Objective:To compare the mid-term clinical effects of AngioJet rheolytic thrombectomy assisted catheter-directed thrombolysis (ART+CDT) with catheter-directed thrombolysis (CDT) in the treatment of acute deep venous thrombosis of lower extremities.Methods:Ninety-one patients admitted to the Department from Jan 2016 to Dec 2017 were placed with inferior vena cava filters and divided into ART+CDT group (30 cases)and CDT group (61 cases). Total urokinase dosge, thrombolytic time, operative cost, length of hospital stay, detumescence rate, thrombus clearance rate, cumulative patency rate of lower limb veins, Villalta score at 2 years and 5 years, thrombosis recurrence rate and chronic venous insufficiency quality of life questionnaire were compared between the two groups.Results:The success rate of surgery was 100% in both groups, there was no mortality. There were significant differences in the short-term postoperative outcomes between the two groups in terms of total dosage of urokinase, thrombolysis time, total cost of surgery, length of hospital stay, detumescence rate, venous patency scores before and after treatment, and venous patency rate (all P<0.05). For the mid- and long-term postoperative outcomes of 2 and 5 years, there were no significant differences in the incidence of PTS, recurrence rate of thrombus, chronic venous function scale, and cumulative patency rate at 2 years (all P>0.05). Conclusions:ART+CDT has a significant advantage over CDT alone in terms of early efficacy and early reopening of blood flow in patients. Both ART+CDT and CDT have a low incidence of PTS and a low recurrence rate of thrombus in the mid-term follow-up, and both have satisfactory performance in the mid- and long-term efficacy of interventional treatment of deep venous thrombosis of lower limbs.

Currently,there is an urgent need to develop new antimicrobial drugs or materials to treat drug-resistant bacterial infectious diseases.The reactive oxygen species(ROS)responsive nano-drug delivery systems hold great significance for bacterial infection treatment.This paper reviewed polymeric,inorganic,and composite ROS-responsive nano-drug delivery systems.It discussed synergistic treatment using these systems with photothermal therapy,photodynamic therapy,sonodynamic therapy,and gas therapy.It outlines new trends in these systems for bacterial infectious disease treatment.

Objective To explore the related risk factors of hypokalemia in elderly patients with acute cerebral hemorrhage(ACH),and construct a risk prediction model based on logistic regres-sion.Methods A total of 190 elderly ACH patients treated in Foshan Hospital of Traditional Chi-nese Medicine from June 2022 to May 2024 were enrolled as study objects,and were divided into hypokalemic group(potassium＜3.5 mmol/L,n=51)and normal group(potassium 3.5-5.5 mmol/L,n=139)according to whether hypokalemia occurred.Logistic regression model was used to analyze the risk factors of hypokalemia in the elderly ACH patients.Based on the identified risk factors,a comprehensive index model was constructed.ROC curve was drawn to analyze the diag-nostic value of the index for occurrence of hypokalemia in the patients.Results Larger female ra-tio,higher NIHSS score at admission,elevated urea nitrogen and blood creatinine at admission,and higher glomerular filtration rate(GFR)≤60 ml/min,and ratio of using hydrochlorothiazide＞20 mg/d were observed in the hypokalemic group than the normal group(P＜0.01).Univariate logistic regression analysis showed that female,NIHSS score at admission,urea nitrogen at ad-mission,serum creatinine at admission,GFR ≤60 ml/min,and hydrochlorothiazide dose＞20 mg/d were risk factors for hypokalemia in the ACH patients(P＜0.05,P＜0.01).Multivariate lo-gistic regression analysis indicated that female,NIHSS score at admission,GFR ≤60 ml/min,and hydrochlorothiazide dose＞20 mg/d were independent risk factors for hypokalemia in the elderly ACH patients(OR=6.393,95％CI:2.138-19.112,P=0.001;OR=3.123,95％CI:2.161-4.513,P=0.000;OR=3.327,95％CI:1.137-9.736,P=0.028;OR=3.111,95％CI:1.083-8.933,P=0.035).ROC curve analysis revealed that the AUC values of female,NIHSS score at admission,GFR,hydrochlorothiazide dose and comprehensive index in predicting hypokalemia in elderly ACH patients were 0.621,0.897,0.601,0.613 and 0.857,with a sensitivity of 52.90％,76.50％,49.00％,54.90％and 72.50％,and a specificity of 71.20％,88.50％,71.20％,67.60％and 87.80％,respectively.Conclusion Female,NIHSS score at admission,GFR ≤60 ml/min,and hydrochlorothiazide dose＞20 mg/d may affect the occurrence of hypokalemia in elderly ACH pa-tients,and our comprehensive index model based on these risk factors has high performance in predicting the occurrence of hypokalemia in elderly ACH patients.

OBJECTIVE: To investigate the effectiveness of joystick technique assisted closed reduction and cannulated screw fixation in the treatment of femoral neck fracture. METHODS: Seventy-four patients with fresh femoral neck fractures who met the selection criteria between April 2017 and December 2018 were selected and divided into observation group (36 cases with closed reduction assisted by joystick technique) and control group (38 cases with closed manual reduction). There was no significant difference in gender, age, fracture side, cause of injury, Garden classification, Pauwels classification, time from injury to operation, and complications (except for hypertension) between the two groups ( P>0.05). The operation time, intraoperative infusion volume, complications, and femoral neck shortening were recorded and compared between the two groups. Garden reduction index was used to evaluate the effect of fracture reduction, and score of fracture reduction (SFR) was designed and was used to evaluate the subtle reduction effect of joystick technique. RESULTS: The operation was successfully completed in both groups. There was no significant difference in operation time and intraoperative infusion volume between the two groups ( P>0.05). All patients were followed up 17-38 months, with an average of 27.7 months. Two patients in the observation group received joint replacement due to failure of internal fixation during the follow-up, and the other patients had fracture healing. Within 1 week after operation, the Garden reduxtion index of the observation group was better than the control group; the SFR score of the observation group was also higher than that of the control group; the proportion of femoral neck shortening within 1 week after operation and at 1 year after operation in the observation group were lower than those in the control group. The differences of the above indexes between the two groups were significant ( P<0.05). CONCLUSION The joystick technique can improve the effectiveness of closed reduction of femoral neck fractures and reduce the incidence of femoral neck shortening. The designed SFR score can directly and objectively evaluate the reduction effect of femoral neck fracture.
Humans ; Treatment Outcome ; Bone Screws ; Femoral Neck Fractures/surgery* ; Plastic Surgery Procedures ; Fracture Fixation, Internal/methods* ; Retrospective Studies

Objective:To investigate the segmentation methods of pancreatic ductal adenocarcinoma (PDAC) tumor regions in 18F-fluorodeoxyglucose (FDG) PET/CT images, as well as their impact on radiomic features-based pathological grade prediction. Methods:A total of 72 patients (46 males, 26 females, age range: 25-87 years) with pathologically confirmed PDAC and a preoperative 18F-FDG PET/CT scan in Peking Union Medical College Hospital between September 2010 and January 2016 were enrolled retrospectively. The cohort of patients was classified as well differentiated group and non-well differentiated group based on the pathological grade of PDAC, and patients were divided into training set and validation set in the ratio of 3∶1 randomly. Two physicians performed manual contours in the tumor region (referred as region of interest (ROI)_M1 and ROI_M2) and semi-automatic ROIs based on standardized uptake value (SUV) gradient edge search (referred as ROI_G) and 40% threshold applied to the maximum SUV (SUV max; referred as ROI_S) were drawn. The four types of segmentation results were compared in terms of volume and Dice similarity coefficient (DSC). Shape, first-order, and texture features were extracted from PET/CT original and preprocessed images, and the interclass correlation coefficient (ICC) was used to assess each feature′s consistency across all segmentations. Kruskal-Wallis rank sum test, independent-sample t test or z test were used to analyze the data. The area under the receiver operating characteristic curve was used to assess model accuracy, and cross validation was used to assess generalization ability. Results:There were 55 patients in the training set (14 well differentiated cases and 41 non-well differentiated cases) and 17 patients in the validation set (4 well differentiated cases and 13 non-well differentiated cases). A total of 44 selected features were predictive of the pathological grade of PDAC among 20 feature groups. There was significant difference among the volumes of ROI_M1, ROI_M2, ROI_G and ROI_S (10.29(4.01, 19.43), 9.34(4.26, 17.27), 11.86(5.52, 19.74) and 15.08(9.62, 27.44) cm 3; H=18.641, P<0.05). The degree of contour coincidence and feature consistency between ROI_M1 and ROI_M2 were both higher (DSC=0.86 (0.76, 0.90), ICC=0.86 (0.74, 0.94)). Compared to manual contours, the degree of contour coincidence and feature consistency of ROI_G (DSC: 0.86(0.75, 0.91), 0.91(0.85, 0.96); ICC: 0.87(0.72, 0.94), 0.94(0.88, 0.98)) were better. There was no statistically significant difference in model accuracy or generalization ability between ROI_M1 and ROI_G ( z=1.052, t=0.712, both P>0.05). The accuracy of ROI_M2 was better than ROI_G ( z=3.031, P=0.002), but the generalization ability of ROI_M2 was insufficient ( t=3.086, P=0.012). Conclusions:Although the manual contour prediction models are highly accurate, their performance are unstable. Semi-automatic contouring based on gradient can achieve comparable accuracy to manual contouring, and the model′s generalization ability is stronger.

Gestational diabetes mellitus (GDM) is characterized by glycemia and insulin disorders. Bile acids (BAs) have emerged as vital signaling molecules in glucose metabolic regulation. BA change in GDM is still unclear, which exerts great significance to illustrate the change of BAs in GDM. GDM patients and normal pregnant women were enrolled during the oral glucose tolerance test (OGTT) screening period. Fasting serums were sampled for the measurement of BAs. BA metabolism profiles were analyzed in both pregnant women with GDM and those with normal glucose tolerance (NGT). Delivery characteristics, delivery gestational age, and infant birthweight were extracted from medical records. GDM patients presented distinctive features compared with NGT patients, including higher body mass index (BMI), elevated serum glucose concentration, raised insulin (both fasting and OGTT), and increased hemoglobin A1c (HbA1c) levels. Higher homeostasis model assessment of insulin resistance (HOMA-IR) and decreased β-cell compensation (i.e., oral disposition index (DI

Pseudouridine(Ψ)is the most prevalent post-transcriptional RNA modification and is widespread in small cellular RNAs and mRNAs.However,the functions,mechanisms,and precise distribution of Ψs(especially in mRNAs)still remain largely unclear.The landscape of Ψs across the transcriptome has not yet been fully delineated.Here,we present a highly effective model based on a convolutional neural network(CNN),called PseudoUridyLation Site Estimator(PULSE),to analyze large-scale profiling data of Ψ sites and characterize the contextual sequence features of pseudouridylation.PULSE,consisting of two alternatively-stacked convolution and pooling layers followed by a fully-connected neural network,can automatically learn the hidden patterns of pseu-douridylation from the local sequence information.Extensive validation tests demonstrated that PULSE can outperform other state-of-the-art prediction methods and achieve high prediction accu-racy,thus enabling us to further characterize the transcriptome-wide landscape ofΨ sites.We fur-ther showed that the prediction results derived from PULSE can provide novel insights into understanding the functional roles of pseudouridylation,such as the regulations of RNA secondary structure,codon usage,translation,and RNA stability,and the connection to single nucleotide vari-ants.The source code and final model for PULSE are available at https://github.com/mlcb-thu/PULSE.

Objective To determine the value of using B-type natriuretic peptide (BNP) and D-dimer in preliminary recognition of cardioembolic stroke patients.Methods A mutilple-center study was conducted in Foshan Hospital of traditional Chinese Medicine (TCM) and its affiliated hospitals from July 2015 to July 2016.In the emergency departments (EDs),emergency physicians prospectively assessed consecutive adult patients with acute cardioembolic stroke and measured plasma BNP by POCT platform on admission,then followed up.Stroke neurologists evaluated patients' functional outcome at hospital discharge and also made discharge diagnosis and stroke etiologic subtypes according to the TOAST criteria.Results In this study,290 acute ischemic stroke patients met the study criteria [mean age (68.41 ± 12.06) years;53.8％ female].Of the enrolled patients,28.3％ were diagnosed with LAA at discharge,17.9％ with CE,42.8％ with SAO,11.0％ with SOE or SUE.And the mean BNP concentration was significantly higher in the CE group than that in other three subtypes (P ＜ 0.001).After adjustment for multiple clinical predictors like gender,age,coronary artery disease,atrial fibrillation and renal function,BNP and D-dimer were associated with CE [BNP OR:1.044 (95％ CI 1.025,1.064),P ＜ 0.001;D-dimer OR:1.511(95％ CI 1.020,2.238),P =0.039,respectively].Conclusion Through POCT technique in the EDs,cardioembolic stroke patients can be differentiated from other TOAST subtypes.BNP with/without D-dimer has good but different corresponding diagnostic performance in preliminary recognition of cardioembolic stroke patients.

BACKGROUND: In the treatment of senile distal tibia fractures, locking compression plate (LCP) combined with minimally invasive percutaneous plate osteosynthesis (MIPO) exerts a satisfactory repair effect, and contributes to the function recovery of lower limbs.OBJECTIVE: To retrospectively analyze the efficacy of LCP combined with MIPO versus intramedullary interlocking nailing for senile distal tibia fractures.METHODS: Fifty-six elderly patients with distal tibia fracture were allotted to minimally invasive and intramedullary nailing groups (n=28 per group), and received the treatment of LCP combined with MIPO and intramedullary interlocking nailing fixation, respectively. The operation time, intraoperative blood loss, postoperative AOFAS ankle-hind foot scale scores, postoperative ambulation time, healing time, postoperative complications and the excellent and good rate in Johner-Wruhs' criteria were compared between two groups.RESULTS AND CONCLUSION: (1) The operation time, AOFAS ankle-hind foot scale scores, ambulation time, and healing time in the minimally invasive group were significantly superior to those in the intramedullary nailing group (P < 0.05). (2) The minimally invasive group showed a significantly higher excellent and good rate (96%) than the intramedullary nailing group (79%) (P < 0.05). (3) Compared with the intramedullary nailing group, the incidence of complications was significantly reduced in the minimally invasive group (P < 0.05). (4) Our findings suggest that the combination of LCP and MIPO not only preserves the most of blood supply, and soft tissues surrounding the fracture end as suggested by the BO principle, but also is conducive for fracture healing, and holds good efficacy.

BACKGROUNDPancreatic cancer is a common malignant tumor of the digestive system. It is the fourth major cause of tumor-related death and its morbidity is increasing, and hence it is imperative to develop effective forms of therapy for pancreatic cancer. Peptide tyrosine-tyrosine (PYY) is an important gastrointestinal peptide hormone. According to previous literatures, PYY has been shown to inhibit tumor proliferation in cellular and animal models, but there has been limited research on the detailed mechanism of PYY in pancreatic cancer. This study was to observe the effects of PYY on pancreatic cancer cell and investigate the possible mechanism.

METHODSThe expression of Y1, Y2, and Y5 receptors on pancreatic cancer cell lines were detected by reverse transcription quantitative polymerase chain reaction (RT-qPCR). The cytotoxicity of PYY toward the MiaPaCa-2 cell was evaluated by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay; the cell morphology and structure changes were observed under inverted microscope and transmission electron microscope respectively. Apoptosis and cell cycle were evaluated by flow cytometry. The activity of caspase-3 was determined by activity assay kits and Western blotting. The expression of survivin, vascular endothelial growth factor (VEGF), and cyclooxygenase-2 (COX-2) were determined by RT-qPCR and Western blotting.

RESULTSExpression of Y2 receptor is the most abundant PYY receptor on pancreatic cancer cell. PYY inhibited MiaPaCa-2 cell proliferation, blocked it in G0/G1 phase, increased the proportion of apoptosis cells and caspase-3 activity, and reduced the expression of survivin, VEGF, and COX-2.

CONCLUSIONSPYY weakened the ability of the pancreatic MiaPaCa-2 cell viability through cell cycle blocking and apoptosis inducing. The inhibition effect of PYY may be mediated by the Y2 receptor. The increased caspase-3 activity and reduced expression of survivin, VEGF, and COX-2 may serve as a novel mechanism in PYY inhibition effect on MiaPaCa-2 cell.

Blotting, Western ; Caspase 3 ; genetics ; metabolism ; Cell Cycle ; drug effects ; genetics ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Cyclooxygenase 2 ; genetics ; metabolism ; Dipeptides ; pharmacology ; Humans ; Inhibitor of Apoptosis Proteins ; genetics ; metabolism ; Pancreatic Neoplasms ; genetics ; metabolism ; Reverse Transcriptase Polymerase Chain Reaction ; Vascular Endothelial Growth Factor A ; genetics ; metabolism