12MCON, the 15MCON group showed significantly increased hepatic TG, Cu2+, ROS, and MDA levels (P<0.01), decreased SOD (P<0.01), hepatocyte swelling, and disordered arrangement. The mRNA and protein levels of ferredoxin 1 (FDX1), dihydrolipoamide S-acetyltransferase (DLAT), heat shock protein 70 (HSP70), dihydrolipoamide dehydrogenase (DLD), pyruvate dehydrogenase E1 subunit-β (PDHB), nuclear factor erythroid 2-related factor 2 (Nrf2), and peroxisome proliferator-activated receptor γ (PPARγ) were significantly elevated (P<0.05, P<0.01). Compared with 15MCON group, the 15MHFD and 20MCON groups exhibited further increases in TG, Cu2+, ROS, and MDA (P<0.01), reduced SOD (P<0.01), and aggravated hepatocyte swelling and disorder. There were increased lipid droplets with mild vacuolization in the 15MHFD group, and no significant lipid deposition was observed in the 20MCON group. FDX1, DLAT, HSP70, DLD, PDHB, Nrf2, and PPARγ mRNA and protein levels were significantly increased (P<0.05, P<0.01). Compared with 20MCON group, the model group demonstrated markedly elevated TG, Cu2+, ROS, and MDA (P<0.01), reduced SOD (P<0.01), severe hepatic steatosis, and upregulated expression of FDX1, DLAT, HSP70, DLD, PDHB, Nrf2, and PPARγ mRNA and proteins (P<0.05, P<0.01). All abnormalities were significantly reversed after Liangyi Paste treatment. ConclusionLiangyi paste can ameliorate hepatic lipid deposition in naturally aged mice with a high-fat diet by modulating the cuproptosis/oxidative stress pathway.
4.Improvement effects of Yiqi yangyin huoxue formula on renal injury in IgA nephropathy rats and its relationship with NEAT1/RACK1/NLRP3 pathway
Xidong JIA ; Chundong SONG ; Xu WANG ; Yifan TAO
China Pharmacy 2026;37(17):2235-2240
OBJECTIVE To investigate the improving effect of Yiqi yangyin huoxue formula on renal injury in immunoglobulin A nephropathy (IgAN) rats, and explore its potential molecular mechanism based on nuclear-enriched abundant transcript 1 (NEAT1)/receptor of activated C kinase 1 (RACK1)/NOD-like receptor family pyrin domain containing 3 (NLRP3) pathway.METHODS SD rats were divided into blank group and model-establishing group. Rats in the model-establishing group were induced to establish IgAN model by combined treatment of bovine serum albumin, carbon tetrachloride and lipopolysaccharide. Rats with successful model establishment were randomly divided into model group, prednisone acetate group (6.25 mg/kg), low-dose and high-dose Yiqi yangyin huoxue formula groups (11, 22 g/kg). Each group was intragastrically administered corresponding drugs or normal saline once a day for 6 consecutive weeks. After the last administration, urinary red blood cell count, 24-hour urinary total protein (24 h-UTP), serum creatinine (Cr), blood urea nitrogen (BUN), albumin (ALB), alanine amino-transferase (ALT) and interleukin-1β (IL-1β) levels were detected. Pathomorphological changes of renal tissues and immunoglobulin A (IgA) deposition in glomerular mesangial region were observed. The mRNA expression of NEAT1, as well as mRNA and protein expression levels of RACK1 and NLRP3 in renal tissues were determined.RESULTS Compared with the blank group, the model group presented glomerular mesangial matrix hyperplasia accompanied by inflammatory cell infiltration, and extensive renal tubular dilation with focal atrophy. The levels of 24 h-UTP, urinary red blood cell count, serum IL-1β, Cr, BUN, ALT, mean fluorescence intensity of IgA deposition in glomerular mesangial area, mRNA expression level of NEAT1, mRNA and protein expression levels of RACK1 and NLRP3 in renal tissues were significantly increased ( P <0.05), while serum ALB level was significantly decreased ( P <0.05). Compared with the model group, the glomerular structure was basically restored and renal tubular injury was obviously alleviated in low-dose and high-dose Yiqi yangyin huoxue formula groups; all the above quantitative indicators were significantly reversed ( P <0.05).CONCLUSIONS Yiqi yangyin huoxue formula can mitigate the inflammatory response and ameliorate renal injury in IgAN rats, and its mechanism may be related to the inhibition of NEAT1/RACK1/NLRP3 pathway activity.
5.MADS-Net: a Multi-scale Attention and Dynamic Sparse Mask Fusion Network for Electrical Impedance Tomography Image Reconstruction in Breast Screening
Cheng-Tao YU ; Jia-Hui WANG ; Song-Pei HU ; Huai-Jin CHEN ; Li DING ; Xia YE ; Jia-Feng YAO
Progress in Biochemistry and Biophysics 2026;53(9):2480-2496
ObjectiveTo address the key challenges in breast electrical impedance tomography (EIT) reconstruction including the severe ill‑posedness of the inverse problem, limited measurement information from the electrodes, low contrast of small lesions, as well as the common drawbacks of traditional reconstruction methods such as boundary blurring, low spatial resolution, and weak small-target detection capability, and to overcome the limitations of existing deep learning approaches namely low training efficiency, insufficient physical consistency, and substantial information loss during the low‑to‑high dimensional mapping process, this study proposes a multi‑scale attention and dynamic sparse mask fusion network (MADS‑Net). The proposed method aims to enhance high‑resolution reconstruction accuracy, small-lesion detectability, noise robustness, and computational efficiency in breast‑screening-oriented EIT, thereby providing a feasible solution for the application of EIT in breast functional imaging. MethodsThe proposed network adopts a strategy of “locate first, reconstruct later”. It realizes adaptive allocation of computational resources through a dynamic mask module, alleviates information loss in the low-to-high dimensional mapping process via a multi-scale attention mechanism, and embeds physical constraints to improve the physical rationality of reconstruction results. The performance of the proposed method was validated through systematic numerical simulations, agar phantom experiments, and porcine tissue experiments. Comparisons were made with mainstream methods including the Gauss-Newton algorithm, convolutional neural networks, U-Net, and Deep D-Bar. The image correlation coefficient (ICC), root mean square error (RMSE), and peak signal-to-noise ratio (PSNR) were adopted as quantitative evaluation metrics. Furthermore, lesion‑level evaluation metrics were introduced to assess the capability of different methods in reconstructing abnormal target boundaries and small‑sized target regions. ResultsExperimental results demonstrate that MADS-Net outperforms all comparison methods across all test scenarios. In numerical simulations, it achieves higher accuracy in target morphology and spatial location recovery as well as better background suppression. In agar phantom experiments, its detection and imaging reliability for small targets is significantly superior to the comparison methods. In porcine tissue experiments, the model maintains good generalization performance and can adapt to complex biological tissue imaging scenarios. Quantitative results show that MADS-Net achieves an average ICC of 0.917 6±0.048 8, an RMSE as low as0.060 6±0.031 6, and a PSNR of (23.893 9±2.685 3) dB. It successfully detects tiny targets as small as 5 mm within a 100 mm diameter sensing field, reduces the total training duration by 23.5% compared with the baseline method, and maintains stable reconstruction performance even under strong noise interference. ConclusionThe results demonstrate that MADS-Net achieves favorable EIT reconstruction performance in numerical simulations, agar phantom experiments, and porcine tissue experiments, even under common practical imaging challenges including low signal-to-noise ratio and blurred tissue boundaries. This study provides a methodological reference for further research on EIT in breast-screening-related scenarios and other medical functional imaging tasks, and also offers a low-cost, radiation-free alternative for breast lesion screening that aligns with the clinical demand for non-invasive diagnostic tools. It should be noted that real clinical breast data have not yet been used for validation in this study, and the clinical applicability of the proposed method requires further investigation. Future work will prioritize collecting multi-center real clinical breast datasets, and further optimize the model’s generalization ability to adapt to individual differences in breast tissue composition to promote its clinical application.
6.Influenza A virus infection activates TLR3-mediated necroptosis
Weijie LI ; Congying HUANG ; Ziling ZENG ; Xiang LI ; Jia XU ; Tian GONG ; Hao ZHANG ; Xinyan ZHANG ; Ping WANG ; Yuanjia HU ; Haiyu XU ; Lijuan SONG
Science of Traditional Chinese Medicine 2026;4(1):40-49
Background: Influenza A virus (IAV) is a negative-sense RNA virus of the Orthomyxoviridae family and is the etiological agent of a highly contagious acute respiratory disease that can lead to acute lung injury. Objective: To elucidate the molecular mechanisms of IAV infection, an integrative research approach combining gene expression profiling, multinetwork analysis, and in vivo experimental validations was employed. Methods: First, a series of network-based analyses were performed, including protein-protein interaction network construction, weighted gene co-expression network analysis, and subsequent gene set enrichment analysis, to identify the major underlying mechanisms of IAV infection. Following gene expression analysis, core targets, both direct and indirect regulators, were screened. An IAV (H1N1) strain A/PR/8/34-induced acute lung injury mouse model was constructed for in vivo validations. Batch one included two groups to evaluate findings from the multi-network analysis: Mock (n = 10; 5 males and 5 females) and IAV (n = 10; 5 males and 5 females). Batch two included three groups to assess the role of toll-like receptor 3 (TLR3) in IAV infection: Mock (n = 6; 3 males and 3 females), IAV (n = 6; 3 males and 3 females), and TLR3 inhibitor (n = 6; 3 males and 3 females). Body weight was measured on days 0, 3, and 5 after infection. On day 5, lung tissues were collected to assess viral load and histopathological changes. Key targets were examined using enzyme-linked immunosorbent assay, Western blotting, and immunofluorescence staining, both in sera and lung tissues. Results: IAV infection was significantly associated with dysregulation of the immune-inflammation system, such as the LTR, nucle-otide-binding oligomerization domain-(NOD) like receptor, retinoic acid-inducible gene I-like receptor, and nuclear factor kappa-B signaling pathways. Gene set enrichment analysis further indicated that the TLR and necroptosis signaling pathways played crucial roles in the progression of IAV infection (TLR signaling pathway normalized enrichment score = 2.3941, P = 1.00 × 10 −10; necroptosis normalized enrichment score = 1.9421, P = 6.21 × 10 −7). Among the core targets, TLR3 and mixed lineage kinase domain-like protein (MLKL) may regulate gene expression at the transcriptional level (all P < 0.05). In vivo validation using an IAV (PR8) infected acute lung injury mouse model demonstrated increased viral load and lung index, alveolar structural damage, and inflammatory cell infiltration. Immunofluorescence staining exhibited large gaps in Lamin B1 staining and breaches in Emerin signals following IAV-PR8 infection. Expression levels of TLR3, p-receptor-interacting serine/threonine-protein kinase 3 (RIPK3)/RIPK3, and p-mixed lineage kinase domain-like protein (MLKL)/MLKL proteins in lung tissues, as well as proinflammatory factors and mediators in sera, were significantly elevated after IAV infection. Moreover, enhanced neutrophil infiltration (myeloperoxidase) and citrullinated histone H3 (a neutrophil extracellular trap-specific marker), both established indicators of neutrophil extracellular trap formation, were observed. Notably, treatment with a TLR3 inhibitor significantly ameliorated IAV-induced acute lung injury by regulating necroptosis-related targets. Conclusion: Our study provides network-based in vivo evidence that TLR3-receptor-interacting serine/threonine-protein kinase 3-MLKL-mediated necroptosis may underlie IAV-induced acute lung injury and could serve as a potential therapeutic target in severe influenza cases.
7.Inhibitory effect and mechanism of traditional Chinese medicine on liver fibrosis and hepatic sinusoidal capillarization
Long WANG ; Li MA ; Andong SONG ; Guohua LI ; Tingting JIA
Journal of Clinical Hepatology 2026;42(5):1166-1171
Hepatic sinusoidal capillarization is the first event in the process of fibrogenesis, and inhibiting hepatic sinusoidal capillarization can effectively improve the pathological process of liver fibrosis. Various studies have shown that traditional Chinese medicine can significantly inhibit hepatic sinusoidal capillarization. This article systematically reviews the effective constituents, monomers, and compound prescriptions of traditional Chinese medicine, summarizes their mechanism of action in inhibiting hepatic sinusoidal capillarization, and analyzes the theoretical core of traditional Chinese medicine in inhibiting hepatic sinusoidal capillarization from the perspective of traditional Chinese medicine, in order to provide ideas and literature support for the treatment of liver fibrosis.
8.The epidemiologic characteristics of parasitic and vector-borne diseases in Minhang and Jinshan districts, Shanghai
Dun-jia WANG ; Xiao-lu HE ; Tian-tian ZHANG ; Tang WANG ; Zhao-peng DONG ; Can-lei SONG ; Shi-ji TAO ; Zheng-xing HOU ; Yu-ping CHENG ; Yi-bin ZHOU
Acta Parasitologica et Medica Entomologica Sinica 2026;33(3):173-179
Objective The aim of the study is to analyze the incidence patterns and epidemiological characteristics of parasitic and vector-borne diseases in the Minhang and Jinshan districts of Shanghai, and provide evidence-based information for optimizing prevention and control measures. Methods We collected information from epidemic reports and epidemiological investigation forms for cases of parasitic and vector-borne diseases from 2005 to 2024 in Shanghai's Minhang and Jinshan districts. Descriptive epidemiological method were adopted to conduct a comparative analysis of incidence trends, epidemic characteristics, and infection sources. Results A total of 229 cases in 7 categories were reported between 2005 and 2024, with an average annual incidence rate of 0.36/100 000. The average annual incidence rate in Minhang District was significantly higher than that in Jinshan District. The most prevalent diseases were malaria and dengue fever, followed by Japanese encephalitis. Monthly case reports were available, predominantly from June to October, with a peak in July-August. A statistically significant difference was observed between the two districts in case distribution during June-October (P<0.001), whereas no significant difference was found for July-August (P=0.331). The majority of cases were young men (111/229,48.47%), aged 20-39 years. Migrant workers/farmers constituted the largest occupational group (55/229, 24.02%). Registered residents of other provinces and cities (147/229,64.19%), and the main source of infection was overseas importation (112/229,48.91%). There were no statistically significant differences in gender and household-registration composition between the two districts (P>0.05). Significant differences existed in age, occupation, and source of infection (P<0.05). The imported diseases were malaria and dengue fever, with Africa and Southeast Asia being the primary source locations. Malaria was the predominant disease imported from other provinces and cities, with cases having been imported from abroad since 2012. Local infections were mainly Japanese encephalitis, followed by malaria (with the last local case reported in 2010). Cases between 2005 and 2009 were predominantly imported from other provinces and cities. The proportion of cases imported from abroad increased sharply after 2010, particularly in Minhang District. Local infections sometimes arise in Jinshan District, with Japanese encephalitis serving as the primary type. Conclusions Incidence rates of parasitic and vector-borne diseases in Minhang and Jinshan districts have generally remained low. To further reduce this disease burden, it will be necessary to strengthen joint measures for prevention and control, eliminate the environmental risk factors of vector organisms, enhance monitoring and precise control of the environment and inbound personnel to prevent the occurrence and transmission of parasitic and vector-borne diseases.
9.Correlation between CCTA coronary artery stenosis and CT-FFR in single cardiac cycle
China Medical Equipment 2025;22(9):52-55
Objective:To study the correlation between coronary artery stenosis of coronary computed tomography angiography(CCTA)and computed tomography fractional flow reserve(CT-FFR)in single cardiac cycle.Methods:A total of 100 patients with highly suspected coronary artery stenosis who visited our hospital from Jan 2023 to Jan 2025 were selected as the study subjects.All patients underwent CCTA examination in single cardiac cycle,and the examination results were input into professional software to assess the degree of CCTA coronary artery stenosis,and CT-FFR values of them were measured and calculated.Results:According to the results of CCTA assessment,there were 15 cases with mild stenosis,61 cases with moderate stenosis,and 24 cases with severe stenosis in 100 patients with suspected coronary artery stenosis.The results of Pearson correlation analysis indicated that there was a negative correlation between CCTA coronary artery stenosis and CT-FFR in single cardiac cycle(r=-0.690,P<0.001).The area under curve(AUC)value of the receiver operating characteristic(ROC)curve of CT-FFR was 0.940(95%CI was 0.892-0.989)in assessing coronary artery stenosis,and the sensitivity,specificity,cutoff value and Youden index of that were respectively 0.776,0.933,0.815 and 0.709.Conclusion:There is a close correlation between the degree of CCTA coronary artery stenosis and CT-FFR in single cardiac cycle,which means the smaller CT-FFR value indicates higher degree of CCTA coronary artery stenosis.
10.Integrated Transcriptomic Landscape and Deep Learning Based Survival Prediction in Uterine Sarcomas
Yaolin SONG ; Guangqi LI ; Zhenqi ZHANG ; Yinbo LIU ; Huiqing JIA ; Chao ZHANG ; Jigang WANG ; Yanjiao HU ; Fengyun HAO ; Xianglan LIU ; Yunxia XIE ; Ding MA ; Ganghua LI ; Zaixian TAI ; Xiaoming XING
Cancer Research and Treatment 2025;57(1):250-266
Purpose:
The genomic characteristics of uterine sarcomas have not been fully elucidated. This study aimed to explore the genomic landscape of the uterine sarcomas (USs).
Materials and Methods:
Comprehensive genomic analysis through RNA-sequencing was conducted. Gene fusion, differentially expressed genes (DEGs), signaling pathway enrichment, immune cell infiltration, and prognosis were analyzed. A deep learning model was constructed to predict the survival of US patients.
Results:
A total of 71 US samples were examined, including 47 endometrial stromal sarcomas (ESS), 18 uterine leiomyosarcomas (uLMS), three adenosarcomas, two carcinosarcomas, and one uterine tumor resembling an ovarian sex-cord tumor. ESS (including high-grade ESS [HGESS] and low-grade ESS [LGESS]) and uLMS showed distinct gene fusion signatures; a novel gene fusion site, MRPS18A–PDC-AS1 could be a potential diagnostic marker for the pathology differential diagnosis of uLMS and ESS; 797 and 477 uterine sarcoma DEGs (uDEGs) were identified in the ESS vs. uLMS and HGESS vs. LGESS groups, respectively. The uDEGs were enriched in multiple pathways. Fifteen genes including LAMB4 were confirmed with prognostic value in USs; immune infiltration analysis revealed the prognositic value of myeloid dendritic cells, plasmacytoid dendritic cells, natural killer cells, macrophage M1, monocytes and hematopoietic stem cells in USs; the deep learning model named Max-Mean Non-Local multi-instance learning (MMN-MIL) showed satisfactory performance in predicting the survival of US patients, with the area under the receiver operating curve curve reached 0.909 and accuracy achieved 0.804.
Conclusion
USs harbored distinct gene fusion characteristics and gene expression features between HGESS, LGESS, and uLMS. The MMN-MIL model could effectively predict the survival of US patients.


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