Background: A simple superoposterior approach to thoracic transforaminal epidural injections (TFEIs) under ultrasonographic guidance was proposed to reduce zoster-associated pain (ZAP) involving multiple thoracic nerves and the likelihood of transitioning to postherpetic neuralgia (PHN). Methods: Patients were prospectively enrolled. Primary endpoints were the burden of illness (BOI) scores and epidural contrast spread. Secondary endpoints included number of needle insertion attempts, sensory blockade, hemodynamic changes, procedure time, radiation dose, adverse events, rescue analgesics, PHN incidence and EuroQoL 5-Dimension scores. Results: Thirty-five injections were performed in 27 patients. Median levels of cephalad-caudad epidural contrast spread were 3, 4, and 5 ml following injections of 2, 3, and 4 ml. Dorsal epidural spread was observed at levels 3, 4, and 5, whereas concurrent ventral spread was observed at levels 2, 3, and 4. BOI scores at 30–180 days significantly decreased (mean difference: −25.3, 95% CI [−57.4 to 6.6], P = 0.005), accounting for reduced rescue analgesic requirements and PHN occurrence and improved EuroQoL 5-Dimension scores. Median sensory blockade at 5 min post-procedure was at level 2, 3, and 4 after 2, 3, and 4 ml of therapeutic injectate. No significant hemodynamic changes were noted at 15 min post-injection. No serious adverse events were observed. Conclusions Spread of thoracic epidural contrast to all involved nerves was confirmed using this novel technique. Simplified needle placement reduced the technical difficulty and risk of complications. It might be a promising alternative approach for ZAP.

Objective To observe the impact factors of vascular heat sink effect during in vitro microwave ablation(MWA)of porcine lung.Methods Simulation models were established using in vitro porcine lung tissue blocks based on isobaric inflation with an air pump and cyclic perfusion of duck blood with a glass tube and peristaltic pump,etc.MWA was performed under 8 different combining conditions(vessel diameter of 3 or 5 mm,blood perfusion of 30 or 50 cm/s,as well as distance between vessel and ablation antenna of 5 or 10 mm)each for 3 times.The highest temperature TV on vessel side and TC on control side during MWA,and ablation depth DV on vessel side and DC on control side after MWA were recorded.Multi-factor linear regression equations were constructed based on simulated vessel diameters,blood perfusion and distance between vessel and ablation antenna,and the impact factors of|TC-TV|and|DC-DV|were screened,respectively.Results Simulated vessel diameter showed linear positive correlation with both|TC-TV|and|DC-DV|(both P＜0.001).Simulated distance between vessel and ablation antenna showed linear negative correlation with both|TC-TV|and|DC-DV|(both P＜0.001),and the latter had more obvious impact on vascular heat sink effect than the former.Meanwhile,no significant linear relationship was found between simulated blood perfusion and|TC-TV|nor|DC-DV|(both P＞0.05).Conclusion Simulated vessel diameter and distance between vessel and ablation antenna were both impact factors of vascular heat sink effect during in vitro MWA of porcine lung,and the latter was more influential,whereas simulated blood perfusion showed no significant impact on it.

Background: A simple superoposterior approach to thoracic transforaminal epidural injections (TFEIs) under ultrasonographic guidance was proposed to reduce zoster-associated pain (ZAP) involving multiple thoracic nerves and the likelihood of transitioning to postherpetic neuralgia (PHN). Methods: Patients were prospectively enrolled. Primary endpoints were the burden of illness (BOI) scores and epidural contrast spread. Secondary endpoints included number of needle insertion attempts, sensory blockade, hemodynamic changes, procedure time, radiation dose, adverse events, rescue analgesics, PHN incidence and EuroQoL 5-Dimension scores. Results: Thirty-five injections were performed in 27 patients. Median levels of cephalad-caudad epidural contrast spread were 3, 4, and 5 ml following injections of 2, 3, and 4 ml. Dorsal epidural spread was observed at levels 3, 4, and 5, whereas concurrent ventral spread was observed at levels 2, 3, and 4. BOI scores at 30–180 days significantly decreased (mean difference: −25.3, 95% CI [−57.4 to 6.6], P = 0.005), accounting for reduced rescue analgesic requirements and PHN occurrence and improved EuroQoL 5-Dimension scores. Median sensory blockade at 5 min post-procedure was at level 2, 3, and 4 after 2, 3, and 4 ml of therapeutic injectate. No significant hemodynamic changes were noted at 15 min post-injection. No serious adverse events were observed. Conclusions Spread of thoracic epidural contrast to all involved nerves was confirmed using this novel technique. Simplified needle placement reduced the technical difficulty and risk of complications. It might be a promising alternative approach for ZAP.

Background: A simple superoposterior approach to thoracic transforaminal epidural injections (TFEIs) under ultrasonographic guidance was proposed to reduce zoster-associated pain (ZAP) involving multiple thoracic nerves and the likelihood of transitioning to postherpetic neuralgia (PHN). Methods: Patients were prospectively enrolled. Primary endpoints were the burden of illness (BOI) scores and epidural contrast spread. Secondary endpoints included number of needle insertion attempts, sensory blockade, hemodynamic changes, procedure time, radiation dose, adverse events, rescue analgesics, PHN incidence and EuroQoL 5-Dimension scores. Results: Thirty-five injections were performed in 27 patients. Median levels of cephalad-caudad epidural contrast spread were 3, 4, and 5 ml following injections of 2, 3, and 4 ml. Dorsal epidural spread was observed at levels 3, 4, and 5, whereas concurrent ventral spread was observed at levels 2, 3, and 4. BOI scores at 30–180 days significantly decreased (mean difference: −25.3, 95% CI [−57.4 to 6.6], P = 0.005), accounting for reduced rescue analgesic requirements and PHN occurrence and improved EuroQoL 5-Dimension scores. Median sensory blockade at 5 min post-procedure was at level 2, 3, and 4 after 2, 3, and 4 ml of therapeutic injectate. No significant hemodynamic changes were noted at 15 min post-injection. No serious adverse events were observed. Conclusions Spread of thoracic epidural contrast to all involved nerves was confirmed using this novel technique. Simplified needle placement reduced the technical difficulty and risk of complications. It might be a promising alternative approach for ZAP.

Effective annotation of in vivo drug metabolites using liquid chromatography-mass spectrometry (LC-MS) remains a formidable challenge. Herein, a metabolic reaction-based molecular networking (MRMN) strategy is introduced, which enables the "one-pot" discovery of prototype drugs and their metabolites. MRMN constructs networks by matching metabolic reactions and evaluating MS² spectral similarity, incorporating innovations and improvements in feature degradation of MS² spectra, exclusion of endogenous interference, and recognition of redundant nodes. A minimum 75% correlation between structural similarity and MS² similarity of neighboring metabolites was ensured, mitigating false negatives due to spectral feature degradation. At least 79% of nodes, 49% of edges, and 97% of subnetworks were reduced by an exclusion strategy of endogenous ions compared to the Global Natural Products Social Molecular Networking (GNPS) platform. Furthermore, an approach of redundant ions identification was refined, achieving a 10%-40% recognition rate across different samples. The effectiveness of MRMN was validated through a single compound, plant extract, and mixtures of multiple plant extracts. Notably, MRMN is freely accessible online at https://yaolab.network, broadening its applications.

Objective To observe the impact factors of vascular heat sink effect during in vitro microwave ablation(MWA)of porcine lung.Methods Simulation models were established using in vitro porcine lung tissue blocks based on isobaric inflation with an air pump and cyclic perfusion of duck blood with a glass tube and peristaltic pump,etc.MWA was performed under 8 different combining conditions(vessel diameter of 3 or 5 mm,blood perfusion of 30 or 50 cm/s,as well as distance between vessel and ablation antenna of 5 or 10 mm)each for 3 times.The highest temperature TV on vessel side and TC on control side during MWA,and ablation depth DV on vessel side and DC on control side after MWA were recorded.Multi-factor linear regression equations were constructed based on simulated vessel diameters,blood perfusion and distance between vessel and ablation antenna,and the impact factors of|TC-TV|and|DC-DV|were screened,respectively.Results Simulated vessel diameter showed linear positive correlation with both|TC-TV|and|DC-DV|(both P＜0.001).Simulated distance between vessel and ablation antenna showed linear negative correlation with both|TC-TV|and|DC-DV|(both P＜0.001),and the latter had more obvious impact on vascular heat sink effect than the former.Meanwhile,no significant linear relationship was found between simulated blood perfusion and|TC-TV|nor|DC-DV|(both P＞0.05).Conclusion Simulated vessel diameter and distance between vessel and ablation antenna were both impact factors of vascular heat sink effect during in vitro MWA of porcine lung,and the latter was more influential,whereas simulated blood perfusion showed no significant impact on it.

Objective To explore the differences in gut microbiota among different histopathologi-cal subtypes of lung cancer.Methods A total of 80 lung cancer patients admitted to the Department of Oncology and Hematology of Anqing First People's Hospital from February 2020 to February 2024 were selected as study subjects.Meanwhile,80 healthy volunteers who underwent physical examina-tions during the same period were selected as control group.According to pathological examination re-sults,the lung cancer patients were divided into three subgroups:lung squamous cell carcinoma group,lung adenocarcinoma group,and lung small-cell cancer group.The 16S ribosomal RNA(16S rRNA)sequencing technology was used to compare the differences in gut microbiota diversity and the characteristics of species relative abundance between lung cancer patients with different patho-logical grades and the control group.Results The proportion of patients with a family history of lung cancer was higher in different lung cancer subtypes than in the control group,and the difference was statistically significant(P＜0.05).The abundance-based coverage estimator(ACE)index,Simpson index,and Shannon index of patients with different lung cancer pathological subtypes were all lower than those in the control group,and the differences were statistically significant(P＜0.05).β-diver-sity analysis showed that there were significant differences in the variation of gut microbial community structure between the control group and lung cancer patients with different pathological types(P＜0.05).The results of LEfSe indicated that there were differences in gut characteristic microbiota among patients with different pathological subtypes.Specifically,Megamonas was enriched in the LUAD group,Butyrivibrio was enriched in the LSCC group,and Akkermansia was enriched in the SCLC group.Conclusion There are significant differences in the composition of gut microbiota between lung cancer patients and the normal population,and the gut microbiota of patients with different lung cancer pathological subtypes have distinct characteristics.These differences may provide new bio-markers and therapeutic strategies for the diagnosis and treatment of lung cancer.

Background: A simple superoposterior approach to thoracic transforaminal epidural injections (TFEIs) under ultrasonographic guidance was proposed to reduce zoster-associated pain (ZAP) involving multiple thoracic nerves and the likelihood of transitioning to postherpetic neuralgia (PHN). Methods: Patients were prospectively enrolled. Primary endpoints were the burden of illness (BOI) scores and epidural contrast spread. Secondary endpoints included number of needle insertion attempts, sensory blockade, hemodynamic changes, procedure time, radiation dose, adverse events, rescue analgesics, PHN incidence and EuroQoL 5-Dimension scores. Results: Thirty-five injections were performed in 27 patients. Median levels of cephalad-caudad epidural contrast spread were 3, 4, and 5 ml following injections of 2, 3, and 4 ml. Dorsal epidural spread was observed at levels 3, 4, and 5, whereas concurrent ventral spread was observed at levels 2, 3, and 4. BOI scores at 30–180 days significantly decreased (mean difference: −25.3, 95% CI [−57.4 to 6.6], P = 0.005), accounting for reduced rescue analgesic requirements and PHN occurrence and improved EuroQoL 5-Dimension scores. Median sensory blockade at 5 min post-procedure was at level 2, 3, and 4 after 2, 3, and 4 ml of therapeutic injectate. No significant hemodynamic changes were noted at 15 min post-injection. No serious adverse events were observed. Conclusions Spread of thoracic epidural contrast to all involved nerves was confirmed using this novel technique. Simplified needle placement reduced the technical difficulty and risk of complications. It might be a promising alternative approach for ZAP.

Objective:This meta-analysis aims to explore the most consistent changes in cortical thickness in drug-naive first-episode patients with major depressive disorder (DF-MDD).Methods:Systematic and comprehensive searches were conducted to acquire relevant literature from the PubMed and Web of Science databases for the studies published from inception to July 23, 2023, by using the keywords ("depression" OR "depressive disorder" OR "unipolar depression") AND ("cortical thickness"OR"thickness"). The SDM (signed differential mapping) software was used to perform whole-brain voxel-wise meta-analysis, heterogeneity test, and assess publication bias. Meta-regression analysis was employed to examine the impact of disease severity on cortical thickness in depression, and heterogeneity was tested, along with an assessment of publication bias.Results:Eight studies were ultimately included, encompassing 417 DF-MDD patients and 409 healthy controls. Compared to the healthy control group, DF-MDD patients exhibited significantly decreased cortical thickness in multiple brain regions, including the supplementary motor area ( Z=-2.471, P<0.000 5) and the rolandic operculum ( Z=-2.190, P<0.000 5). Further regression analysis found that the disease severity was positively correlated with the cortical thickness in the supplementary motor area ( Z=2.265, P<0.000 5) and the rolandic operculum ( Z=1.56, P<0.000 5). Additionally, the average depressive duration was positively correlated with cortical thickness in the right opercular part of the inferior frontal gyrus ( Z=1.922, P<0.000 5), and negatively correlated with changes in the right midcingulate cortex ( Z=-3.035, P<0.000 5) in DF-MDD. Conclusion:DF-MDD patients exhibit reduced cortical thickness in the supplementary motor area and the operculum area during the early stages of the disease. And the observed pattern of cortical alterations is associated with both the severity and duration of the disease.

Objective:To analyze the implementation effects of a medical laboratory talent training program based on local colleges and universities' applied talent-oriented cultivation principal as well as students' interests and industry needs.Methods:Based on the design principals of clarifying the professional orientation, meeting the national standard, reconstructing the curriculum system, introducing the spirit of innovation and entrepreneurship, and multi-dimensional collaborative education, as well as the reverse design path of the outcome-based education concept, we have built a medical laboratory applied talent training system focusing on humanity education, solid foundation, broad employment, and good competency and in accordance with the "three complete education" strategy, along with measures including creating an applied teaching atmosphere, developing an applied curriculum teaching model, providing vocational guidance and improving vocational identity, and promoting education via evaluation. The system was applied to the training and practice of students of grades 2021 and 2022 majoring in medical laboratory technology. SPSS20.0 software was used for statistical analysis.Results:With the concept of application-oriented talent training and the "four-in-one" practical teaching model, students' skills were improved, and the training path was broadened. Compared with those trained with the original program (grades 2019-2020), the graduates trained with the new program (grades 2021-2022) showed a significantly decreased employment rate in medical laboratory jobs in medical institutions from 71.25% to 42.86% ( χ2=12.36, P<0.001), a significantly increased employment rate in in-vitro diagnostics industry from 3.75% to 17.14% ( χ2=7.44, P<0.05), and a significantly increased rate of applying for postgraduate education from 17.05% to 32.86% ( χ2=4.74, P<0.05). Conclusions:The medical laboratory talent training program based on the talent training principal of local colleges and universities combined with students' interests and industry needs can help improve the quality of talent training and broaden the employment path of graduates.