Objective To explore the correlation between the test panel of serum CC chemokine ligand 3(CCL3),soluble podoplanin(sPDPN),fatty acid-binding protein 5(FABP5)and the severity of lung injury and clinical outcomes in children with severe pneumonia.Methods A total of 168 children with severe pneumonia who visited our hospital from January 2022 to January 2023 were included in this study as severe group.The patients were assigned to good outcome group(137 cases)or poor outcome group(31 cases)based on their prognosis.Additional 80 children with mild or moderate pneumonia were treated as non-severe group.In addition,80 children who underwent health checkup were included as control group.Baseline data such as body mass index and duration of disease were observed and recorded for all children.Enzyme linked immunosorbent assay(ELISA)was applied to detect the expression levels of C-reactive protein(CRP),procalcitonin(PCT),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),CCL3,sPDPN,and FABP5 in the serum of all children.The Acute Physiology and Chronic Health Evaluation Ⅱ(APACHEⅡ)score and Lung Injury Prediction(LIPS)score were rated to evaluate the degree of lung injury.Multivariate logistic regression was used to analyze the impact of various factors on the poor outcome of children with severe pneumonia.Spearman correlation was applied to analyze the correlation between the expression levels of CCL3,sPDPN,FABP5 and poor outcome,the severity of lung injury,APACHE Ⅱ score,and LIPS score in children with severe pneumoniae.Receiver operating characteristic(ROC)curve was applied to analyze the diagnostic value of CCL3,sPDPN,and FABP5 expression levels for poor outcome in children with severe pneumonia.Z-test was used to compare the differences in area under the curve(AUC).Results The baseline data such as duration of disease,body mass index,age,and sex did not show significant differences among the control group,non-severe group,and severe group(P＞0.05).The levels of serum CRP,PCT,IL-6,TNF-α,CCL3,sPDPN increased,while the level of FABP5 decreased gradually from the control group to non-severe group,and severe group(P＜0.05).The patients with poor outcomes showed higher serum levels of CRP,PCT,IL-6,TNF-α,CCL3,sPDPN,APACHE Ⅱ score,and LIPS score but lower FABP5 level compared to the patients with good outcomes(P＜0.05).TNF-α,CCL3,sPDPN,APACHE Ⅱ,and LIPS scores were independent risk factors for poor outcomes in children with severe pneumonia,while FABP5 level was independent protective factor for poor outcomes in children with severe pneumonia(P＜0.05).The levels of CCL3 and sPDPN were positively correlated with APACHE Ⅱ score and LIPS score,while FABP5 was negatively correlated with APACHE Ⅱ score and LIPS score(P＜0.05).The AUC of CCL3,sPDPN,and FABP5 alone was 0.802,0.864,and 0.859 respectively for predicting poor prognosis in children with severe pneumonia.The test panel of CCL3+sPDPN+FABP5 was superior to CCL3,sPDPN,or FABP5 alone(Zcombination-CCL3=3.842,Zcombination-sPDPN=2.585,Zcombination-FABP5=2.957,P＜0.05).Conclusions The serum levels of CCL3 and sPDPN are positively correlated with the severity of lung injury,while FABP5 is negatively correlated with the severity of lung injury in children with severe pneumonia.The test panel of CCL3+sPDPN+FABP5 is valuable for predicting poor outcomes in children with severe pneumonia.

Objective To construct a global model of cardiac surface motion based on average intensity projection(AIP)image.Methods The cine magnetic resonance imaging data were divided into training set and test set for model construction and validation.The datum points were obtained on the AIP surface point cloud,and the corresponding points of each cardiac phase surface point cloud were found based on surface features.Principal component analysis was used to extract feature information,establish the mapping relationship between the datum points and the corresponding points,and construct a model for predicting each temporal phase surface point cloud from the AIP surface point cloud.Results The RMSE of the model on test set for corresponding point prediction ranged from(0.209±0.020)mm to(0.841±0.074)mm,while the Euclidean distance for each time phase surface point cloud prediction ranged from(1.399±0.029)mm to(1.658±0.100)mm.Conclusion The proposed global model exhibit high accuracy and can provide a reference for image segmentation and clinical treatments.

Objective:To establish a cutoff level of anti-Müllerian hormone(AMH)which could help with the di-agnosis of polycystic ovary syndrome(PCOS)in adults,and to analyze the risk factors of metabolic syndrome(MS).Methods:A retrospectively analyzed 426 PCOS patients(PCOS group)and 205 healthy controls aged 20-39 years from the Health Checkup Center of the Gynecological Endocrine Center,Hunan Maternal and Child Health Hospital from January 2021 to December 2023.AMH diagnostic validity was estimated by receiver operating characteristic(ROC)curves.Patients were subgrouped into PCOS combined metabolic syndrome group(MS-PCOS)and the uncomplicated MS group(UMS-PCOS)according to metabolic status.Multivariate Logistic regression analysis was performed to determine the risk factors for MS in PCOS patients.Results:The serum AMH level was higher in PCOS group than that in the control group(8.42±3.71 ng/ml vs.2.99±0.94 ng/ml,P＜0.001).AMH cutoff for the diagnosis of PCOS was determined as≥4.87 ng/ml on ROC analysis,and the area under the curve is 0.981 with 92.7％sensitivity and 94.6％specificity.The prevalence of MS was 18.3％(78 ca-ses)in PCOS group.Subgroup analysis showed that MS-PCOS patients had higher waist circumference,BMI,fasting glucose,dyslipidemia,hypertension(BP＞130/85 mmHg),and hormone related index androgen level,but lower AMH vs.UMS-PCOS.Multivariate Logistic regression analysis identified insulin resistance(OR 39.17,95％CI 9.33-164.48),BMI ≥24 kg/m2(OR 3.72,95％CI 1.86-7.45),and hyperandrogenism(OR 2.56,95％CI 1.34-4.89)as independent risk factors of MS.AMH was negatively associated with MS,a single-unit increase in AMH was associated with an 17％decrease in odds of MS(OR 0.83,95％CI 0.73-0.95,P=0.006).Conclusions:Serum AMH levels were significantly higher in adult PCOS patients,with an optimal diagnostic threshold of 4.87 ng/ml.Hyperandrogenism and low AMH levels may predict a higher risk of MS,in addition to metabolism-related factors.

Objective:To establish a cutoff level of anti-Müllerian hormone(AMH)which could help with the di-agnosis of polycystic ovary syndrome(PCOS)in adults,and to analyze the risk factors of metabolic syndrome(MS).Methods:A retrospectively analyzed 426 PCOS patients(PCOS group)and 205 healthy controls aged 20-39 years from the Health Checkup Center of the Gynecological Endocrine Center,Hunan Maternal and Child Health Hospital from January 2021 to December 2023.AMH diagnostic validity was estimated by receiver operating characteristic(ROC)curves.Patients were subgrouped into PCOS combined metabolic syndrome group(MS-PCOS)and the uncomplicated MS group(UMS-PCOS)according to metabolic status.Multivariate Logistic regression analysis was performed to determine the risk factors for MS in PCOS patients.Results:The serum AMH level was higher in PCOS group than that in the control group(8.42±3.71 ng/ml vs.2.99±0.94 ng/ml,P＜0.001).AMH cutoff for the diagnosis of PCOS was determined as≥4.87 ng/ml on ROC analysis,and the area under the curve is 0.981 with 92.7％sensitivity and 94.6％specificity.The prevalence of MS was 18.3％(78 ca-ses)in PCOS group.Subgroup analysis showed that MS-PCOS patients had higher waist circumference,BMI,fasting glucose,dyslipidemia,hypertension(BP＞130/85 mmHg),and hormone related index androgen level,but lower AMH vs.UMS-PCOS.Multivariate Logistic regression analysis identified insulin resistance(OR 39.17,95％CI 9.33-164.48),BMI ≥24 kg/m2(OR 3.72,95％CI 1.86-7.45),and hyperandrogenism(OR 2.56,95％CI 1.34-4.89)as independent risk factors of MS.AMH was negatively associated with MS,a single-unit increase in AMH was associated with an 17％decrease in odds of MS(OR 0.83,95％CI 0.73-0.95,P=0.006).Conclusions:Serum AMH levels were significantly higher in adult PCOS patients,with an optimal diagnostic threshold of 4.87 ng/ml.Hyperandrogenism and low AMH levels may predict a higher risk of MS,in addition to metabolism-related factors.

Objective To explore the correlation between the test panel of serum CC chemokine ligand 3(CCL3),soluble podoplanin(sPDPN),fatty acid-binding protein 5(FABP5)and the severity of lung injury and clinical outcomes in children with severe pneumonia.Methods A total of 168 children with severe pneumonia who visited our hospital from January 2022 to January 2023 were included in this study as severe group.The patients were assigned to good outcome group(137 cases)or poor outcome group(31 cases)based on their prognosis.Additional 80 children with mild or moderate pneumonia were treated as non-severe group.In addition,80 children who underwent health checkup were included as control group.Baseline data such as body mass index and duration of disease were observed and recorded for all children.Enzyme linked immunosorbent assay(ELISA)was applied to detect the expression levels of C-reactive protein(CRP),procalcitonin(PCT),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),CCL3,sPDPN,and FABP5 in the serum of all children.The Acute Physiology and Chronic Health Evaluation Ⅱ(APACHEⅡ)score and Lung Injury Prediction(LIPS)score were rated to evaluate the degree of lung injury.Multivariate logistic regression was used to analyze the impact of various factors on the poor outcome of children with severe pneumonia.Spearman correlation was applied to analyze the correlation between the expression levels of CCL3,sPDPN,FABP5 and poor outcome,the severity of lung injury,APACHE Ⅱ score,and LIPS score in children with severe pneumoniae.Receiver operating characteristic(ROC)curve was applied to analyze the diagnostic value of CCL3,sPDPN,and FABP5 expression levels for poor outcome in children with severe pneumonia.Z-test was used to compare the differences in area under the curve(AUC).Results The baseline data such as duration of disease,body mass index,age,and sex did not show significant differences among the control group,non-severe group,and severe group(P＞0.05).The levels of serum CRP,PCT,IL-6,TNF-α,CCL3,sPDPN increased,while the level of FABP5 decreased gradually from the control group to non-severe group,and severe group(P＜0.05).The patients with poor outcomes showed higher serum levels of CRP,PCT,IL-6,TNF-α,CCL3,sPDPN,APACHE Ⅱ score,and LIPS score but lower FABP5 level compared to the patients with good outcomes(P＜0.05).TNF-α,CCL3,sPDPN,APACHE Ⅱ,and LIPS scores were independent risk factors for poor outcomes in children with severe pneumonia,while FABP5 level was independent protective factor for poor outcomes in children with severe pneumonia(P＜0.05).The levels of CCL3 and sPDPN were positively correlated with APACHE Ⅱ score and LIPS score,while FABP5 was negatively correlated with APACHE Ⅱ score and LIPS score(P＜0.05).The AUC of CCL3,sPDPN,and FABP5 alone was 0.802,0.864,and 0.859 respectively for predicting poor prognosis in children with severe pneumonia.The test panel of CCL3+sPDPN+FABP5 was superior to CCL3,sPDPN,or FABP5 alone(Zcombination-CCL3=3.842,Zcombination-sPDPN=2.585,Zcombination-FABP5=2.957,P＜0.05).Conclusions The serum levels of CCL3 and sPDPN are positively correlated with the severity of lung injury,while FABP5 is negatively correlated with the severity of lung injury in children with severe pneumonia.The test panel of CCL3+sPDPN+FABP5 is valuable for predicting poor outcomes in children with severe pneumonia.

Objective To construct a global model of cardiac surface motion based on average intensity projection(AIP)image.Methods The cine magnetic resonance imaging data were divided into training set and test set for model construction and validation.The datum points were obtained on the AIP surface point cloud,and the corresponding points of each cardiac phase surface point cloud were found based on surface features.Principal component analysis was used to extract feature information,establish the mapping relationship between the datum points and the corresponding points,and construct a model for predicting each temporal phase surface point cloud from the AIP surface point cloud.Results The RMSE of the model on test set for corresponding point prediction ranged from(0.209±0.020)mm to(0.841±0.074)mm,while the Euclidean distance for each time phase surface point cloud prediction ranged from(1.399±0.029)mm to(1.658±0.100)mm.Conclusion The proposed global model exhibit high accuracy and can provide a reference for image segmentation and clinical treatments.

Objective To investigate the correlation of neutrophil to high-density lipoprotein cho-lesterol ratio(NHR)and lipoprotein(a)[Lp(a)]with occurrence of acute ischemic stroke(AIS)in elderly patients with non-valvular atrial fibrillation(NVAF).Methods A total of 301 elderly NVAF patients admitted to Hefei First People's Hospital from May 2020 to May 2023 were en-rolled,and according to whether they were combined with AIS or not,they were divided into stroke group(143 cases)and non-stroke group(158 cases).Binary logistic regression analysis was used to screen risk factors,and ROC curve was plotted to assess their predictive values for AIS.Results Lp(a)and NHR in stroke group were significantly higher than those in non-stroke group,the difference was statistically significant(P＜0.01).Multivariate binary logistic regression analysis showed that NHR and Lp(a)were independent risk factors for death with NVAF com-bined AIS(OR=1.728,95％CI:1.367-2.186,P=0.000;OR=1.005,95％CI:1.002-1.007,P=0.000);ROC curve analysis indicated that the AUC value of NHR and Lp(a)in diagnosing AIS in NVAF patients was 0.668 and 0.735,respectively,and that of their combination was 0.789,which was significantly higher than that of NHR and Lp(a)alone(P＜0.01).Conclusion NHR and Lp(a)are independently related to AIS in NVAF patients,and their combination has certain diagnos-tic efficacy.

Objective Construct a human SNP genetic marker detection system using next generation sequencing technology and validate the system performance.Methods Based on multiple PCR amplification and capture technology,a set of detection system containing 621 autosomal SNPs and 398 Y chromosome SNPs was developed for accurate identification of individuals.To comprehensively evaluate the performance of the system,research was conducted on the overall coverage and balance,accuracy,sensitivity,repeatability,simulated degradation of samples,suitability of sample types,species specificity,mixed sample differentiation of the panel and so on.Results This system showed high coverage,uniformity and accuracy.when the input DNA was 0.062 5 ng,The system could detect more than 1 000 SNPs sites.And the system has a high detection efficiency for degradation test materials under the appropriate starting quantity.The repeatability between different personnel and different PCR instruments was 99.7%,indicating good repeatability.It is suitable for common forensic test materials,has high specificity,and has no spot detection for non-human samples in the test environment.When the gender ratio is 1∶20 or 20∶1,a single sample and mixed samples can still be distinguished.Conclusion The system has good classification accuracy and repeatability,with high sensitivity and high detection flux.It has strong detection ability for degraded and mixed samples,and can effectively eliminate interference from non-human species,improving individual recognition ability.

Objective To discuss the nursing cooperation method in CT-guided pulmonary nodule localization using indocyanine green combined with methylene blue.Methods A total of 81 patients,who needed to receive pulmonary nodule localization before thoracoscopic resection,were enrolled in this study.The nursing cooperation measures,including the preparation and injection of indocyanine green combined with methylene blue,breathing mode coordination,position management,precise localization coordination,and psychological care,were analyzed.Results Successful nodule localization was accomplished in all patients.No statistically significant difference in the incidence of adverse events existed between the patients with different clinical characteristics(P＞0.05).The gender,age,lesion site,nodule size,nodule-pleura distance,posture during puncturing and needle path route were not the factors influencing the occurrence of adverse reactions in patients receiving CT-guided pulmonary nodule localization using indocyanine green combined with methylene blue.Conclusion In performing CT-guided pulmonary nodule localization using indocyanine green combined with methylene blue,the nursing cooperation method carries generality and stability,which is suitable for patients with different clinical characteristics.

ABSRACT The development of hepatocellular car-cinoma(HCC)is closely related to the formation of tumour blood vessels.VEGF-mediated angiogenesis is a major driver of the immune escape response in tumours.VEGF binds to vascular endothelial growth factor receptor2(VEGFR2)on endothelial cells,promoting endothelial cell proliferation and migration,inducing vascular changes in HCC,and thus promote the growth of hepatocellular carcino-ma cells.Anti-VEGF and its receptor-targeted mo-lecular drugs are currently effective new treat-ments for HCC.Monoclonal antibodies against VEGF and small-molecule tyrosine kinase inhibitors targeting VEGF have been shown to block its angio-genic activity,alleviate the inhibitory effect of the tumour microenvironment,and ultimately achieve tumour regression.This article provides a review of the research progress of VEGF/VEGFR inhibitors in HCC treatment.