Objective To investigate the value of magnetic resonance image-diffusion weighted imaging(MRI-DMI)combined with attenuation imaging(ATI)in the diagnosis of focal nodular lesions<2 cm in the back-ground of fatty liver.Methods The clinical data of 68 patients with fatty liver complicated with focal nodular lesions<2 cm were retrospectively analyzed from June 2022 to June 2023 in Huaihe Hospital of Henan University.All patients underwent MRI,pathology and ATI examination.According to the degree of fatty liver disease,68 patients were divided into severe group(n=24),moderate group(n=27)and mild group(n=17).The apparent diffusion coefficient(ADC)and acoustic attenuation coefficient(AC)values of patients with different focal lesions were compared with clinical data,and the ADC values and AC values of patients with different fatty liver lesions were compared with clinical data,and the correlation was analyzed by Pearson.To analyze the value of MRI-DWI combined with AC value in the diagnosis of malignant fatty liver disease with focal nodular disease<2 cm.Results Pathological diagnosis showed that 41 of the 68 patients were benign and 27 were malignant.There were no significant differences in low density lipoprotein cholesterol(LDL-C),age,triglyceride(TG),sex,total cholesterol(TC)and high density lipoprotein cholesterol(HDL-C)between benign nodule group and malignant nodule group(P>0.05).There was no difference in TG,age,HDL-C,sex,TC and LDL-C among mild,moderate and severe groups(P>0.05).The ADC value of malignant nodule group was lower than benign nodule group under different b values(P<0.05),and the AC value of malignant nodule group was higher than that of benign nodule group(P<0.05).ADC value under different b values in the severe group was lower than mild and moderate groups(P<0.05),ADC value under different b values in the moderate group was lower than mild group(P<0.05),AC value in the severe group was higher than mild and moderate groups(P<0.05),and AC value in the moderate group was higher than mild group(P<0.05).ADC values at different b values were negatively correlated with the degree of fatty liver disease(P<0.05),but not with TG,HDL-C,TC and LDL-C(P>0.05).AC was positively correlated with the degree of fatty liver disease(P<0.05),negatively correlated with HDL-C(P<0.05),but not with TG,TC and LDL-C(P>0.05).The area under the curve(AUC)values of MRI-DWI,AC and their combi-nation in the diagnosis of fatty liver complicated with focal nodule disease<2 cm into malignancy were 0.775,0.773 and 0.909,respectively(P<0.05),and the AUC value of the combination was higher(P<0.05).Conclusion MRI-DWI and ATI have important value in the differential diagnosis of benign and malignant lesions of focal nodular lesions<2 cm in the background of fatty liver,and the combination of MRI-DWI and ATI has higher diagnostic value.

This study explores the potential antiepileptic mechanism of ursolic acid(UA)and its improvement of GABAergic interneuron damage induced by epilepsy based on transcriptome analysis.Hippocampal tissues from rats in the control group(NC group),epilepsy group(SE group),and epilepsy UA treatment group(UA group)were subjected to full-length transcriptome sequencing.The obtained sequencing data were analyzed,using gene ontology(GO),the Kyoto Encyclopedia of Genes and Genomes(KEGG),and protein-protein interaction(PPI)to perform the analysis of differential genes(DEGs).The expression levels of key differential genes were verified using RT-qPCR in hippocampal tissue.Finally,an epilepsy in vitro model was constructed on primary neurons,RT-qPCR was used to verify the expression levels of key differential genes,and the expression level of GABAA receptor γ2 subunit(GABRG2)on neurons was further examined using immunofluorescence and Western blot.The heatmap of pairwise sample expression correlation and the clustering analysis of differentially expressed genes showed that the SE group was farthest from the NC group,and that after UA treatment,the overall trend shifted towards the normal group.Compared with the SE group,a total of 220 differential genes were screened in the UA group,including 143 upregulated genes and 77 downregulated genes.GO enrichment analysis showed that it involved three processes in the primary classification:biological processes,cellular components,and molecular functions.KEGG pathway enrichment analysis showed that DEGs were involved in 36 biological pathways,including cAMP signaling pathway and calcium signaling pathway.PPI analysis showed that DEGs were closely related to GABA and inflammation.RT-qPCR results showed that UA treatment increased the expression levels of GABA receptor-related gene(Gng4),GABA synthesis-related gene(Camk2a,Vgf,and Npy)and inflammation-related gene(Timp1 and Spp1)in hippocampal tissue,and decreased the expression levels of GABA synthesis-related gene(Nptx2)and cAMP-related pathway gene(Gnas).It further confirmed that UA treatment increased the expression levels of Gng4 and Camk2a on neurons and decreased the expression level of Gnas.Immunofluorescence and Western blot results showed that,compared with the SE group,the expression level of GABRG2 on primary neurons increased after UA treatment.This study enriched the transcriptome data of UA's antiepileptic effect and laid a theoretical foundation for further research on UA's antiepileptic and neuroprotective effects.

MEK is a canonical effector of mutant KRAS; however, MEK inhibitors fail to yield satisfactory clinical outcomes in KRAS-mutant cancers. Here, we identified mitochondrial oxidative phosphorylation (OXPHOS) induction as a profound metabolic alteration to confer KRAS-mutant non-small cell lung cancer (NSCLC) resistance to the clinical MEK inhibitor trametinib. Metabolic flux analysis demonstrated that pyruvate metabolism and fatty acid oxidation were markedly enhanced and coordinately powered the OXPHOS system in resistant cells after trametinib treatment, satisfying their energy demand and protecting them from apoptosis. As molecular events in this process, the pyruvate dehydrogenase complex (PDHc) and carnitine palmitoyl transferase IA (CPTIA), two rate-limiting enzymes that control the metabolic flux of pyruvate and palmitic acid to mitochondrial respiration were activated through phosphorylation and transcriptional regulation. Importantly, the co-administration of trametinib and IACS-010759, a clinical mitochondrial complex I inhibitor that blocks OXPHOS, significantly impeded tumor growth and prolonged mouse survival. Overall, our findings reveal that MEK inhibitor therapy creates a metabolic vulnerability in the mitochondria and further develop an effective combinatorial strategy to circumvent MEK inhibitors resistance in KRAS-driven NSCLC.

Objective:Using ultrasound imaging technology to evaluate the contraction characteristics of diaphragm in patients with chronic low back pain.Methods:Twenty nine patients with chronic low back pain and 26 healthy persons recruited from the rehabilitation department of the Third Affiliated Hospital of Sun Yat-sen University from November 2019 to April 2020 were selected and divided into the low back pain (LBP) group and the healthy control group. The thickness of the diaphragm (Tdi) of the subjects during deep breathing was evaluated by portable color Doppler ultrasound equipment under different body positions. The subjects were required to perform maximum inspiration for total lung capacity (TLC) and expiration for functional residual capacity (FRC) in the supine and standing position, respectively. The end-inspiratory diaphragm thickness (TdiTLC) and end-expiratory diaphragm thickness (TdiFRC) were recorded, and the diaphragmatic thickening fraction (DTF) was calculated. The general data of subjects with lower back pain and the correlation between Oswestry Dysfunction Index (ODI) and diaphragm function were analyzed; The diaphragm function of healthy control group and LBP group were compared; The receiver operating characteristic (ROC) curve of Tdi and DTF in the diagnosis of lower back pain were analyzed.Results:ODI lifting score was negatively correlated with standing TdiTLC ( r=-0.50, P<0.01). In intra-group comparison, the TdiTLC and TdiFRC values of healthy subjects in standing position were increased compared with those in supine position ( t=6.115, 7.314, all P<0.001); In standing position, TdiTCL and TdiFRC values in LBP group were increased compared with those in supine position ( t=2.834, 4.673, all P<0.01). In comparison between groups, TdiTLC values in supine and standing position of LBP group were significantly lower than those in healthy control group ( t=2.597, 3.338, all P<0.05); In standing position, TdiFRC of patients in LBP group was significantly lower than that of healthy control group ( t=2.098, P=0.041) and DTF value of patients in LBP group was significantly lower than that of healthy control group ( t=2.902, P=0.006). When TdiTCL≤3.3 mm in supine position was used to predict low back pain, the diagnostic sensitivity and specificity were 78.6% and 53.8%, respectively, and the area under the curve was 0.661. When TdiTCL≤4.5 mm in standing position was used to predict low back pain, the diagnostic sensitivity and specificity were 95.7% and 46.2%, respectively, and the area under the curve was 0.759. When DTF≤81.3% in standing position was used to predict low back pain, the diagnostic sensitivity and specificity were 52.2% and 84.6%, respectively, and the area under the curve was 0.698. Conclusions:It is found in our study that the diaphragm contractile function of patients with lower back pain is worse than that of normal subjects, and the difference was significant in standing position. We suggest that the right-side ultrasound image acquisition in the patient′s standing position is helpful to ensure the accuracy and objectivity of the measurement results. TdiTCL≤4.5 mm or DTF≤81.3% in standing position can be used as one of the reference indexes for the combined diagnosis of chronic low back pain.

ObjectiveTo investigate the effect of Loki Zupa on airway remodeling in asthma based on ultra-performance liquid chromatography-tandem mass spectrometry（UPLC-MS）combined with network pharmacology and experimental verification. MethodThe chemical constituents in Loki Zupa were identified by UPLC-MS. The potential active constituents of Loki Zupa were screened out based on literature retrieval， oral availability （OB） and drug-likeness （DL） in the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform（TCMSP） and Lipinski's rule of five in SwissADEM. The constituent targets of Loki Zupa were obtained through the SwissTargetPrediction. The relevant targets of airway remodeling in asthma were screened out from Online Mendelian Inheritance in Man（OMIM）， GeneCards， DrugBank， and DisGeNET. The STRING was used to conduct protein-protein interaction （PPI） among the main targets. Gene Ontology （GO） and Kyoto Encyclopedia of Genes and Genomes（KEGG） pathway enrichment analyses were carried out through DAVID. Finally， an asthmatic airway remodeling model was induced by ovalbumin （OVA） in mice， followed by hematoxylin and eosin（HE）， periodic acid Schiff（PAS）， and Masson staining for the observation of the pathological conditions of lung tissues. The inflammatory cells in the bronchoalveolar lavage fluid（BALF） of mice were detected. The protein expression levels in mouse lung tissues were detected by Western blot and key signaling pathways were further determined. ResultEighty-two constituents were detected in the negative ion mode and 74 in the positive ion mode by UPLC-MS. Thirty-six candidate constituents and 578 predicted targets of Loki Zupa were screened out through network pharmacology， and 173 common targets with airway remodeling in asthma were obtained， including key compounds such as sebacic acid， pectolinarigenin， naringenin， apigenin， and potential targets such as protein kinase B1（Akt）1 and hypoxia-inducible factor 1α（HIF-1α）. As predicted by KEGG enrichment analysis， Loki Zupa mainly exerted the effect against airway remodeling in asthma through phosphatidylinositol 3-kinase （PI3K）/Akt， HIF-1α， mitogen-activated protein kinase （MAPK）， and other signaling pathways. Animal experiments showed that the compound formula of Loki Zupa could reduce the proliferation of airway goblet cells in asthmatic mice， improve the deposition of collagen under the airway epithelium， and decrease the up-regulated relative expression levels of phosphorylate（p）-Akt/Akt and HIF-1α by OVA sensitization in mice （P<0.05， P<0.01）， which was consistent with the results of network pharmacology. ConclusionUPLC-MS combined with network pharmacology was used to preliminarily clarify the chemical composition of Loki Zupa and its underlying mechanism in intervention in airway remodeling in asthma. Specifically， Loki Zupa presumably synergistically intervened in airway remodeling in asthma through key targets represented by Akt1 and HIF-1α， and multiple pathways represented by the PI3K/Akt and HIF-lα pathways， which is expected to provide ideas for further research on Loki Zupa.

Objective:To explore the characteristics, diagnosis, and treatment of precursor B-cell acute lymphocytic leukemia with C- MYC rearrangement (preBLL) in children. Methods:The clinical data in 2 cases of childhood preBLL in Department of Hematology, Children′s Hospital Affiliated to Capital Institute of Pediatrics in June and August 2019 were summarized and analyzed.Results:Both cases were acute lymphoblastic leukemia with precursor B-cell immunophenotype.Hepatosplenomegaly and peripheral white blood cells were significantly increased, and the morphology of bone marrow was L3. C- MYC rearrangement was discovered by cytogenetic tests.Both children have received the treatment of the mature B-cell tumor protocol (FAB/LMB96), and early remission was developed in 1 case with TP53 gene mutation but relapsed thereafter and died finally.Another case had reached sustained complete remission after treatment. Conclusions:Children with preBLL is rare, and routine C- MYC rearrangement should be performed in children with Precursor B-cell lymphoblastic leukemia whose morphology of bone marrow was L3.Its treatment needs to be further studied, and multi-center clinical trials need to be actively conducted to analyze and summarize large numbers of cases to identify effective protocol and improve the prognosis.

Dysphagia is often associated with incoordination between breathing and swallowing, resulting in the occurrence of aspiration, cough and aspiration pneumonia. This article reviewed the specific physiological mechanisms of respiration and swallowing and their clinical applications, which aimed to focus on the relationship between respiration and swallowing systems in health and disease, and to explore its guiding value in the clinical treatment of dysphagia.

Objective To determine the relationship between Methylenetetrahydrofolate reductase (MTHFR)(C677T, A1298C and G1793A)polymorphisms and stillbirth.Methods 33 unexplained stillbirth and 582 normal livebirth were col-lected for case-control study from August 2014 to August 2016.The genotyping of C677T,A1298C and G1793A polymor-phisms of the MTHFR gene was tested by using restriction fragment length polymorphism polymerase chain reaction.The relationship between MTHFR polymorphisms and stillbirth susceltibility was analyzed by logistic regression.Results There was no significant difference in the genetype frequencies of A1298C and G1793A of MTHFR polymorphisms between case and control.But there was significant difference in the genetype frequencies of C677T between case and control (CT:P=0.02,χ2=3.67;TT:P=0.02,χ2=3.65).Heterozygous CT and homozygous TT would be high risk factors of stillbirth. C677T was found in one (14.3%)of the cases with early stillbirth and in three (11.5%)of the cases with late stillbirth, having no significant difference.Twin pregnancy and MTHFR C677T increased the risk 8-fold (P<0.001,χ2=13.28)and 3.4(P=0.02,χ2=3.65)for stillbirth,respectively.Conclusion MTHFR C677T polymorphism is high risk factors associ-ated with the susceptibility of stillbirth.MTHFR C677T may be used as a prognostic marker of pregnancy cases predisposed to preterm delivery.

Objective To investigate the role and significance of neuropilin-2(NRP2)for regulating the angiogenesis of pancreatic neuroendocrine tumors(PNETs).Methods The NRP2 expression in pancreatic neuroendocrine tumer BON-1 cell line was intevened.The BON-1 cells cultural supernatants in the control group and interference group were used to treat human umbilical vein endothelial cells(HUVEC).CCK-8 was used to detect the cell proliferation,Transwell was used to detected the cell migration and the tubule formation test was used detect the pro-angiogenesis.Results The CCK-8 detection showed that there was no statistically significant difference in the supernatant treated HUVEC proliferations between the interference group and control group medium(P>0.05):the absorbancy in the control group was 0.35±0.04,while which in the interference group was 0.32±0.04.The Transwell test showed that the invasion ability of HUVEC treated with cultural supernatants in the interference group was weakened compared with the control group,the control group was(203±13)/hole,while the interference group was(100±10)/hole(P＜0.01);the tubule formation test showed that HUVEC tubular formation treated by cultural supernatant in the interference group was decreased,the control group was 40±5,while the interference group was 24±3(P＜0.01).Conclusion Interfering NRP2 expression of BON-1 cells can inhibit the vessel formation ability of co-cultured HUVEC,suggesting that NRP2 may have the pro-angiogenesis effect of PNETs,and may be a potential new target for the treatment of PNETs.

The effects of fucoidan on the lipidomics profiling of juvenile yellow catfish (pelteobagrus fulvidraco) during different feeding time (week 1, week 2, week 3 and week 8) were investigated by ultra-performance liquid chromatography-quadrupole-time-of-flight-mass spectrometry (UPLC-Q-TOF-MS) combined with multivariate data analysis, e.g.principal component analysis (PCA) and partial least squares-discriminate analysis (PLS-DA).Based on VIP and p values, 11 lipid biomarkers were screened including lysophosphatidylcholine (Lyso-PC) 16∶0, phosphatidylcholine (PC) 22∶6/16∶0, phosphatidylethanolamine (PE) 22∶6/16∶0, phosphatidylinositol (PI) 18∶0/22∶6, diacylglycerol (DAG) 16∶0/16∶0,DAG 16∶0/18∶1, DAG 18∶1/18∶1, triglycerides (TAG) 20∶5/16∶0/18∶3, TAG 20∶4/16∶1/18∶2, TAG 16∶0/18∶2/20∶5 and TAG 18∶2/14∶0/18∶1.It was found that Lyso-PC, PC, PE and PI had the largest levels at the eighth week;the levels of DAG were decreased at the second and fourth weeks, and increased at the eighth week.While TAG was different: the content of TAG 18∶2/14∶0/18∶1, TAG 20∶5/16∶0/18∶3 and TAG 20∶4/16∶1/18∶2 increased in response to fucoidan, but TAG 16∶0/18∶2/20∶5 decreased little.Therefore, for juvenile yellow catfish, fucoidan can affect its lipid metabolism, which provides a theoretical basis for investigation of the influence of fucoidan on the response mechanism of lipid metabolism of juvenile yellow catfish.