Histopathological examination is currently the gold standard for the diagnosis of metabolic associated fatty liver disease （MAFLD）； however， due to its invasiveness， high risks， and low feasibility， application of noninvasive indicators in the staging and classification of MAFLD has become a research hotspot. This article systematically reviews the efficacy of dynamic changes in various noninvasive markers in reflecting histological changes and clinical outcome events in MAFLD patients， in order to provide theoretical support for dynamic monitoring and individualized management of the disease.

This study identified the types and pathogen carrying status of fleas on the surface of sheep in some areas of southern Xinjiang,and analyzed the genetic evolution differences with respect to related pathogens.The aim was to provide a reference for the local prevention and control of fleas and insect borne infectious diseases.A total of 1 586 fleas were collected from agricultural and pas-toral areas of Tumushuke City and Hotan Prefecture.Flea species were identified on the basis of morphology and the Pulex irritans mi-tochondrial COII gene.Flea DNA was extracted,and PCR was conducted to amplify the Bartonella gltA gene;Arsenophonus,Ana-plasma,Ehrlichia,and Wolbachia 16S rRNA genes;RickettsiaOmpA,17kDa,16S rRNA genes,and Yersinia pestis 16S rDNA gene.The amplified products were sequenced,and the homology of the genes of the three detected pathogens(gltA gene of Bartonella,16S rRNA gene of Wolbachia,and Anaplasma phagocytophilum)with respect to known corresponding genes of the same pathogen in Gen-Bank was analyzed.Phylogenetic trees were constructed with the adjacency method in MEGA 11.0.According to morphological and mo-lecular biology identification results,all fleas collected in this study were Pulex irritans.PCR indicated that the target gene fragments had been added to the mitochondrial COII,BartonellagltA,Wolbachia,and autophagosomal 16S rRNA genes of human fleas,all of which were consistent with the expected fragment sizes.Target bands were not amplified from Ehrlichia,Arsenophonus,spotted fever group Rickettsia,and Yersinia pestis.According to homology and genetic evolution analysis of human flea mitochondrial COII and the corresponding genes of the above-described pathogens,the COX2 gene(ON455234.1)of human fleas in Tumushuke city and Iran ob-tained in this study showed the highest homology(99.84%).The COII gene(NC_063709.1)of human fleas in Hetan City and Hunan region showed the highest homology(100%).Our findings further confirmed that the flea species was Pulex irritans.The PCR amplifi-cation results indicated that the collected Pulex irritans carried multiple pathogens,among which Bartonella and Wolbachia had the highest infection rates,and the infection rate with Anaplasma phagocytophilum was relatively low.This study is the first to discover flea species on the surface of sheep in some areas of southern Xinjiang.Our findings preliminarily confirmed that Bartonella,Wolba-chia,and Anaplasma phagocytophilum are the main Pulex irritans pathogens.

Objective:To analyze the risk factors for symptomatic cerebral infarction (SCI) in patients with spontaneous intracerebral hemorrhage (ICH).Methods:A total of 337 patients with spontaneous ICH admitted to the stroke center of Zhengzhou People’s Hospital were consecutively collected from May 2019 to March 2023. Patients were divided into the SCI group and without SCI group according to whether the presence of new neurological deficits consistent with diffusion-weighted imaging hyperintense lesions distant from the hematoma. Magnetic resonance was used to quantify cerebral small vessel disease imaging markers and the degree of cerebral artery stenosis (CAS). SPSS 25.0 software was used for data analysis. Univariate and multivariable Logistic regression models were adopted to assess risk factors associated with concomitant SCI. Subgroup analysis stratified by mean arterial pressure (MAP) tertiles was performed.Results:Compared with patients without SCI, patients with SCI have more histories of ischemic stroke, higher rates of complication of pneumonia and deep venous thrombosis, higher baseline systolic blood pressure, greater MAP change, higher periventricular white matter hyperintensities score and deep white matter hyperintensities (DWMHs) score, and more severe CAS (all P<0.05). Multivariable regression analysis showed that, the degree of CAS ( B=1.095, OR=2.989, 95% CI=1.645-5.432, P<0.001) and DWMHs score ( B=0.789, OR=2.201, 95% CI=1.163-4.166, P=0.015) were risk factors for ICH patients with SCI. Compared with patients with mild CAS, the proportion of SCI significantly increased in patients with moderate and severe CAS in the maximum MAP change group (both P<0.05). Compared with patients with mild DWMHs, the proportion of SCI in patients with severe DWMHs in the maximum MAP change group significantly increased ( P=0.002). Conclusion:Severe CAS and DWMHs are independent risk factors for SCI after ICH, especially with greater fluctuations in MAP change.

Objective To develop an artificial intelligence(AI)diagnostic system for computed tomography angiography(CTA)images related to acute aortic syndrome(AAS)and to evaluate its efficacy in diagnosing and differentiating between AAS subtypes.Methods We collected the CTA images of patients diagnosed with aortic dissection(AD),intramural hematoma(IMH),or penetrating atherosclerotic ulcer(PAU)who were treated in the Department of Peripheral Vascular Diseases,The First Affiliated Hospital of Xi'an Jiaotong University,from June 2016 to June 2022.Based on the strict inclusion and exclusion criteria,2 057 CTA images were selected and extracted.Normal human aorta CTA images served as the control group.The YOLO v7 neural network was used to diagnose and differentiate subgroups of AAS patients in the CTA images,and its diagnostic performance was evaluated.Results The sensitivity,specificity,positive predictive value,negative predictive value,and total accuracy of the AAS diagnostic system based on the YOLO v7 were 98.72％,83.10％,97.82％,89.40％,and 96.92％,respectively.The total accuracy for differential diagnosis of the subgroups was 85.58％.The total accuracy of diagnosis results was significantly higher than that of differential diagnosis results(P＜0.05).Conclusion The AI-based AAS diagnostic system utilizing YOLO v7 meets the established standards for disease diagnosis.However,further research is warranted involving larger image databases and more advanced deep learning networks to improve the differentiation among AAS subtypes.

Purpose To explore the expression level of let-7b-5p in glioma and its effects and potential mecha-nisms on U251 cell growth.Methods The expression of let-7b-5p in glioma was detected using qRT-PCR.Data from the CGGA database were analyzed to examine the relationship between the let-7b-5p expression levels,WHO grade and overall survival rates of glioma patients.Transient transfection was used to downregulate the expression of let-7b-5p and IGF1R in U251 cells.The role and potential mechanism of let-7b-5p in the U251 cell were evaluated using qRT-PCR,CCK8 assays,clone formation assays,Western blotting,and double luciferase reporter assays.Results The expres-sion of let-7b-5p in glioma cells(A172:3.64±0.64,V251:4.56±0.52,U87-MG:3.31±0.50)and tissues(2.18±0.22)was significantly higher than that in astrocytes(HMC3:1.00±0.21,P＜0.05 or P＜0.01)and nor-mal brain tissues(1.01±0.19,P＜0.05).Let-7b-5p expression was negatively correlated with WHO grades but pos-itively correlated with survival rates in primary and recurrent glioma patients(P＜0.000 1 and P=0.028,respective-ly).Knockdown of let-7b-5p in U251 cells significantly promoted the growth of glioma cells(CCK8:knockdown group 126.00±12.09 vs miR-NC group 90.93±5.13,P＜0.05)and activated PI3K/AKT signal pathway.Suppressing IGF1R expression in U251 cells reversed the effects of let-7b-5p knockdown on glioma cell growth[CCK8:let-7b-5p knockdown+IGF1R knockdown group(92.08±6.14)vs let-7b-5p knockdown+sh-NC group(116.67.08±8.50)]and PI3K/AKT signal pathway activation.Conclusion Let-7b-5p functions as a tumor suppressor gene in glioma.It may regulate glioma cell growth by targeting IGF1R and modulating PI3K/AKT signal pathway.

Radionuclide drug conjugates(RDC)represent the culmination of interdisciplinary integra-tion.By virtue of their precise targeting capability,high diagnostic sensitivity,and remarkable therapeutic effi-cacy in tumor diagnosis and treatment,RDC has emerged as promising theranostic agents with immense applica-tion potential.This article systematically reviews the progress in RDC development in China from 2009 to 2024,encompassing an overview of RDC,its structure and classification,trends in clinical research,advances in clinical trials,and national policy support.The aim is to provide valuable insights for researchers in related fields,thereby facilitating further development and application of RDC-based therapeutics.

Objective To explore the independent risk factors for long-term adverse prognosis after percutaneous renal artery angioplasty in patients with transplant renal artery stenosis(TRAS).Methods We retrospectively collected medical records and surgery details of TRAS patients who underwent renal artery angioplasty at the Department of Peripheral Vascular Diseases,The First Affiliated Hospital of Xi'an Jiaotong University,from January 2017 to June 2021.All patients were followed up for 3 years post-operation.Multivariate Cox regression analyses were performed to find the independent predictive factors for long-term adverse prognosis after renal artery angioplasty in the TRAS patients.Results A total of 45 TRAS patients who underwent percutaneous renal artery angioplasty were included in this study.During the five-year follow-up period,10 patients(22.2％)experienced long-term adverse events.These consisted of 3 patients(6.7％)who died from any cause,1 patient(2.2％)who developed transplant renal artery dissection,6 patients(13.3％)who had restenosis of the transplant renal artery,and 1 patient(2.2％)who lost the transplant kidney and received dialysis again.Multivariate Cox regression analysis showed that male gender(HR=4.915,95％CI:1.036-23.328,P=0.045)and balloon angioplasty alone(HR=8.594,95％CI:2.191-33.710,P=0.002)were independent risk factors for long-term adverse prognosis after renal artery angioplasty in TRAS patients.Conclusion Male gender and balloon angioplasty alone are independent risk factors for long-term adverse prognosis after renal artery angioplasty in TRAS patients.

Objective To investigate the diagnostic accuracy and clinical applicability of the Linknet-VGG16 deep learning algorithm for measuring the effective optical zone(EOZ)after corneal refractive surgery.Methods This single-center retrospective cohort study included 69 patients(69 eyes)who underwent femtosecond laser-assisted in situ kerato-mileusis(FS-LASIK)(34 eyes)or small incision lenticule extraction(SMILE)(35 eyes)at the Refractive Surgery Center of Affiliated Zhengzhou Aier Eye Hospital of Henan University from June 2023 to June 2024.Data from the right eyes of all patients were selected for statistical analysis.During the surgery,patients in the FS-LASIK group adopted the VisuMax fem-tosecond laser system combined with the Amaris 750S excimer laser system,while those in the SMILE group only used the VisuMax femtosecond laser system.A total of 276 Pentacam images were re-examined postoperatively.A Linknet segmenta-tion model based on the VGG16 encoder was constructed,and image normalization techniques were applied to accelerate model convergence.Model performance was assessed using accuracy,intersection over union(IoU),and the Dice coeffi-cient.The traditional EOZ measurement method based on corneal tangential curvature served as the reference standard.Bland-Altman analysis was conducted to evaluate consistency across all images and within each group,and the time effi-ciency of both methods was compared.Results Six representative medical image segmentation architectures(U-Net,U-Net++,DeepLabv3-ResNet50,DeepLabv3+-ResNet50,Unet-Densenet169,and Linknet-VGG16)were systematically evaluated.The Linknet-VGG16 model demonstrated superior performance over the other 5 models in pixel-level accuracy,IoU and Dice coefficient,which were 99.83％,99.48％and 99.74％,respectively.Although there was no significant differ-ence in accuracy and Dice coefficient between Linknet-VGG16 and U-Net models(whose accuracy was 99.82％and Dice coefficient was 99.72％),the inference speed of the U-Net model(62.46 ms)was 31.76％slower than that of the Linknet-VGG16 model(42.62 ms).The evaluation results of a clinically applicable comprehensive scoring model(weights:accura-cy 20％,IoU 20％,Dice coefficient 20％,speed 25％,model size 15％)showed that the Linknet-VGG16 model achieved a score of 88.01,surpassing other architectures(U-Net:86.29;DeepLabv3+-ResNet50:80.41;DeepLabv3-ResNet50:73.82;U-Net++:73.22;Unet-Densenet169:66.66).Bland-Altman analysis revealed that the mean difference of the 136 images in the FS-LASIK group was 0.01 mm[95％limits of agreement(LoA):-0.36 to 0.35 mm],with 96.3％of data points falling within the LoA.The mean difference of the 140 images in the SMILE group was-0.01 mm(95％LoA:-0.36 to 0.33 mum),with 95.7％of data points falling within the LoA.The mean difference of all 276 images was 0.00 mm(95％LoA:-0.36 to 0.34 mm),with 96.4％of data points falling within the LoA.These results indicated excellent consistency.The average measurement time per image using the traditional EOZ measurement method was 13.00 minutes,whereas the deep learning model required only 3.22 seconds.Conclusion The traditional EOZ measurement method based on corne-al tangential curvature exhibits good consistency with the fully automatic EOZ measurement method based on deep learning algorithms,achieving high image recognition accuracy.Additionally,the deep learning algorithm significantly reduces measurement time,compared with the traditional method based on corneal tangential curvature.

Oral fluid specimens are a new type of specimen whose clinical application value is widely evaluated. Compared with conventional pathogen detection technology, they have the advantages of non-invasive, simple operation and self-collection. They can be used for biochemical analysis, nucleic acid detection of infectious pathogens and tumor cells, and have been recommended for screening and diagnosis of certain diseases. This article mainly summarizes the collection methods of oral fluid and related samples, as well as their application in the diagnosis of infectious pathogens, providing a reference for the detection and research of clinical infectious disease etiology in China.