Objective:To develop a deep learning model based on super-resolution endorectal ultrasound（ERUS）images for the preoperative prediction of perineural invasion（PNI）in patients with rectal cancer，thereby providing a reference for risk stratification and individualized treatment planning.Methods:A retrospective analysis was conducted on 382 patients with rectal cancer who underwent total mesorectal excision at Fujian Medical University Union Hospital between June 2019 and February 2024. Patients were randomly divided into a training set（ n=305）and a test set（ n=77）at a ratio of 8∶2，and further grouped into PNI-negative group and PNI-positive group subgroups based on pathological results. Super-resolution ultrasound images were generated from original ERUS images using a generative adversarial network（GAN）. Deep convolutional neural networks were developed based on features from intratumoral and peritumoral regions to identify the optimal region of interest（ROI）. The dSR5_ResNet18 and dSR5_ResNet50 models were constructed using the super-resolution images with a 5-pixel peritumoral extension. Representative clinical features were selected for subgroup analysis based on sample size and intergroup statistical differences between PNI-positive and PNI-negative patients. Forest plots were used to evaluate model applicability and robustness across subgroups. Results:The dSR5_ResNet18 model，built using super-resolution images of the tumor combined with a 5-pixel peritumoral region，achieved the best predictive performance，with an AUC of 0.867（95% CI=0.782 - 0.952）in the test set. Decision curve analysis demonstrated that the dSR5_ResNet18 model provided the greatest net clinical benefit. Forest plot analysis indicated strong generalizability of the models across subgroups such as pathological N stage，maximum lesion length，and lymph node enlargement，though relatively weaker performance was observed in the carcinoembryonic antigen（CEA）subgroup. Among all models，dSR5_ResNet18 exhibited the most consistent performance across subgroups，with the narrowest confidence intervals and highest robustness. Conclusions:The deep learning model incorporating ERUS-based super-resolution reconstruction demonstrated excellent performance in the preoperative prediction of PNI in rectal cancer. It offers significant advantages in image quality and generalizability，and may serve as a valuable tool to assist clinicians in formulating personalized treatment strategies.

Objective:To develop a deep learning model based on super-resolution endorectal ultrasound（ERUS）images for the preoperative prediction of perineural invasion（PNI）in patients with rectal cancer，thereby providing a reference for risk stratification and individualized treatment planning.Methods:A retrospective analysis was conducted on 382 patients with rectal cancer who underwent total mesorectal excision at Fujian Medical University Union Hospital between June 2019 and February 2024. Patients were randomly divided into a training set（ n=305）and a test set（ n=77）at a ratio of 8∶2，and further grouped into PNI-negative group and PNI-positive group subgroups based on pathological results. Super-resolution ultrasound images were generated from original ERUS images using a generative adversarial network（GAN）. Deep convolutional neural networks were developed based on features from intratumoral and peritumoral regions to identify the optimal region of interest（ROI）. The dSR5_ResNet18 and dSR5_ResNet50 models were constructed using the super-resolution images with a 5-pixel peritumoral extension. Representative clinical features were selected for subgroup analysis based on sample size and intergroup statistical differences between PNI-positive and PNI-negative patients. Forest plots were used to evaluate model applicability and robustness across subgroups. Results:The dSR5_ResNet18 model，built using super-resolution images of the tumor combined with a 5-pixel peritumoral region，achieved the best predictive performance，with an AUC of 0.867（95% CI=0.782 - 0.952）in the test set. Decision curve analysis demonstrated that the dSR5_ResNet18 model provided the greatest net clinical benefit. Forest plot analysis indicated strong generalizability of the models across subgroups such as pathological N stage，maximum lesion length，and lymph node enlargement，though relatively weaker performance was observed in the carcinoembryonic antigen（CEA）subgroup. Among all models，dSR5_ResNet18 exhibited the most consistent performance across subgroups，with the narrowest confidence intervals and highest robustness. Conclusions:The deep learning model incorporating ERUS-based super-resolution reconstruction demonstrated excellent performance in the preoperative prediction of PNI in rectal cancer. It offers significant advantages in image quality and generalizability，and may serve as a valuable tool to assist clinicians in formulating personalized treatment strategies.

Objective:To investigate the level of endogenous hydrogen sulfide (H 2S) in contrast-induced acute kidney injury (CIAKI), as well as the potential role of H 2S against CIAKI by down-regulating NLRP3 inflammasome. Methods:Twenty-four healthy male Sprague-Dawley rats, weighing 180-220 g, were randomly divided into three groups according to the random number table method: control group, CIAKI group (iopromide 2.9 g/kg) and CIAKI+NaHS group (NaHS 4 mg/kg for three days before 2.9 g/kg iopromide injection). Kidneys were collected for whole-genome sequencing and bioinformatic analysis. HE and PAS staining were used for kidney histological examination. TUNEL assays were applied to detect renal tubular epithelial injury. Expressions of NLRP3 inflammasome (NLRP3, ASC and caspase-1) were evaluated by immunofluorescence staining. The role of H 2S in contrast (iopromide 200 mgI/kg)-induced injury on human renal tubular epithelium (HK-2 cells) was investigated, and CCK-8 assay was used to detect cellular viability. Results:Compared with the control group, the expression of endogenous H 2S synthetases-related genes [cystathionine β-synthase ( CBS), cystathionine-γ-lyase ( CSE) and 3-mercaptopyruvate sulfurtransferase ( 3- MST)] was lower in CIAKI group (all P<0.05). The gene expression levels of CBS, CSE and 3- MST were negatively correlated with renal function biomarkers serum creatinine, blood urea nitrogen and cystatin-C (all P<0.05). Compared with the CIAKI group, CIAKI+NaHS group showed alleviated creatinine, blood urea nitrogen and cystatin-C, improved histological changes, reduced apoptosis. Moreover, the expression levels of NLRP3, ASC and caspase-1 in CIAKI+NaHS group were lower than those in CIAKI group (all P<0.05). In HK-2 cells, compared with the contrast group, the cellular viability was higher in the contrast+NaHS group; reducing endogenous H 2S by CBS inhibitor could enhance contrast-induced cell viability ( P<0.05). Conclusions:Injury of endogenous H 2S system is pivotal to CIAKI pathogenesis. Up-regulation of H 2S ameliorates renal injury of CIAKI rats, which may be related to regulation of NLRP3 inflammasome.

Objective To explore MSCT findings of pulmonary tuberculoma.Methods MSCT data of 62 patients with pulmonary tuberculoma confirmed by clinical and pathological results were analyzed retrospectively.Results Of the 62 patients,64 lesions were detected with single in 60 cases and multiple in 2 cases.The MSCT signs showed as follows:circumscribed round,oval,egg-like or irregular nodules or masses,size ranging from 2-3 cm,cavity in 31 lesions,calcification in 25 lesions,pleural indentation sign in 45 lesions and pleural tail sign in 1 2 lesions.Conclusion The MSCT features of pulmonary tuberculoma are relatively specific such as the multiple patch calcifications within mass,calcification of the whole mass and semilunar cavity on the lateral side of the hilum.The MSCT is a valuable examination for the accurate diagnosis of pulmonary tuberculoma.

Objective To establish a quantitative method for the simultaneous measurement of the residual level of three pesticides in Nelumbinis semen by GC-MS/MS. Methods The samples were extracted by acetonitrile and purify by Cleanert TPH column. The samples were then tested by GC-MS/MS. Information on relative retention time and mass charge ratio was used for qualitative analysis. The peak area obtained by secondary ion MS of bifenthrin (181.1/166.1)was used as the reference peak to calculate the relative correction factor for the peak area of fenpropathrin (265.1/210.1) and deltamethrin (252.9/93.0), to establish a method using bifenthrin as the reference substance to determinate there sidual quantity of three pesticides in Nelumbinis semen by GC-MS/MS. Results When the injection quantity of the sample containing bifenthrin,fenpropathrin and deltamethrin in the range of 0.01-0.1 ng , there was a good linear relationship between the injection quantity and peak are a Limitation of quantification (LOQ) of bifenthrin , fenpropathrin and deltamethrin were 4.321×10-4 ng, 3.435×10-4 ng, 8.913×10-3 ng, respectively. The average recovery rates of bifenthrin, fenpropathrin and deltamethrin were 93.5％, 93.5％ and 93.8％, respectively. Conclusions The method of quantitative analysis of multi-components with a single-marker is simple, quick and accurate. It suitable for the detection of residual quantity of bifenthrin, fenpropathrin and deltamethrin in Nelumbinis semen.

Objective To establish a HPLC method for determination of madecassoside and asiaticoside in Centella asiatica formula granules.Methods Chromatographic separation was performed on Ultimate AQ-C18 column(4.6 mm×250 mm,5 μm) with mobile phase of acetonitrile(A)-2 mmol/L β-cyclodextrin(0~30 min:21% A→23% A;30~60 min:23% A→25% A).The flow rate was set at 1.0 ml/min, the column temperature at 30 ℃ and detection wavelength at 205 nm.Results Madecassoside and asiaticoside showed good linearity (r>0.9995) in the ranges of 0.187 7~3.754 μg and 0.184 3~3.686 μg respectively.The specificity, repeatability, precision,recovery and stability were satisfied to the method validation requirements of China Pharmacopoeia.Conclusion The method can determine madecassoside and asiaticoside in Centella asiatica formula granules.

Objective:To establish a quantitative analysis method to determine the content of sulfurous anhydride in Rhizoma di-oscoreae by ion chromatography-direct extraction. Methods:Sulfurous anhydride was extracted by KOH solution (25 mmol·L-1). An IonPac? AS11-HC column(250 mm × 4 mm, 9. 0 μm) was used. The column temperature was 20℃, the eluent was KOH solution (20 mmol·L-1 ) at flow rate of 1. 00 ml·min-1 and the conductivity temperature was 20℃. Results:There was a good linear rela-tionship between the injection quantity (1.160-29.100 μg)and the peak area of sulfite(r =0.999 9). The average recovery was 98. 9%(RSD=0. 6%, n=9). The quantitation limit was 1. 38 ng·ml-1. Conclusion: The method is simple, accurate and rapid, which is appropriate for the quantitative analysis of sulfite anhydride in Rhizoma dioscoreae.

Objective To explore the incidence of post-transplant diabetes mellitus (PTDM) by means of fasting plasma glucose (FPG) and other associated risk factors in patients surviving for more than 1 year after renal transplantation.Methods A total of 428 non-diabetic patients,who underwent kidney transplantation from 1 January,1993 to 31 December,2008,were followed up in order to ascertain the prevalence of PTDM after transplantation and other associated risk factors by means of FPG.Results Of the 428 patients,87 developed PTDM (20.3％) within a mean follow-up of (5.65 ± 3.68) years after renal transplantation.The onset of PTDM occurred in 57 patients (65.5％ of total PTDM) primarily within the first year after transplantation.Univariate analysis showed that older age,body mass index (BMI),smoking history,family history of diabetes mellitus,deceased donor transplantation,hepatitis C virus infection,cytomegalovirus infection,FPG before transplantation as well as 1 week after transplantation,total cholesterol and triglyceride before transplantation,switching from cyclosporine to tacrolimus(FK506),and peak plasma concentration of cyclosporine in the first 6 and 12 months were associated with the onset of PTDM.The prevalence of PTDM was markedly elevated in the group who has cyclosporine converted to FK506 (P＜0.05),but not in the group with cyclosporine converted to rapamycin.By multivariate analysis,FPG before transplantation,age,BMI,and deceased donor transplantation were independently associated with the onset of PTDM.Conclusions There is high incidence of PTDM in patients following renal transplantation; and early diagnosis,treatment as well as prevention are mandatory.

ObjectiveTo explore the long-term fluctuation of fasting plasma glucose (FPG) and its effect on prognosis in patients surviving for more than 1 year after renal transplantation.MethodsFour hundred and forty-six patients underwent kidney transplantation from January,1993 to December,2008.According to preoperative FPG levels,patients were divided into diabetic,impaired fasting glucose (IFG),and normal fasting glucose (NFG)groups. The changing trend of FPG level was observed and analyzed. For 428 non-diabetic patients before transplantation,the prevalence and different outcomes of post-transplantation diabetes( PTDM ) according to FPG after transplantation were analyzed.The characteristics of the patients with persistent PTDM ( P-PTDM ) and transient PTDM (T-PTDM) were compared.The incidence of complications and patient survival between the PTDM group and non-PTDM groups were also compared.ResultsFPG level was increased early and then decreased in patients after renal transplantation.Of the 428 patients,87 developed into PTDM ( 20.3％ ) including 15 T-PTDM patients ( 17.2％ of total PTDM ),who eventually recovered to NFG or IFG.Compared with P-PTDM group,the incidence of acute rejection episodes was higher for T-PTDM ( P =0.043 ).The incidence of infections,hypertension,and dyslipidemia within the first year,was higher in PTDM group compared with non-PTDM group but patient survival was not different within a mean follow-up of ( 5.65 ± 3.68 ) years.ConclusionPTDM will not be permanent and may recover to NFG or IFG in the course of the disease.Acute rejections are associated with the onset of T-PTDM.The overall patient survival is not affected by PTDM,although complications,such as infections,hypertention,and hyperlipidemia are more frequently encountered in PTDM patients.

Post-transplant diabetes mellitus (PTDM) remains a major clinical challenge following transplantation.This article reviews the long-term negative impact of PTDM on transplant recipients, including impaired allograft function, poor patient survival, accelerated onset of diabetic complications, a significantly higher rate of infection, as well as chronic rejection, etc.