OBJECTIVES: To explore the mechanism through which moxibustion promotes endometrial repair in rats with in thin endometrium (TE). METHODS: Female SD rats were randomized into control group, 95% anhydrous ethanol-induced TE model group and moxibustion (at "Guan Yuan") group. High-throughput sequencing was used to identify the target genes of TE, and the targeting relationship between miR-223-3p and NLRP3 was verified using a dual luciferase assay. Histopathological of rat uterus was observed with HE staining, and expressions of miR-223-3p and NLRP3 were detected using RT-qPCR; serum levels of IL-1β and IL-18 of the rats were detected using ELISA, and protein expressions of NLRP3, ASC, caspase-1 and GSDMD in the uterus were detected with Western blotting. The pregnancies of the rats after treatment were counted. RESULTS: Enrichment analysis of the differential genes suggested up-regulated inflammatory response in TE, and dual luciferase assay verified targeted inhibition of NLRP3 expression by miR-223-3p. The rat models of TE had significantly decreased endometrial thickness and reduced endometrial glands and blood vessels with enhanced mRNA expression of NLRP3, increased serum levels of IL-1β and IL-18, up-regulated protein expressions of NLRP3, ASC, caspase-1 and GSDMD, lowered pregnancy rates on both the affected and unaffected sides and the overall number of pregnancies. Treatment of the rat models with mo-xibustion obviously increased the endometrial thickness and the density of glands and blood vessels, up-regulated miR-223-3p expression, lowered serum IL-1β and IL-18 levels and the protein expressions of NLRP3, ASC, caspase-1 and GSDMD, and significantly increased the number of pregnancies. CONCLUSIONS Moxibustion at "Guan Yuan" acupoint up-regulates the expression of miR-223-3p, which results in targeted inhibition of NLRP3 to suppress pyroptosis and promote endometrial repair in rat models of TE.
Animals ; Female ; MicroRNAs/genetics* ; NLR Family, Pyrin Domain-Containing 3 Protein/metabolism* ; Endometrium/pathology* ; Rats, Sprague-Dawley ; Rats ; Moxibustion ; Pyroptosis ; Up-Regulation ; Interleukin-1beta/metabolism* ; Interleukin-18 ; Caspase 1/metabolism*

Objective To evaluate the application of high-resolution magnetic resonance vessel wall imaging(HRMR-VWI)in identifying high-risk features of intracranial atherosclerotic plaques,and to analyze the correlation between plaque characteristics and stroke recurrence under varying degrees of stenosis.Methods The data from 368 patients with intracranial atherosclerotic stenosis(ICAS)across two centers were retrospectively analyzed.Based on the degree of stenosis,all patients were categorized into mild-to-moderate stenosis group(luminal stenosis<70%,n=155)and severe stenosis group(luminal stenosis≥70%,n=213).HRMR-VWI images and clinical information of the patients were collected and analyzed,and the culprit plaques were quantitatively analyzed.Univariate and multivariate logistic regression analyses were employed to identify the risk factors for stroke recurrence,and the predictive performance was evaluated using the area under the curve(AUC)of the receiver operating characteristic(ROC)curve.Results Higher normalized wall index(NWI)[odds ratio(OR)=1.082,95%confidence interval(CI)1.050-1.118,P<0.05]and the presence of intraplaque hemorrhage(IPH)(OR=1.843,95%CI 1.120-3.036,P<0.05)were risk factors for stroke recurrence in all patients.And these two factors were also significant in the mild-to-moderate stenosis group(NWI:OR=1.088,95%CI 1.009-1.186,P<0.05;IPH:OR=4.049,95%CI 1.227-16.065,P<0.05).A predictive model for stroke recurrence was constructed using the combination of IPH and NWI,with the best performance in the mild-to-moderate stenosis group(AUC=0.813,95%CI 0.723-0.906).Conclusion In patients with luminal stenosis<70%,the increase of NWI and the presence of IPH have been validated as significant and effective indicators for predicting stroke recurrence,demonstrating notable predictive performance.In contrast,among patients with luminal stenosis≥70%,the utility of plaque characteristics in predicting stroke recurrence is relatively lower,indicating that the correlation between plaque characteristics and stroke recurrence varies across different degrees of stenosis.

Purpose To explore the value of amide proton transfer(APT)imaging combined with diffusion kurtosis imaging(DKI)in the differential diagnosis of prostate carcinoma and benign prostatic hyperplasia.Materials and Methods A retrospective analysis was conducted on 120 patients who underwent multi-parameter prostate MRI and pathological biopsy at the First Affiliated Hospital of Xinxiang Medical University from January 2020 to August 2021,including 66 cases of benign prostatic hyperplasia and 54 cases of prostate carcinoma.The parameters of APT imaging and DKI,including magnetization transfer ratio asymmetry(MTRasym),mean kurtosis(MK),mean diffusion coefficient(MD)and fraction anisotropy were measured,and the parameters between the two groups were compared and analyzed.The receiver operating characteristic curve and Delong test were used to analyze the efficacy of each parameter,APT or DKI sequence alone and their combined diagnosis,and the correlation among the parameters was analyzed.Results Compared with the benign prostatic hyperplasia group,the MTRasym,MK and fraction anisotropy of the prostate carcinoma group were significantly higher,while the MD was significantly lower,with statistical significance(t=8.23,12.53,2.20,-11.12,all P<0.05).The areas under the curve for the above parameters were 0.852,0.933,0.615 and 0.910,respectively.The diagnostic efficacy of APT combined with DKI for differentiating prostate carcinoma from benign prostatic hyperplasia is numerically higher than that of APT alone or DKI alone,with the areas under the curve being 0.994,0.988 and 0.852,respectively,as well as a sensitivity of 96.30%and a specificity of 98.48%.There was a statistically significant difference in efficacy between the APT+DKI combined approach and APT alone(Z=4.387,P<0.05),while no statistically significant difference exists between the combined approach and DKI alone(Z=1.375,P>0.05).MTRasym was positively correlated with MK(r=0.45,P<0.001).MD was negatively correlated with MTRasym and MK(r=-0.439,-0.500,both P<0.001).Conclusion The parameters MTRasym,MK and MD of APT and DKI have relatively high value in distinguishing prostate carcinoma from benign prostatic hyperplasia,and the combined diagnostic efficiency of the two sequences tends to increase,with some parameters showing correlation.

Purpose To explore the value of magnetic resonance amide proton transfer(APT)imaging combined with diffusion weighted imaging(DWI)in the differential diagnosis of prostate cancer and benign prostatic hyperplasia.Materials and Methods A retrospective analysis was made on 52 patients with prostate cancer and 60 patients with benign prostatic hyperplasia in the First Affiliated Hospital of Xinxiang Medical University from February 2020 to August 2021.The APT parameter values magnetization transfer ratio asymmetry(MTRasym)and DWI parameter values apparent diffusion coefficient(ADC)of the two groups were measured,respectively.The parameter differences between the two groups were compared and analyzed,the significant parameters and the efficacy of their joint diagnosis were evaluated.Then compared the performance of each parameter and joint diagnosis,and analyze the correlation between the two parameters.Results The MTRasym in the prostate cancer group[(3.70±0.94)%]was significantly higher than that in the prostate hyperplasia group[(2.35±0.60)%](t=8.89,P＜0.05);ADC value in prostate cancer group[(0.93±0.15)×10-3 mm2/s]was significantly lower than that in the prostate hyperplasia group[(1.32±0.22)×10-3 mm2/s](t=-11.01,P＜0.05).The areas under the curve for identifying prostate cancer and benign prostatic hyperplasia using MTRasym value,ADC value and their combination were 0.886,0.914 and 0.966,respectively.There was no statistically significant difference in the diagnostic efficacy between the MTRasym value and the ADC value(P＞0.05),and the combined diagnostic efficacy of the two was superior to the individual diagnostic efficacy of the MTRasym value and ADC value(Z=3.125,2.776,P＜0.05).The MTRasym was negatively correlated with the ADC value(r=-0.469,P＜0.001).Conclusion APT and DWI have high efficacy in distinguishing between prostate cancer and benign prostatic hyperplasia.The combination of the two sequences has higher diagnostic efficacy.

Purpose To explore the value of magnetic resonance amide proton transfer(APT)imaging combined with diffusion weighted imaging(DWI)in the differential diagnosis of prostate cancer and benign prostatic hyperplasia.Materials and Methods A retrospective analysis was made on 52 patients with prostate cancer and 60 patients with benign prostatic hyperplasia in the First Affiliated Hospital of Xinxiang Medical University from February 2020 to August 2021.The APT parameter values magnetization transfer ratio asymmetry(MTRasym)and DWI parameter values apparent diffusion coefficient(ADC)of the two groups were measured,respectively.The parameter differences between the two groups were compared and analyzed,the significant parameters and the efficacy of their joint diagnosis were evaluated.Then compared the performance of each parameter and joint diagnosis,and analyze the correlation between the two parameters.Results The MTRasym in the prostate cancer group[(3.70±0.94)%]was significantly higher than that in the prostate hyperplasia group[(2.35±0.60)%](t=8.89,P＜0.05);ADC value in prostate cancer group[(0.93±0.15)×10-3 mm2/s]was significantly lower than that in the prostate hyperplasia group[(1.32±0.22)×10-3 mm2/s](t=-11.01,P＜0.05).The areas under the curve for identifying prostate cancer and benign prostatic hyperplasia using MTRasym value,ADC value and their combination were 0.886,0.914 and 0.966,respectively.There was no statistically significant difference in the diagnostic efficacy between the MTRasym value and the ADC value(P＞0.05),and the combined diagnostic efficacy of the two was superior to the individual diagnostic efficacy of the MTRasym value and ADC value(Z=3.125,2.776,P＜0.05).The MTRasym was negatively correlated with the ADC value(r=-0.469,P＜0.001).Conclusion APT and DWI have high efficacy in distinguishing between prostate cancer and benign prostatic hyperplasia.The combination of the two sequences has higher diagnostic efficacy.

Purpose To explore the value of amide proton transfer(APT)imaging combined with diffusion kurtosis imaging(DKI)in the differential diagnosis of prostate carcinoma and benign prostatic hyperplasia.Materials and Methods A retrospective analysis was conducted on 120 patients who underwent multi-parameter prostate MRI and pathological biopsy at the First Affiliated Hospital of Xinxiang Medical University from January 2020 to August 2021,including 66 cases of benign prostatic hyperplasia and 54 cases of prostate carcinoma.The parameters of APT imaging and DKI,including magnetization transfer ratio asymmetry(MTRasym),mean kurtosis(MK),mean diffusion coefficient(MD)and fraction anisotropy were measured,and the parameters between the two groups were compared and analyzed.The receiver operating characteristic curve and Delong test were used to analyze the efficacy of each parameter,APT or DKI sequence alone and their combined diagnosis,and the correlation among the parameters was analyzed.Results Compared with the benign prostatic hyperplasia group,the MTRasym,MK and fraction anisotropy of the prostate carcinoma group were significantly higher,while the MD was significantly lower,with statistical significance(t=8.23,12.53,2.20,-11.12,all P<0.05).The areas under the curve for the above parameters were 0.852,0.933,0.615 and 0.910,respectively.The diagnostic efficacy of APT combined with DKI for differentiating prostate carcinoma from benign prostatic hyperplasia is numerically higher than that of APT alone or DKI alone,with the areas under the curve being 0.994,0.988 and 0.852,respectively,as well as a sensitivity of 96.30%and a specificity of 98.48%.There was a statistically significant difference in efficacy between the APT+DKI combined approach and APT alone(Z=4.387,P<0.05),while no statistically significant difference exists between the combined approach and DKI alone(Z=1.375,P>0.05).MTRasym was positively correlated with MK(r=0.45,P<0.001).MD was negatively correlated with MTRasym and MK(r=-0.439,-0.500,both P<0.001).Conclusion The parameters MTRasym,MK and MD of APT and DKI have relatively high value in distinguishing prostate carcinoma from benign prostatic hyperplasia,and the combined diagnostic efficiency of the two sequences tends to increase,with some parameters showing correlation.

Objective To observe the value of the integrated model of MR high-resolution vascular wall imaging(HR-VWI)and attention mechanism for predicting stroke recurrence in symptomatic intracranial atherosclerotic stenosis(sICAS)patients.Methods A total of 363 patients with sICAS who underwent HR-VWI were enrolled and stratified into training set(n=254)and validation set(n=109)according to their origins.Employing a radiomics model that utilized HR-VWI T1 and contrast-enhanced sequences for feature extraction,image data were captured from relevant plaques.Subsequently,a Trans model was developed by integrating the Transformer attention mechanism.The predictive performance and clinical utility of conventional radiomics models and Trans models for forecasting stroke recurrence among patients with sICAS were evaluated.Results In training set and validation set,the area under the curve of Trans model for predicting stroke recurrence in sICAS patients was 0.992 and 0.988,respectively,both superior to that of T1 model,T1 enhanced model and dual sequence model(all P＜0.05).The calibration curve and decision curve analysis showed that Trans model had good predictive probability and clinical practicality.Conclusion The obtained integrated model of HR-VWI radiomics combined with attention mechanism had certain value for predicting stroke recurrence in patients with sICAS.

Objective To observe the value of the integrated model of MR high-resolution vascular wall imaging(HR-VWI)and attention mechanism for predicting stroke recurrence in symptomatic intracranial atherosclerotic stenosis(sICAS)patients.Methods A total of 363 patients with sICAS who underwent HR-VWI were enrolled and stratified into training set(n=254)and validation set(n=109)according to their origins.Employing a radiomics model that utilized HR-VWI T1 and contrast-enhanced sequences for feature extraction,image data were captured from relevant plaques.Subsequently,a Trans model was developed by integrating the Transformer attention mechanism.The predictive performance and clinical utility of conventional radiomics models and Trans models for forecasting stroke recurrence among patients with sICAS were evaluated.Results In training set and validation set,the area under the curve of Trans model for predicting stroke recurrence in sICAS patients was 0.992 and 0.988,respectively,both superior to that of T1 model,T1 enhanced model and dual sequence model(all P＜0.05).The calibration curve and decision curve analysis showed that Trans model had good predictive probability and clinical practicality.Conclusion The obtained integrated model of HR-VWI radiomics combined with attention mechanism had certain value for predicting stroke recurrence in patients with sICAS.

Objective To evaluate the application of high-resolution magnetic resonance vessel wall imaging(HRMR-VWI)in identifying high-risk features of intracranial atherosclerotic plaques,and to analyze the correlation between plaque characteristics and stroke recurrence under varying degrees of stenosis.Methods The data from 368 patients with intracranial atherosclerotic stenosis(ICAS)across two centers were retrospectively analyzed.Based on the degree of stenosis,all patients were categorized into mild-to-moderate stenosis group(luminal stenosis<70%,n=155)and severe stenosis group(luminal stenosis≥70%,n=213).HRMR-VWI images and clinical information of the patients were collected and analyzed,and the culprit plaques were quantitatively analyzed.Univariate and multivariate logistic regression analyses were employed to identify the risk factors for stroke recurrence,and the predictive performance was evaluated using the area under the curve(AUC)of the receiver operating characteristic(ROC)curve.Results Higher normalized wall index(NWI)[odds ratio(OR)=1.082,95%confidence interval(CI)1.050-1.118,P<0.05]and the presence of intraplaque hemorrhage(IPH)(OR=1.843,95%CI 1.120-3.036,P<0.05)were risk factors for stroke recurrence in all patients.And these two factors were also significant in the mild-to-moderate stenosis group(NWI:OR=1.088,95%CI 1.009-1.186,P<0.05;IPH:OR=4.049,95%CI 1.227-16.065,P<0.05).A predictive model for stroke recurrence was constructed using the combination of IPH and NWI,with the best performance in the mild-to-moderate stenosis group(AUC=0.813,95%CI 0.723-0.906).Conclusion In patients with luminal stenosis<70%,the increase of NWI and the presence of IPH have been validated as significant and effective indicators for predicting stroke recurrence,demonstrating notable predictive performance.In contrast,among patients with luminal stenosis≥70%,the utility of plaque characteristics in predicting stroke recurrence is relatively lower,indicating that the correlation between plaque characteristics and stroke recurrence varies across different degrees of stenosis.

Objective:To analyze regional differences in MMACHC gene variations among patients with cblC-type methylmalonic acidemia (MMA) in China and to explore the relationship between these variations and neonatal screening, biochemical markers and prognosis.Methods:Retrospective case summary. Clinical and laboratory data, including general condition, biochemical markers and genetic analysis, were collected from 1 859 cblC MMA patients from 2005 to 2023. Patients were divided into 7 groups according to their regions: north China, northeast China, east China, central China, south China, southwest China and northwest China. They were also classified into neonatal screening and non-neonatal screening groups. Mann-Whitney U and Kruskal-Wallis tests were used to compare biochemical marker levels. In contrast, the Chi-square test was applied to compare MMACHC gene variant frequencies, neonatal screening proportion, onset age and prognosis between groups. Results:Among 1 859 cases of cblC MMA, 1 019 were male and 840 were female, with a consultation age of 1.0 (0.1, 5.0) month. A total of 1 787 cases carried compound heterozygous or homozygous variants and only 1 variant site was identified in 72 cases. The 10 most frequent variants were c.609G>A (1 238 cases), c.658_660delAAG (343 cases), c.80A>G (284 cases), c.482G>A (239 cases), c.567dupT (191 cases), c.656_658delAGA (131 cases), c.217C>T (109 cases), c.394C>T (105 cases), c.445_446delTG (51 cases) and c.1A>G (50 cases). The frequency of the c.609G>A was the lowest in northwest China (28.8% (44/154), χ2=-18.42, P<0.05). The frequency of the c.567dupT was the most common in southwest China (25.0% (20/80), χ2=71.70, P<0.001) and c.656_658delAGA had the highest frequency in northeast China (9.3% (19/205), χ2=32.08, P<0.001). Non-missense variants (91.2% (62/68), 88.5% (46/52)) and early-onset patients (90.0% (36/40), 94.4% (34/36)) were both more prevalent in southwest and south China ( χ2=14.95, 31.69, both P<0.05). The proportion of neonatal screening was the lowest in south China (22.2% (8/36), χ2=98.48, P<0.05), where the mortality rate was the highest (19.1% (4/21), χ2=38.98, P<0.001). East China exhibited the highest frequency of missense variants (21.5% (339/1 579)), the highest proportion of patients identified through neonatal screening (54.5% (465/853)), and a more significant proportion of patients with good prognosis (36.6% (227/621), χ2=14.57, 93.49, 38.98, all P<0.05). In addition, the c.482G>A variant was more frequent in patients diagnosed by neonatal screening compared to those diagnosed by other methods (8.3% (132/1 586) vs. 5.9% (122/2 060), χ2=7.97, P<0.05). Conclusions:The frequency of MMACHC gene variation varies across different regions. The c.609G>A was least frequent in northwest China, c.567dupT was most common in southwest China, and c.656_658delAGA was most prevalent in northeast China. South China had the lowest neonatal screening rate and the highest mortality. At the same time, east China exhibited the highest frequency of missense variants, the highest proportion of patients identified through neonatal screening and the best prognosis. The c.482G>A variant was more frequent in patients diagnosed by neonatal screening compared to those diagnosed by other methods.