Objective To explore the mechanism of Tongdu Xingshen acupuncture,the clinical efficacy,systemic inflammatory response,blood-brain barrier and intestinal flora in patients with cognitive impairment after ischemic stroke(IS)were studied.Methods Thirty patients(3 cases shedding)with cognitive impairment after IS were included as the disease group,including patients before treatment as the disease group,patients after Tongdu Xingshen acupuncture treatment as the electroacupuncture group,and 30 healthy controls(3 cases shedding)were included as the healthy group.In the electroacupuncture group,on the basis of the basic treatment,Tongdu Xingshen acupuncture was applied,which was 30 min each time,once a day for 14 days.The MMSE,MoCA and MBI scores of the three groups were observed.The fecal and serum samples from all study subjects were collected,and 16S rDNA sequencing technology and ELISA were used to detect the changes of proinflammatory factors IL-6,IL-1β,TNF-α and S100β in serum in intestinal flora and feces.Results Compared with the healthy group,the MMSE,MoCA,and MBI score of patients in the disease group decreased significantly(P<0.05),serum proinflammatory factors and S100β protein content increased significantly(P<0.05),and the Shannon index(P<0.01)and Simpson index(P<0.001)increased significantly.Compared with the disease group,the MMSE,MoCA,and MBI score of the EA group increased significantly(P<0.05),the serum levels of proinflammatory factors and S100β decreased significantly(P<0.05),Shannon index and Simpson index decreased(P>0.05).The dominant bacterial flora in the healthy group mainly included Bacteroides,Bifidobacterium,Bacteroides,Faecalibacterium,Bifidobacteriaceae,Ruminococcaceae,and Bacteroides and other beneficial bacteria(P<0.05).The dominant flora in the disease group included Proteobacteria,Enterobacteriaceae,Escherichia,Klebsiella and other opportunistic bacteria(P<0.05),while the dominant flora in the EA group was consistent with the healthy group,the relative abundance of beneficial bacteria increased significantly(P<0.05),and the relative abundance of opportunistic bacteria decreased significantly(P<0.05).Spearman correlation analysis found that beneficial bacteria were positively correlated with clinical efficacy related indicators,but with serum proinflammatory factors and the content of S100β was negatively correlated.Conclusion Tongdu Xingshen acupuncture can regulate the diversity of intestinal flora to increase the abundance of Bacteroides,Bifidobacterium,Faecalibacterium,and other beneficial bacteria,regulate the intestinal microecological balance,Thereby regulating systemic inflammation and blood-brain barrier function,which plays a role in improving cognitive function.

Objective:To investigate the value of 3.0T magnetic resonance imaging(MRI)in the assessment for clinically pathologic features of prostate cancer(PCa).Methods:The case data of 102 PCa patients who were confirmed by histology in The Second Affiliated Hospital of Bengbu Medical University from April 2020 to July 2024 were retrospectively analyzed.51 PCa patients of them were included in cancer group,and 51 patients with prostatic hyperplasia were included in hyperplasia group.Multi-parametric MRI was implemented in all patients.Imaging performance was scored by using Prostate Imaging Reporting and Data System version 2.1(PI-RADS v2.1).The distribution of scores between the two groups was compared and analyzed.The correlations between the PI-RADS v2.1 scores and PCa clinically pathological features which included Gleason scores,serum prostate specific antigen(PSA)level,tumor staging and aggressiveness were analyzed and explored by using Spearman correlation analysis.The diagnostic efficacy of the 3.0T MRI technique for PCa was analyzed by using the receiver operating characteristic(ROC)curve.Results:The PI-RADS v2.1 score of cancer group was 4(4,5)scores,which was significantly higher than 2(3,4)scores of hyperplasia group,and the difference of that between two groups was significant(U=369.5,P<0.05).The rate of high scores(4,5 scores)of cancer group was more than that of hyperplasia group in the distribution of scores,and the difference of that between two groups was significant(x2=51.220,P<0.05).In patients of cancer group,PI-RADS v2.1 score showed significant correlation with serum PSA level,Gleason score,tumor staging and aggressiveness(P<0.05),respectively,and they were significant(r=0.815,0.723,0.693,P<0.05).ROC curve analysis showed that the area under curve(AUC)value of PI-RADS v2.1 score was 0.858(95%CI:0.783-0.932)in diagnosing PCa,which can effectively distinguish PCa and prostate hyperplasia.It had higher diagnostic efficacy,which was higher than that of serum PSA.Conclusions:3.0T MRI has favorable accuracy in diagnosing PCa,and it can be used as a noninvasive test method to diagnose and assess pathological features of tumor.

Objective To explore the mechanism of Tongdu Xingshen acupuncture,the clinical efficacy,systemic inflammatory response,blood-brain barrier and intestinal flora in patients with cognitive impairment after ischemic stroke(IS)were studied.Methods Thirty patients(3 cases shedding)with cognitive impairment after IS were included as the disease group,including patients before treatment as the disease group,patients after Tongdu Xingshen acupuncture treatment as the electroacupuncture group,and 30 healthy controls(3 cases shedding)were included as the healthy group.In the electroacupuncture group,on the basis of the basic treatment,Tongdu Xingshen acupuncture was applied,which was 30 min each time,once a day for 14 days.The MMSE,MoCA and MBI scores of the three groups were observed.The fecal and serum samples from all study subjects were collected,and 16S rDNA sequencing technology and ELISA were used to detect the changes of proinflammatory factors IL-6,IL-1β,TNF-α and S100β in serum in intestinal flora and feces.Results Compared with the healthy group,the MMSE,MoCA,and MBI score of patients in the disease group decreased significantly(P<0.05),serum proinflammatory factors and S100β protein content increased significantly(P<0.05),and the Shannon index(P<0.01)and Simpson index(P<0.001)increased significantly.Compared with the disease group,the MMSE,MoCA,and MBI score of the EA group increased significantly(P<0.05),the serum levels of proinflammatory factors and S100β decreased significantly(P<0.05),Shannon index and Simpson index decreased(P>0.05).The dominant bacterial flora in the healthy group mainly included Bacteroides,Bifidobacterium,Bacteroides,Faecalibacterium,Bifidobacteriaceae,Ruminococcaceae,and Bacteroides and other beneficial bacteria(P<0.05).The dominant flora in the disease group included Proteobacteria,Enterobacteriaceae,Escherichia,Klebsiella and other opportunistic bacteria(P<0.05),while the dominant flora in the EA group was consistent with the healthy group,the relative abundance of beneficial bacteria increased significantly(P<0.05),and the relative abundance of opportunistic bacteria decreased significantly(P<0.05).Spearman correlation analysis found that beneficial bacteria were positively correlated with clinical efficacy related indicators,but with serum proinflammatory factors and the content of S100β was negatively correlated.Conclusion Tongdu Xingshen acupuncture can regulate the diversity of intestinal flora to increase the abundance of Bacteroides,Bifidobacterium,Faecalibacterium,and other beneficial bacteria,regulate the intestinal microecological balance,Thereby regulating systemic inflammation and blood-brain barrier function,which plays a role in improving cognitive function.

Objective To investigate the diagnostic value of neutrophils CD64(nCD64)index,C reactive protein(CRP),interleukin-6(IL-6)and procalcitonin(PCT)in viral and bacterial upper respiratory tract infections.Methods Patients with upper respiratory tract infection treated in Hangzhou Xixi Hospital Affiliated to Zhejiang Chinese Medical University from January 2023 to January 2024 were selected as study objects.According to the results of etiological examination,they were divided into bacterial infection group(46 cases)and viral infection group(58 cases).The levels of nCD64 index,CRP,IL-6 and PCT before medication were compared between two groups.Receiver operating characteristic(ROC)curve was used to evaluate the value of infection markers in the differential diagnosis of bacterial and viral upper respiratory tract infections.Results The levels of CRP,nCD64 index,IL-6 and PCT in bacterial infection group were significantly higher than those in viral infection group(P＜0.01).ROC curve results showed that the area under the curve(AUC)of nCD64 index,CRP,PCT and IL-6 to distinguish the two types of infection were 0.818,0.776,0.692 and 0.654,respectively,and the combined AUC of four indexes was 0.870.Conclusion nCD64 index,CRP,IL-6 and PCT are closely related to the pathogen types of patients with upper respiratory tract infection,and the combined detection of all indicators can improve the diagnostic efficiency of upper respiratory tract infection types.

Objective To investigate the diagnostic value of neutrophils CD64(nCD64)index,C reactive protein(CRP),interleukin-6(IL-6)and procalcitonin(PCT)in viral and bacterial upper respiratory tract infections.Methods Patients with upper respiratory tract infection treated in Hangzhou Xixi Hospital Affiliated to Zhejiang Chinese Medical University from January 2023 to January 2024 were selected as study objects.According to the results of etiological examination,they were divided into bacterial infection group(46 cases)and viral infection group(58 cases).The levels of nCD64 index,CRP,IL-6 and PCT before medication were compared between two groups.Receiver operating characteristic(ROC)curve was used to evaluate the value of infection markers in the differential diagnosis of bacterial and viral upper respiratory tract infections.Results The levels of CRP,nCD64 index,IL-6 and PCT in bacterial infection group were significantly higher than those in viral infection group(P＜0.01).ROC curve results showed that the area under the curve(AUC)of nCD64 index,CRP,PCT and IL-6 to distinguish the two types of infection were 0.818,0.776,0.692 and 0.654,respectively,and the combined AUC of four indexes was 0.870.Conclusion nCD64 index,CRP,IL-6 and PCT are closely related to the pathogen types of patients with upper respiratory tract infection,and the combined detection of all indicators can improve the diagnostic efficiency of upper respiratory tract infection types.

Objective:To investigate the value of 3.0T magnetic resonance imaging(MRI)in the assessment for clinically pathologic features of prostate cancer(PCa).Methods:The case data of 102 PCa patients who were confirmed by histology in The Second Affiliated Hospital of Bengbu Medical University from April 2020 to July 2024 were retrospectively analyzed.51 PCa patients of them were included in cancer group,and 51 patients with prostatic hyperplasia were included in hyperplasia group.Multi-parametric MRI was implemented in all patients.Imaging performance was scored by using Prostate Imaging Reporting and Data System version 2.1(PI-RADS v2.1).The distribution of scores between the two groups was compared and analyzed.The correlations between the PI-RADS v2.1 scores and PCa clinically pathological features which included Gleason scores,serum prostate specific antigen(PSA)level,tumor staging and aggressiveness were analyzed and explored by using Spearman correlation analysis.The diagnostic efficacy of the 3.0T MRI technique for PCa was analyzed by using the receiver operating characteristic(ROC)curve.Results:The PI-RADS v2.1 score of cancer group was 4(4,5)scores,which was significantly higher than 2(3,4)scores of hyperplasia group,and the difference of that between two groups was significant(U=369.5,P<0.05).The rate of high scores(4,5 scores)of cancer group was more than that of hyperplasia group in the distribution of scores,and the difference of that between two groups was significant(x2=51.220,P<0.05).In patients of cancer group,PI-RADS v2.1 score showed significant correlation with serum PSA level,Gleason score,tumor staging and aggressiveness(P<0.05),respectively,and they were significant(r=0.815,0.723,0.693,P<0.05).ROC curve analysis showed that the area under curve(AUC)value of PI-RADS v2.1 score was 0.858(95%CI:0.783-0.932)in diagnosing PCa,which can effectively distinguish PCa and prostate hyperplasia.It had higher diagnostic efficacy,which was higher than that of serum PSA.Conclusions:3.0T MRI has favorable accuracy in diagnosing PCa,and it can be used as a noninvasive test method to diagnose and assess pathological features of tumor.

Objective:To discuss the distinctive sonographic feature and the biological behavior of renal angiomyolipoma(RAML),and to provide the reference for the clinicians to make the accurate diagnosis of RAML.Methods:The clinical data of one patient with invasive classical RAML combined with pseudaneurysm formation were collected.The sonographic appearances were analyzed in conjunction with the pathological characteristics to clarify the biological behavior of RAML,and the relevant literatures were reviewed.Results:The patient,a 60-year-old female,visited the local hospital due to discomfort in the lumbar area,and received CT examination,and the CT examination results revealed a left renal mass,so the patient came to our hospital.The specialist clinical examinations and laboratory investigations were unremarkable.The ultrasound results indicated an enlarged left kidney with a cystic and solid mass at the upper pole,which featured pseudaneurysm formation(originating from the interlobar arteries);the enhanced CT image results suggested a high probability of upper pole renal carcinoma combined with aneurysmal formation within the tumor,alongside invasion into the left adrenal gland.The patient underwent laparoscopic radical left nephrectomy,and the postoperative pathology confirmed the diagnosis of invasive classical RAML.Conclusion:The classical RAML can exhibit the invasive biological behavior.The pseudaneurysm formation is a special sonographic manifestation of RAML,which can be challenging to differentiate from the other renal tumors.

Objective:To analyze the clinical features and genetic basis of a child with Disorder of sex development (DSD).Methods:A child who was admitted to the Linyi People′s Hospital for primary amenorrhoea on July 29, 2019 was selected as the study subject. Clinical data of the child was collected. Chromosomal karyotyping and quantitative real-time PCR were used to detect Y chromosome microdeletions and other chromosomal aberrations. Next-generation sequencing was carried out for the child and her parents. Candidate variant was verified by Sanger sequencing and bioinformatic analysis.Results:The child, a 13-year-old girl, has featured primary amenorrhoea and onset of secondary sex characteristics of males. Ultrasound exam had detected no uterus and definite ovarian structure, but narrow band vaginal hypoecho and curved cavernoid structure. The child was found to have a 46, XY karyotype without an AZF deletion. DNA sequencing revealed that she has harbored a maternally derived c. 323delA (p.Q108Rfs*188) variant in the nuclear receptor subfamily 5 group A member 1 ( NR5A1) gene, which may result in a truncated protein. The variant was classified as pathogenic (PVS1+ PM2_Supporting+ PP4) based on the guidelines from the American College of Medical Genetics and Genomics. Conclusion:The NR5A1: c. 323delA variant probably underlay the pathogenesis of 46, XY DSD in this child. The discovery of the novel variant has enriched the mutational spectrum of NR5A1 gene and provided a basis for clinical diagnosis, treatment and prenatal diagnosis.

Diabetic retinal neurodegeneration is a serious complication of diabetes mellitus, manifested by apoptosis and gliosis, and its pathogenesis is closely related to the oxidative stress induced by high glucose levels. The increase in blood glucose in the body leads to excessive production of reactive oxygen species and the downregulation of antioxidant defense signaling pathways, which leads to oxidative stress in the body, which in turn induces apoptosis, mitochondrial damage and autophagy, resulting in diabetic retinal neurodegeneration. Antioxidant stress therapy with gene therapy, flavonoids, recombinant Ad-β-catenin carriers, and autophagy inducers to exert neuroprotective effects. In the future, more clinical trials are needed to explore the effective dosage and side effects of drugs, and to develop new drugs and treatment strategies for oxidative stress to prevent and treat diabetic retinal neurodegeneration and protect retinal nerve function.

Objective:A nationwide multi-center and large sample survey was conducted to compare the validity of the Mini International Neuropsychiatric Interview (Hypo-) Manic Episode with Mixed Features-DSM-5 Module (MINI-M) questionnaire and the Clinically Useful Depression Outcome Scale Supplemented with Questions for the DSM-5 Mixed Features Specifier (CUDOS-M) depression subscale in identifying mixed features in patients experiencing (hypo-) manic episodes.Methods:Using a convenience sampling method, 366 patients with bipolar disorder experiencing acute (hypo-) manic episodes who met the inclusion and exclusion criteria were recruited. The diagnosis of "with mixed features" was based on the DSM-5 criteria for mixed features. The predictive validity of the MINI-M questionnaire and the CUDOS-M depression subscale to screen mixed features was analyzed using the receiver operating characteristic (ROC) curve. Additionally, the difference in area under the ROC curve (AUC) between the two instruments was compared.Results:The AUC for the MINI-M questionnaire and the CUDOS-M depression subscale in screening mixed features were 0.79 (95 %CI=0.75-0.84) and 0.81 (95 %CI=0.77-0.86), respectively. There was no statistically significant difference in AUC between the two measurements ( Z=-1.19, P>0.05). Among patients with acute (hypo-) manic episodes, 45.9% (168/366) presented with mixed features according to the DSM-5 criteria, while the corresponding figures were 43.7% (160/366) using the MINI-M questionnaire (total score≥3) and 42.1% (154/366) using the CUDOS-M depression subscale (total score≥20). Screening results were comparable among the three measures. Conclusion:Mixed features are common among patients experiencing acute (hypo-) manic episodes. The MINI-M questionnaire and the CUDOS-M depression subscale demonstrate equivalent validity in identifying mixed features.