Objective:To develop radiomics score (RS) based on 18F-FDG PET/CT, and construct the machine learning model combining clinical and other relevant factors for personalized prediction of 2-year event-free survival (2-EFS) in patients with diffuse large B-cell lymphoma (DLBCL), and to perform interpretability analysis of the model. Methods:A total of 91 patients (49 males, 42 females; age (57.8±12.8) years) with pathologically confirmed DLBCL from December 2017 to December 2020 at the First Hospital of Shanxi Medical University were retrospectively analyzed. According to the ratio of 7∶3, patients were randomly divided into training set ( n=63) and test set ( n=28), and divided into non-progression group and progression group according to the follow-up results. The whole-body PET semi-quantitative parameters were calculated from the PET/CT images before treatment, and 328 radiomics features were extracted from the largest target lesions of patients. The least absolute shrinkage and selection operator (LASSO) was used to develop the RS. Clinical and PET characteristic difference analysis was performed through χ2 test and Mann-Whitney U test. Extreme gradient boosting (XGBoost) models were constructed based on clinical, PET radiomics features and RS, and the prediction efficiency of each model was evaluated by ROC AUC. The model interpretability was analyzed by using shapely additive explanation (SHAP). Results:Of all patients, 32 had disease progression and 59 did not. There were no significant differences in baseline characteristics between the training set and the test set ( χ2 values: 0.06-1.84, U values: 665.00-763.00, all P>0.05). The comparison between the progression group and non-progression group in the training set showed statistical differences in the international prognostic index (IPI) score ( χ2=4.87, P=0.027), myelocytomatosis viral oncogene (MYC) protein expression ( χ2=4.29, P=0.038), and metabolic tumor volume (MTV; U=307.00, P=0.038). Seven radiomics features were screened by LASSO. Among XGBoost models with different feature combinations, IPI score, MYC protein expression, MTV combined with RS had the highest predictive efficiency (training set: AUC=0.73; test set: AUC=0.70). Through SHAP analysis, RS was the most predictive feature in the optimal model. Conclusion:The machine learning integrated model of IPI score, MYC protein expression and MTV combined with RS can effectively predict the prognosis of DLBCL patients, and baseline 18F-FDG PET/CT radiomics can be used as a potential means to evaluate the prognosis of DLBCL patients.

Objective:To investigate the steady-state mechanism of interconversion between the SMN1 and SMN2 genes in a normal population. Methods:Fluorescence PCR capillary electrophoresis was employed to assess gene conversion and copy number variation of SMN1 and SMN2 in a cohort of 1, 133 healthy individuals (including 256 males and 877 females) recruited between 2019 and 2023. This study was approved by the Ethics Committee of Henan Provincial People′s Hospital (Ethics No.: 2019-134). Results:No significant gender difference was observed in the single copy carrying rate of SMN1. The probability of conversion from SMN1 to SMN2 was determined to be 3.2% for females, 2.7% for males, and 3.1% for the overall population. The probability of conversion from SMN2 to SMN1 was found to be 5.5% for females, 6.3% for males, and 5.6% for the overall population. No statistically significant difference was found in the conversion probability between different genders ( P>0.05). Among the 99 cases of gene conversion, the SMN1 gene predominantly exhibited a copy number of 2 (97.0%), with the remainder having 3 copies (3%). The SMN2 gene primarily showed a copy number of 2 (72.7%), with the rest having 1 copy (27.3%). Conclusion:Gene conversion tends to normalize the copy numbers of both SMN1 and SMN2 genes towards 2. However, SMN1 exhibited a higher priority over SMN2, causing the copy numbers approaching two.

Objective To construct a patient decision aid(PtDA)for exercise training in pa-tients with chronic obstructive pulmonary disease(COPD)and explore its impacts on decision-making quality of patients' exercise regimens.Methods The development of the PtDA for exercise training in COPD patients was accomplished through literature analysis,the Delphi method,and user surveys,followed by an intervention study.A total of 59 inpatients with COPD were included as study sub-jects.The control group received routine care along with general exercise training guidance,while the intervention group received routine care combined with shared decision-making for exercise training based on the PtDA.The decision conflict and decision preparedness levels of patients in both groups were compared before the intervention and on the day of discharge.The exercise self-efficacy of pa-tients was measured before intervention,on the day of discharge,and 1 month and 3 months after dis-charge.Results The intervention group had significantly lower scores for decision conflict and signif-icantly higher scores for decision preparedness and exercise self-efficacy compared with the control group(P＜0.05).Conclusion The PtDA for exercise training can improve decision conflict and de-cision preparedness in COPD patients,enhance their exercise self-efficacy levels,and provide references for healthcare professionals in improving exercise adherence.

OBJECTIVE: To investigate the steady-state mechanism of interconversion between the SMN1 and SMN2 genes in a normal population. METHODS: Fluorescence PCR capillary electrophoresis was employed to assess gene conversion and copy number variation of SMN1 and SMN2 in a cohort of 1,133 healthy individuals (including 256 males and 877 females) recruited between 2019 and 2023. This study was approved by the Ethics Committee of Henan Provincial People's Hospital (Ethics No.: 2019-134). RESULTS: No significant gender difference was observed in the single copy carrying rate of SMN1. The probability of conversion from SMN1 to SMN2 was determined to be 3.2% for females, 2.7% for males, and 3.1% for the overall population. The probability of conversion from SMN2 to SMN1 was found to be 5.5% for females, 6.3% for males, and 5.6% for the overall population. No statistically significant difference was found in the conversion probability between different genders (P > 0.05). Among the 99 cases of gene conversion, the SMN1 gene predominantly exhibited a copy number of 2 (97.0%), with the remainder having 3 copies (3%). The SMN2 gene primarily showed a copy number of 2 (72.7%), with the rest having 1 copy (27.3%). CONCLUSION Gene conversion tends to normalize the copy numbers of both SMN1 and SMN2 genes towards 2. However, SMN1 exhibited a higher priority over SMN2, causing the copy numbers approaching two.
Humans ; Male ; Female ; Survival of Motor Neuron 2 Protein/genetics* ; Survival of Motor Neuron 1 Protein/genetics* ; Gene Conversion ; DNA Copy Number Variations/genetics* ; Adult ; Middle Aged ; Gene Dosage

Objective:To compare the clinical efficacy of laparoscopic Miles surgery through extraperitoneal stoma and intraperitoneal stoma.Methods:The medical records of 140 patients with low rectal cancer after laparoscopic Miles surgery admitted to Gastrointestinal Surgery of Northern Jiangsu People′s Hospital of Jiangsu Province from January 2018 to December 2022 were retrospectively analyzed. Among them, 80 were males and 60 were females, aged 50 to 75 years old, with an average age of 63.95 years old. They were divided into observation group (extraperitoneal stoma, n=70) and control group (intraperitoneal stoma, n=70) based on the stoma method. Through telephone, WeChat, outpatient follow-up and other contact methods, the intraoperative and postoperative recovery, the incidence of perioperative complications (stoma edema, stoma ischemia, peristoma inflammation, perineal/pelvic infection, lung infection) and the incidence of complications at 6 months and 1 year after surgery (stoma stricture, parastoma hernia/internal hernia, stoma prolapse/retraction), and the difference in the ability of artificial anus to control defecation at 1 year after surgery were compared between the two groups. SPSS27.0 statistical software was used for data analysis and processing. Results:(1) Incidence of individual complications such as lung infection between the two groups of patients during the perioperative period (4.3% vs 4.3%, χ2=0.17, P=0.676), stoma edema (25.7% vs 21.4%, χ2=0.36, P=0.550), stoma ischemia (7.1% vs 7.1%, χ2=0.00, P=1.000), peristomal inflammation (20.0% vs. 18.6%, χ2=0.05, P=0.830), perineal/pelvic infection (15.7% vs 27.1%, χ2=2.72, P=0.099), there was no difference between the two groups. There was still no difference in the overall complication rate between the two groups (72.9% vs 78.6%, χ2=0.62, P=0.430). (2) After follow-up to 6 months after surgery, the overall complication rate was 5.7% in the observation group compared with 22.9% in the control group ( χ2=7.06, P=0.008). In particular, the incidence of post-operative parastomal hernia/internal hernia did not occur in the observation group, while 8.6% of patients in the control group occurred (18.6% vs 42.9%, χ2=4.35, P=0.037). (3) After follow-up to 1 year after surgery, the overall complication rate in the observation group was lower than that in the control group ( χ2=8.59, P=0.003). The incidence of parastomal hernia/internal hernia after operation in the observation group was lower than that in the control group (2.9% vs 14.3%, χ2=4.47, P=0.034). (4) At the one-year follow-up, the overall excellent and good rate in the evaluation of bowel function in the observation group was higher than that in the control group (71.4% vs 48.6%, χ2=7.62, P=0.006). Conclusions:In laparoscopic Miles surgery for patients with rectal cancer, choosing extraperitoneal stoma has achieved good results, which can reduce the risk of complications 6 months or even 1 year after surgery, especially in preventing and controlling parastomal hernia/internal hernia. It has significant advantages, and at the same time, it can also promote the recovery of patients′ bowel function and reduce other related complications, thereby ensuring patient safety.

Objective:To explore the effects and potential mechanisms of cell growth regulator 1 ( CGREF1) with an EF hand domain in colorectal cancer proliferation and migration. Methods:Fifty paraffin specimens of colorectal cancer tissues and corresponding paracancerous tissues were selected from January 2023 to January 2024 from the Northern Jiangsu People's Hospital Affiliated to Yangzhou University for analysis, and TCGA, GDSC, KMPLOT and STRING databases were used to explore the expression, prognosis, immune microenvironment, drug sensitivity and related signaling pathway functions of CGREF1 in colorectal cancer. Tissue and cellular expression levels of CGREF1 were analyzed by immunohistochemistry and qRT-PCR. Lentiviral-mediated CGREF1 overexpression in SW-620 cells (OE- CGREF1 vs NC groups) was functionally characterized through CCK-8 proliferation assays, colony formation tests, and scratch wound healing migration assays, with mechanistic investigation via Western blot analysis of apoptosis markers, invasion-related proteins, and RAS/RAF/ERK pathway components. In vivo tumorigenicity was assessed by subcutaneous injection of control or CGREF1-overexpressing SW620 cells in nude mice ( n=3 per group) with tumor growth monitoring. Software of GraphPad Prism 9 was used for statistical analysis of experimental data. Results:CGREF1CGREF1RASERK Studies based on databases, clinical samples and colorectal cancer cell line analyses demonstrated that CGREF1 is downregulated in colorectal cancer, where low CGREF1 expression showed positive correlation with tumor diameter and invasion depth. CGREF1 is closely related to tumor immune infiltration microenvironment and sensitivity to multiple anti-tumor drugs. Overexpression of CGREF1 promoted cell apoptosis while inhibiting cell proliferation, invasion and migration. Overexpression of CGREF1 downregulated the expression levels of RAS, ERK and P-P38/MAPK pathway proteins. CGREF1 inhibited tumor growth in vivo. Conclusion:CGREF1 can inhibit the proliferation, colony formation, and migration of CRC cells through the RAS/ERK/MAPK pathway.

Objective To explore the value of high-frequency ultrasound in the detection of metastatic hepatocellular carcinoma and displaying lesion characteristics. Methods A total of 38 paitients with hepatocellular carcinoma satellite lesions within 40 mm of subcutaneous tissue were underwent low-frequency (1-5 MHz) and high-frequency (6-9 MHz) ultrasound. Detection rates and ultrasonic features were compared. Results High-frequency grayscale ultrasound had a higher detection rate (71.1% vs. 36.8%, P＜0.001). Subgroup analysis showed higher detection rates with chemotherapy history (88.9% vs. 33.3%, P＝0.002), fatty liver (71.9% vs 31.3%, P＜0.001) or superficial lesion (within 20 mm, 76.5% vs 41.2%, P＝0.031). High-frequency ultrasound also showed clearer margins (P＝0.004) and more arterial-phase rim enhancement (P＝0.007). Conclusions 6-9 MHz ultrasound detects metastatic hepatocellular carcinoma, especially superficial lesions, more effectively than 1-5 MHz ultrasound and better visualizes characteristics.

OBJECTIVES: To investigate the role of activating transcription factor 3 (ATF3) in atherosclerotic plaques for regulating inflammatory responses during atherosclerosis (AS) progression. METHODS: Human coronary artery specimens from autopsy cases were examined for ATF3 protein expression and localization using immunofluorescence staining and Western blotting. Apolipoprotein E-deficient (ApoE^-/-) mouse models of AS induced by high-fat diet (HFD) feeding for 12 weeks were subjected to tail vein injection of adeno-associated virus serotype 9 (AAV9) to knock down ATF3 expression. After an additional 5 weeks of HFD feeding, the mice were euthanized for analyzing structural changes of the aortic plaques, and the expression levels of ATF3, inflammatory factors (CD45, CD68, IL-1β, and TNF-α), and NF-κB pathway proteins (P-IKKα/β and P-NF-κB p65) were detected. In the cell experiment, THP-1-derived foam cells were transfected with an ATF3-overexpressing plasmid or an ATF3-specific siRNA to validate the relationship between ATF3 and NF‑κB signaling. RESULTS: In human atherosclerotic plaques, ATF3 expression was significantly elevated and partially co-localized with CD68. ATF3 knockout in ApoE^-/- mice significantly increased aortic plaque volume, upregulated the inflammatory factors, enhanced phosphorylation of the NF‑κB pathway proteins, and increased the expressions of VCAM1, MMP9, and MMP2 in the plaques. In THP-1-derived foam cells, ATF3 silencing caused activation of the NF‑κB pathway, while ATF3 overexpression suppressed the activity of the NF-κB pathway. CONCLUSIONS AS promotes ATF3 expression, and ATF3 deficiency exacerbates AS progression by enhancing plaque inflammation via activating the NF-κB pathway, suggesting the potential of ATF3 as a therapeutic target for AS.
Animals ; Activating Transcription Factor 3/metabolism* ; Signal Transduction ; NF-kappa B/metabolism* ; Humans ; Mice ; Plaque, Atherosclerotic/metabolism* ; Inflammation/metabolism* ; Apolipoproteins E ; Atherosclerosis/metabolism* ; Diet, High-Fat

Objective To investigate the regulatory role and mechanism of mitochondrial riboso-mal protein S35(MRPS35)in the proliferation,invasion,and migration of colon cancer cells.Meth-ods A total of 120 colon cancer tissues and adjacent normal tissues from patients undergoing radical resection for colon cancer were collected.Human colon cancer cell lines(HCT116,SW480,SW620)and a human normal colon epithelial cell line(NCM460)were cultured.Bioinformatics analysis,real-time quantitative polymerase chain reaction,Western blot,immunohistochemical(IHC)analysis,and cellular functional experiments(plate clone formation assay,scratch test,Transwell migration assay,CCK-8 cell viability assay)were conducted to evaluate the expression and regulatory mechanism of MRPS35 in colon cancer.Results Bioinformatics analysis showed that the expression level of the MRPS35 gene was higher in colorectal cancer tissues than in adjacent normal tissues(P＜0.05).The relative expression levels of MRPS35 mRNA and MRPS35 protein were higher in human colon cancer cell lines(HCT116,SW480,SW620)than in NCM460 cells(P＜0.05).The relative ex-pression level of MRPS35 protein was higher in colon cancer tissues than that in adjacent normal tis-sues(P＜0.05).The expression level of MRPS35 was significantly correlated with tumor diameter,tumor differentiation,and T stage(P=0.002,0.021,0.036).Patients with high MRPS35 expres-sion had a higher overall survival rate than those with low MRPS35 expression(Log-rank P=0.015).After knockdown of MRPS35,the abilities of colon cancer cell cloning,proliferation,invasion,and migration were significantly enhanced.Furthermore,the expression of Wnt1,β-Catenin,and their downstream target proteins increased significantly after MRPS35 knockdown.Conclusion MRPS35 is significantly overexpressed in both colon cancer tissues and colon cancer cells,and it may inhibit the occurrence and development of colon cancer by regulating the Wnt/β-Catenin signaling pathway.Therefore,MRPS35 has the potential to become a novel biomarker and therapeutic target for colon cancer.

Silicone implant leakage and capsular calcification are potential complications following breast augmentation with silicone implants. This article presents a case of silicone implant leakage accompanied by capsular calcification following breast augmentation surgery. A 51-year-old female presented with self-reported breast hardening over 21 years after undergoing bilateral silicone implant augmentation mammoplasty and sought medical attention at the Department of Plastic Surgery, the First Affiliated Hospital of Dalian Medical University in 2019. Physical examination revealed eggshell-like hardening of the implants with Baker grade Ⅱ capsular contracture. CT scans demonstrated capsular calcification, leading to bilateral explantation and capsulectomy. Intraoperative findings showed calcified capsules with gelatinous material adherent to the surface. Postoperative compositional analysis confirmed calcium phosphate deposits in the calcified lesions. During the 6-year follow-up, the patient remained asymptomatic without breast pain, new masses, or impaired upper limb mobility. The incisions healed well with no sensory abnormalities. Literature review suggested that implant leakage may result from either long-term mechanical irritation secondary to capsular calcification or occult silicone leakage.