Background/Aims: Natural killer (NK) cell function is generally considered dampened in chronic hepatitis B virus (HBV) infection; however, the NK cell pool exhibits phenotypic and functional heterogeneity, and the antibody--mediated effect of NK cells remains less characterized. This study evaluated the dynamic changes in antibody-mediated NK cell responses and the involvement of distinct NK subsets across disease stages and during antiviral treatment. Methods: A T-cell receptor-like antibody specific for the HBV core 18–27 peptide (cTCRL-Ab) was used to determine the antibody-mediated effect of NK cells, and an array of NK cell surface markers were analyzed in cross-sectional and longitudinal cohorts of patients with chronic HBV infection. Single-cell RNA sequencing (scRNA-seq) was performed to identify the heterogeneity of NK subsets. Results: The cTCRL-Ab enabled the detection of NK cell cytolytic activity and IFNγ production. Notably, cTCRL-Ab-mediated NK cell responses were compromised in chronically HBV-infected patients, particularly in those receiving pegylated interferon-α (Peg-IFNα), which was associated with the downregulation of CD16 expression. Correspondingly, Peg-IFNα inhibited cTCRL-Ab-mediated NK cell function by reducing CD16 expression in vitro. scRNA-seq revealed that CD16 downregulation occurred mainly within a dysfunctional CD16hi NK subset exhibiting exhaustion properties. In contrast, an activated CD16hiNK subpopulation (CX3CR1⁺KLRC2–CD16hi) with high cytotoxicity was enriched in patients who experienced favorable treatment responses. Furthermore, the intrahepatic CX3CR1+KLRC2–CD16hi subset tended to exhibit functional restoration in HBsAg-loss individuals. Conclusions Our data contribute to the understanding of antibody-mediated responses of NK cells in chronic HBV infection, and highlight a previously unappreciated functional CX3CR1+KLRC2–CD16hiNK subset as a potential therapeutic target.

Objective:To evaluate the performance of the neural network model in segmenting gout tophus in the first metatarsophalangeal（MTP1）joint ultrasound images.Methods:A total of 1 218 tophus images from 381 patients who underwent MTP1 ultrasound examinations in the Affiliated Hospital of Qingdao University between May 2023 and December 2024 were prospectively collected. The images were divided into training，validation，and test sets in a ratio of 7∶2∶1. Multiple neural network models were trained to automatically identify and segment tophus in the images，with physician-annotated tophus regions serving as the reference standard. Model performance was evaluated in the test set，and the impact of tophus characteristics（e.g.，echogenicity，size，and presence of bone erosion）on segmentation efficacy was analyzed.Results:In the test set，CMUNeXt demonstrated superior tophus segmentation performance versus Unet，Unet++，TransUnet，and CMU-Net，achieving an accuracy of 99.1%，precision of 79.1%，recall of 84.6%，intersection over union of 68.8%，and Dice similarity coefficient of 80.2%. Logistic regression identified tophus echogenicity，size，and bone erosion as independent efficacy factors OR（95% CI）=7.275（1.598-33.129），21.303（4.282-105.985），13.520（3.617-50.530），0.076（0.007-0.823）（all P<0.05）. Hypoechoic tophus demonstrated significantly superior segmentation performance compared to mixed-echoic and isoechoic tophus（all P<0.05），and lesions with larger maximum diameters（>10 mm）were segmented more effectively than smaller tophus（ P<0.05）. Conclusions:The CMUNeXt model enables accurate identification and segmentation of tophus in MTP1 ultrasound images，particularly excelling for larger and hypoechoic lesions. This approach holds significant promise for AI-assisted diagnosis of MTP1 gouty arthritis.

Objective:To evaluate the performance of the neural network model in segmenting gout tophus in the first metatarsophalangeal（MTP1）joint ultrasound images.Methods:A total of 1 218 tophus images from 381 patients who underwent MTP1 ultrasound examinations in the Affiliated Hospital of Qingdao University between May 2023 and December 2024 were prospectively collected. The images were divided into training，validation，and test sets in a ratio of 7∶2∶1. Multiple neural network models were trained to automatically identify and segment tophus in the images，with physician-annotated tophus regions serving as the reference standard. Model performance was evaluated in the test set，and the impact of tophus characteristics（e.g.，echogenicity，size，and presence of bone erosion）on segmentation efficacy was analyzed.Results:In the test set，CMUNeXt demonstrated superior tophus segmentation performance versus Unet，Unet++，TransUnet，and CMU-Net，achieving an accuracy of 99.1%，precision of 79.1%，recall of 84.6%，intersection over union of 68.8%，and Dice similarity coefficient of 80.2%. Logistic regression identified tophus echogenicity，size，and bone erosion as independent efficacy factors OR（95% CI）=7.275（1.598-33.129），21.303（4.282-105.985），13.520（3.617-50.530），0.076（0.007-0.823）（all P<0.05）. Hypoechoic tophus demonstrated significantly superior segmentation performance compared to mixed-echoic and isoechoic tophus（all P<0.05），and lesions with larger maximum diameters（>10 mm）were segmented more effectively than smaller tophus（ P<0.05）. Conclusions:The CMUNeXt model enables accurate identification and segmentation of tophus in MTP1 ultrasound images，particularly excelling for larger and hypoechoic lesions. This approach holds significant promise for AI-assisted diagnosis of MTP1 gouty arthritis.

Objective To observe the value of intravascular ultrasound elastography(IVUSE)for evaluating efficacy of ezetimibe combined with rosuvastatin for treating carotid atherosclerotic plaques.Methods Totally 200 ischemic cerebrovascular disease patients were prospectively enrolled and randomly divided into study group and control group(each n=100).Patients in study group were treated with ezetimibe combined with rosuvastatin,while those in control group were treated with atorvastatin alone for 4 months.The score of National Institutes of Health stroke scale(NIHSS)and related indicators of laboratory examination were recorded before and after treatment.Routine carotid artery ultrasound and IVUSE examination were performed,their efficacy for detecting vulnerable carotid plaque were compared taken the results of digital subtraction angiography(DSA)and CT before treatment as standards.The changes of clinical data,IVUSE parameters and stability of carotid plaque after treatment were observed.Results DSA detected single plaque in 162 cases and multiple plaques in 38 cases,with a total of 232 plaques,including 192 vulnerable plaques and 40 stable plaques.The accuracy of IVUSE for detecting vulnerable carotid plaque was higher than that of conventional ultrasound(x2=16.019,P＜0.001).After treatment,NIHSS score,total cholesterol,triglycerides,low-and high-density lipoprotein cholesterol improved better in study group than those in control group.Eccentric index and strain rate were higher,while the other plaque IVUSE parameters were lower in study group than those in control group(all P＜0.05).The improvement rate of plaque stability in study group after treatment was higher than that in control group(78.00％[78/100]vs.52.00％[52/100],P＜0.001).Conclusion IVUSE could be used to evaluate the efficacy of ezetimibe combined with rosuvastatin for treating carotid atherosclerotic plaque.

Objective To observe the value of intravascular ultrasound elastography(IVUSE)for evaluating efficacy of ezetimibe combined with rosuvastatin for treating carotid atherosclerotic plaques.Methods Totally 200 ischemic cerebrovascular disease patients were prospectively enrolled and randomly divided into study group and control group(each n=100).Patients in study group were treated with ezetimibe combined with rosuvastatin,while those in control group were treated with atorvastatin alone for 4 months.The score of National Institutes of Health stroke scale(NIHSS)and related indicators of laboratory examination were recorded before and after treatment.Routine carotid artery ultrasound and IVUSE examination were performed,their efficacy for detecting vulnerable carotid plaque were compared taken the results of digital subtraction angiography(DSA)and CT before treatment as standards.The changes of clinical data,IVUSE parameters and stability of carotid plaque after treatment were observed.Results DSA detected single plaque in 162 cases and multiple plaques in 38 cases,with a total of 232 plaques,including 192 vulnerable plaques and 40 stable plaques.The accuracy of IVUSE for detecting vulnerable carotid plaque was higher than that of conventional ultrasound(x2=16.019,P＜0.001).After treatment,NIHSS score,total cholesterol,triglycerides,low-and high-density lipoprotein cholesterol improved better in study group than those in control group.Eccentric index and strain rate were higher,while the other plaque IVUSE parameters were lower in study group than those in control group(all P＜0.05).The improvement rate of plaque stability in study group after treatment was higher than that in control group(78.00％[78/100]vs.52.00％[52/100],P＜0.001).Conclusion IVUSE could be used to evaluate the efficacy of ezetimibe combined with rosuvastatin for treating carotid atherosclerotic plaque.

Objective:To explore the application value of guide tube fenestration and drainage technology in intracranial artery stenting surgery.Methods:A total of 120 patients with symptomatic intracranial atherosclerotic stenosis admitted to the Xingtai Third Hospital from January 2021 to December 2022 were selected and randomly divided into an observation group ( n=60) and a control group ( n=60). Both groups were treated with intracranial artery stenting, with the observation group receiving guidance catheterization and window opening technique during the surgery. Two groups of surgeries were observed and compared: the degree of vascular stenosis before and after surgery, the Montreal Cognitive Assessment Scale (MoCA) scores before and one month after surgery, intraoperative complications, and prognosis. Results:The surgical time and catheter placement time in the observation group were (110.20±23.32)minutes and (11.32±2.01)minutes, respectively, which were significantly shorter than those in the control group (all P<0.05). The stent placement rate and operation success rate in the observation group were 95.00% and 96.67%, respectively, significantly higher than those in the control group (all P<0.05). The degree of postoperative vascular stenosis in the observation group was (32.29±7.11)%, significantly milder than that in the control group [(44.43±8.15)%, P<0.05]. One month after surgery, the MoCA scores of both groups improved significantly compared to before surgery (all P<0.05), and there was no statistically significant difference between the groups ( P>0.05). There was no statistically significant difference in the incidence of collateral circulation occlusion and vascular rupture between the two groups (all P>0.05). During the follow-up period, there was no statistically significant difference in the incidence of restenosis, intracranial hemorrhage, and recurrent ischemic stroke between the observation group and the control group (all P>0.05); The good prognosis rate of the observation group was 73.33%, significantly higher than that of the control group (53.33%, P<0.05). Conclusions:The application of guided catheter fenestration technique in intracranial artery stenting has good value, which is beneficial for improving the stent placement rate and operation success rate, and improving the degree of vascular stenosis.

Objective:To investigate the efficacy and safety of surgery via endoscopic-assisted transcallosal approach in intraventricular hemorrhage (IVH).Methods:A retrospective study was performed; the clinical data of 68 IVH patients admitted to our hospital from October 2016 to January 2020 were analyzed. These patients were divided into endoscopic treatment group ( n=34) and drainage group ( n=34) according to the treatment methods. In the endoscopic treatment group, IVH was evacuated via endoscopic-assisted transcallosal approach; in the drainage group, external ventricular drainage and urokinase injection were performed. Gross hematoma clearance rate (clearance rate≥95%) 1, 3, and 7 d after surgery, complication incidence 7 d and 1 month after surgery, and good prognosis rate (ability of daily living [ADL] grading I-III) 3 months after surgery were compared between the two groups. Results:One, 3, and 7 d after surgery, the gross hematoma clearance rate in the endoscopic treatment group was significantly higher than that in the drainage group ( P<0.05). The recurrent hemorrhage rate within 7 d of surgery, intracranial infection rate, and percentage of patients with secondary hydrocephalus requiring shunt within 30 d of surgery in the endoscopic treatment group were significantly lower than those in the drainage group (2.9% vs. 20.6%, 2.9% vs. 23.5%, 5.9% vs. 17.6%, P<0.05). Three months after follow-up, the good prognosis rate of patients in the endoscopic treatment group was significantly higher than that in the drainage group (91.2% vs. 58.9%, P<0.05). Conclusion:Endoscopic-assisted transcallosal approach is recommended in clinical treatment of IVH, which can significantly reduce postoperative complications and improve postoperative prognosis.

Aiming at the problem of the influence of preloading force on its mechanical response in soft tissue compression experiments, an elimination method of preloading force based on linear loading region is proposed. Unconfined compression experiments under a variety of different preloading forces are performed. The influence of the preloading force on the parameters of constitutive model is analyzed. In the preload phase, the mechanical response of the soft tissue is taken as a linear model. The preloading force is eliminated by taking the preloading phase into account throughout the response process. According to five different preloading forces of the unconfined compression experiments, the elimination method is validated with two different constitutive models of soft tissue, and the error between the models obtained by the preloading force elimination method and the traditional method with the experimental results is compared. The results show that the error obtained by preloading force elimination method is significantly smaller than the traditional method. The preloading force elimination method can eliminate the influence of preloading force on mechanical response to a certain extent, and constitutive model parameters which are closer to the true properties of soft tissue can be obtained.
Elasticity ; Linear Models ; Models, Biological ; Pressure ; Stress, Mechanical

Objective To investigate gender differences of plasma glial cell line-derived neurotro-phic factor (GDNF) levels in patients with major depressive disorder (MDD). Methods MDD subjects (male 20,female 36) and healthy controls (HCs) (male 35,female 45) were divided into four groups by gender. Plasma levels of GDNF were measured and compared in different gender groups. The clinical symp-tom severity of MDD patients was evaluated by 17-item Hamilton Depression Scale (HAMD-17) and Hamil-ton Anxiety Scale (HAMA-17). Results (1)The plasma GDNF level in male patients with major depres-sive disorder (( 1. 55 ± 0. 43 ) pg/ml ) was significantly lower than that in healthy controls (( 1. 86 ± 0. 50)pg/ml,F=4. 64,P=0. 036). There was no significant difference in GDNF level between female de-pression patients((1.62±0.46)pg/ml)) and female healthy control((1. 64±0. 48)pg/ml,F=0. 18,P=0. 672). In HCs,the GDNF level of male was significantly higher than that of female((1. 86±0. 50)pg/ml, (1. 64±0. 48)pg/ml,F=2. 04,P=0. 045). There was no significant difference in GDNF level between male and female patients(P>0. 05). (2) GDNF level in male patients with major depressive disorder was nega-tively correlated with HAMA score(r=-0. 388,P=0. 034). Conclusion The expression of GDNF is affect-ed by sex factors,which may be related to the different pathogenesis of MDD.