Objective To investigate the utility of combining breast mass growth orientation quantification with the S-Detect technique for predicting axillary lymph node(ALN)metastasis in breast cancer.Methods Data was collected from 163 breast cancer patients admitted to our hospital between March 2023 and October 2024,who were categorized into metastatic(n=62)and non-metastatic(n=101)groups based on ALN pathology results.All patients underwent routine preoperative ultrasound and S-Detect examination.Univariate and multivariate regression analyses were performed to assess the correlation between each observational index and ALN metastasis.Significant indexes were identified through screening,leading to the establishment of a logistic regression prediction model.The predictive value of the model was evaluated using receiver operating characteristic(ROC)curve analysis.Results The univariate analysis revealed statistically significant differences(P<0.05)in the maximum diameter of the mass,border characteristics,margin features,calcification patterns,orientation angle,and blood flow between the two groups.Multifactorial analysis demonstrated that calcification,border characteristics,orientation angle,margin features,and maximum diameter independently influenced the prediction of axillary lymph node(ALN)status in breast cancer patients(P<0.05).Consequently,a logistic regression prediction model was constructed as follows:Y=-7.995+2.299×maximal diameter+1.171×border+2.137×margin+1.397×calcication+0.034×orientation angle.The area under curve(AUC)for this combined prediction model was 0.869 which significantly outperformed each independent influencing factor alone(P<0.05),indicating good agreement between this joint prediction model and pathological results(Kappa=0.701,P<0.05).Conclusions Quantification of the orientation angle of a breast mass aids in predicting axillary lymph node(ALN)metastasis and enhances the interpretation and application of non-parallel orientations.The combination of quantifying growth orientation based on breast mass with artificial intelligence S-Detect technique demonstrates promising predictive value for ALN metastasis in breast cancer,providing a reference basis for personalized treatment.

Objective To study the effect of Liuwei Dihuangwan on autophagy level and its mechanism in SAMP8 mice and Aβ-stimulated BV2 cell model,and to explore the molecular mechanism of tonifying the kidney and filling up the essence to prevent and control Alzheimer's disease(AD)through interfering with autophagy.Methods Ten 7-month-old male anti-aging mice(SAMR1)were taken as the normal group,and 40 7-month-old male rapid aging mice(SAMP8)were randomly control and model groups,equal volumes of saline were administered by gavage twice a day for 4 weeks,and the levels of Aβ expression in the hippocampus of the mice in each group were detected by immunofluorescence;The expression levels of FcγRⅡB,c-Src and SHP-1 in the hippocampus of each group were detected by Western blot;BV2 cells were cultured and Fcγ receptor Ⅱ-b(FcγRⅡB)overexpression vectors were constructed;the AD state cell model was established by treating the BV2 cells with 5 μmol·L-1 Aβ1-42,and the Liuwei Dihuangwan drug-containing serum was prepared.The cells were divided into NC group,Aβ1-42 group,blank serum group,drug-containing serum group,Vector group,FcγRⅡB OE group,and drug-containing serum+FcγRⅡB OE group;immunofluorescence was used to detect the expression level of Aβ protein in the cells of each group;Western blot was used to detect the expression level of p62,LC3 Ⅱ/Ⅰ,FcγRⅡB,SHP-1,and c-Src in cells of each group.Results Compared with the normal group,the hippocampal Aβ,FcγRⅡB,SHP-1,and c-Src expression levels in the model group of mice were significantly higher(P<0.01),and compared with the model group,the expression levels of Aβ,FcγRⅡB,SHP-1,and c-Src in the low-,medium-,and high-dose groups of Liuwei Dihuangwan were significantly lower(P<0.01),it also showed a significant dose dependent relationship.Compared with NC group,the protein expressions of Aβ,p62,FcγRⅡB,SHP-1 and c-Src in Aβ1-42 group were significantly increased(P<0.01),and LC3Ⅱ/Ⅰ was significantly decreased(P<0.01);Compared with Aβ1-42 group and blank serum group,the protein expressions of Aβ,p62,FcγRⅡB,SHP-1 and c-Src in drug-containing serum group were significantly decreased(P<0.01),and LC3Ⅱ/Ⅰ was significantly increased(P<0.01);Compared with NC group and Vector group,the expression of Aβ in FcγRⅡB OE group was increased,the protein expressions of p62,FcγRⅡB,SHP-1 and c-Src were significantly increased(P<0.01),and LC3Ⅱ/Ⅰ was significantly decreased(P<0.01);Compared with the drug-containing serum group,the protein expressions of Aβ,p62,FcγRⅡB,SHP-1 and c-Src in the drug-containing serum+FcγRⅡB OE group were significantly increased(P<0.01),and the protein expression levels of LC3Ⅱ/Ⅰ were significantly decreased(P<0.01).Conclusion Liuwei Dihuangwan improved AD by inhibiting microglia FcγRⅡB/c-Src pathway and increasing autophagy level.

Objective To study the effect of Liuwei Dihuangwan on autophagy level and its mechanism in SAMP8 mice and Aβ-stimulated BV2 cell model,and to explore the molecular mechanism of tonifying the kidney and filling up the essence to prevent and control Alzheimer's disease(AD)through interfering with autophagy.Methods Ten 7-month-old male anti-aging mice(SAMR1)were taken as the normal group,and 40 7-month-old male rapid aging mice(SAMP8)were randomly control and model groups,equal volumes of saline were administered by gavage twice a day for 4 weeks,and the levels of Aβ expression in the hippocampus of the mice in each group were detected by immunofluorescence;The expression levels of FcγRⅡB,c-Src and SHP-1 in the hippocampus of each group were detected by Western blot;BV2 cells were cultured and Fcγ receptor Ⅱ-b(FcγRⅡB)overexpression vectors were constructed;the AD state cell model was established by treating the BV2 cells with 5 μmol·L-1 Aβ1-42,and the Liuwei Dihuangwan drug-containing serum was prepared.The cells were divided into NC group,Aβ1-42 group,blank serum group,drug-containing serum group,Vector group,FcγRⅡB OE group,and drug-containing serum+FcγRⅡB OE group;immunofluorescence was used to detect the expression level of Aβ protein in the cells of each group;Western blot was used to detect the expression level of p62,LC3 Ⅱ/Ⅰ,FcγRⅡB,SHP-1,and c-Src in cells of each group.Results Compared with the normal group,the hippocampal Aβ,FcγRⅡB,SHP-1,and c-Src expression levels in the model group of mice were significantly higher(P<0.01),and compared with the model group,the expression levels of Aβ,FcγRⅡB,SHP-1,and c-Src in the low-,medium-,and high-dose groups of Liuwei Dihuangwan were significantly lower(P<0.01),it also showed a significant dose dependent relationship.Compared with NC group,the protein expressions of Aβ,p62,FcγRⅡB,SHP-1 and c-Src in Aβ1-42 group were significantly increased(P<0.01),and LC3Ⅱ/Ⅰ was significantly decreased(P<0.01);Compared with Aβ1-42 group and blank serum group,the protein expressions of Aβ,p62,FcγRⅡB,SHP-1 and c-Src in drug-containing serum group were significantly decreased(P<0.01),and LC3Ⅱ/Ⅰ was significantly increased(P<0.01);Compared with NC group and Vector group,the expression of Aβ in FcγRⅡB OE group was increased,the protein expressions of p62,FcγRⅡB,SHP-1 and c-Src were significantly increased(P<0.01),and LC3Ⅱ/Ⅰ was significantly decreased(P<0.01);Compared with the drug-containing serum group,the protein expressions of Aβ,p62,FcγRⅡB,SHP-1 and c-Src in the drug-containing serum+FcγRⅡB OE group were significantly increased(P<0.01),and the protein expression levels of LC3Ⅱ/Ⅰ were significantly decreased(P<0.01).Conclusion Liuwei Dihuangwan improved AD by inhibiting microglia FcγRⅡB/c-Src pathway and increasing autophagy level.

Objective To investigate the utility of combining breast mass growth orientation quantification with the S-Detect technique for predicting axillary lymph node(ALN)metastasis in breast cancer.Methods Data was collected from 163 breast cancer patients admitted to our hospital between March 2023 and October 2024,who were categorized into metastatic(n=62)and non-metastatic(n=101)groups based on ALN pathology results.All patients underwent routine preoperative ultrasound and S-Detect examination.Univariate and multivariate regression analyses were performed to assess the correlation between each observational index and ALN metastasis.Significant indexes were identified through screening,leading to the establishment of a logistic regression prediction model.The predictive value of the model was evaluated using receiver operating characteristic(ROC)curve analysis.Results The univariate analysis revealed statistically significant differences(P<0.05)in the maximum diameter of the mass,border characteristics,margin features,calcification patterns,orientation angle,and blood flow between the two groups.Multifactorial analysis demonstrated that calcification,border characteristics,orientation angle,margin features,and maximum diameter independently influenced the prediction of axillary lymph node(ALN)status in breast cancer patients(P<0.05).Consequently,a logistic regression prediction model was constructed as follows:Y=-7.995+2.299×maximal diameter+1.171×border+2.137×margin+1.397×calcication+0.034×orientation angle.The area under curve(AUC)for this combined prediction model was 0.869 which significantly outperformed each independent influencing factor alone(P<0.05),indicating good agreement between this joint prediction model and pathological results(Kappa=0.701,P<0.05).Conclusions Quantification of the orientation angle of a breast mass aids in predicting axillary lymph node(ALN)metastasis and enhances the interpretation and application of non-parallel orientations.The combination of quantifying growth orientation based on breast mass with artificial intelligence S-Detect technique demonstrates promising predictive value for ALN metastasis in breast cancer,providing a reference basis for personalized treatment.

Objective:To establish the reference values of stimulation single fiber electromyography (SFEMG) in orbicularis oculi, and to explore its sensitivity in repetitive nerve stimulation (RNS) negative ocular myasthenia gravis (OMG) patients, and the relationship between jitter and various clinical parameters.Methods:Thirty-two healthy volunteers were included to establish the reference value of normal controls from January 2019 to December 2019. From December 2019 to January 2023, 36 OMG patients with negative RNS were collected. Quantitative MG score (QMGS) was performed, neostigmine test and antibody titers as well as thymus CT results were recorded. One side of the orbicularis oculi muscle was tested with a disposable concentric needle electrode in stimulation SFEMG, and the mean consecutive difference (MCD) value was calculated, which was compared with the average MCD value and upper limit of individual values in normal controls to evaluate whether the jitter was abnormal. Spearman correlation analysis of abnormal mean MCD values with QMGS and antibody titer was conducted.Results:Among the 32 healthy volunteers, there were 13 males and 19 females, the age was (46.8 ±18.7) years, and the MCD was (19.0 ±4.4) μs. The upper limit of the reference value was 27.7 μs for average MCD, and 37.4 μs for 10% individual values. Among 36 OMG patients negative at RNS tests, 20 were male and 16 were female, with a age of (37.2 ±17.0) years. The MCD was (29.9 ±14.7) μs, and Jitter was abnormal in 29 patients (81%). Among them, 20 (20/25) patients were antibody positive, 6 (6/26) patients had thymic hyperplasia, and 7 (7/26) patients had thymoma. The QMGS was 3(2, 4). There were 7 patients (19%) with normal jitter, whose QMGS was 3(2, 4). Among the patients with normal Jitter, 5 (5/5) patients were antibody positive, 2 (2/6) patients had thymic hyperplasia. There was no statistically significant difference in clinical indicators between the two groups of patients with abnormal or normal jitter. There was no significant correlation in antibody titer or QMGS with abnormal mean MCD value. Conclusions:The upper limit of the mean MCD value in the normal controls is 27.7 μs. The upper limit of a single value is 37.4 μs. Its sensitivity for OMG patients with RNS negative is 81%, and the abnormal mean MCD value does not show a significant correlation with various clinical indicators. Abnormal jitter indicates dysfunction of neuromuscular junction transmission, which is an important neuroelectrophysiological indicator for MG patients and is suitable for RNS negative patients. Orbicularis oculi muscle stimulation SFEMG provides a reliable and sensitive electrophysiological means for functional evaluation of neuromuscular junction.

Objective: To investigate the status of hair loss and analyze the influencing factors among university students in Hangzhou City, so as to provide insights into the management of hair loss among university students. Methods: University students were recruited using a convenient sampling method from 4 universities in Hangzhou City in June 2021. The basic characteristics and life styles were collected using online questionnaire surveys. Self-reported hair loss was evaluated using the grading scales for loss of hair (Hamilton-Norwood scale for males and modified Ludwig scale for females), and factors affecting self-reported hair loss were identified among university students using the multivariable logistic regression model. Results: A total of 1 060 questionnaires were allocated, and 1 038 valid questionnaires were recovered, with an effective recovery rate of 97.92%. The respondents included 391 males ( 37.67% ) and 647 females ( 62.33% ), and 463 respondents ( 44.61% ) reported hair loss, including 431 students with mild hair loss ( 93.09% ). Multivariable logistic regression analysis showed that university students in their fourth or fifth years ( OR=1.721, 95%CI: 1.126-2.630 ), art specialty ( OR=0.411, 95%CI: 0.207-0.816 ), overweight or obesity (OR=1.685, 95%CI: 1.050-2.704), diet taste ( sweet: OR=2.131, 95%CI: 1.370-3.316; spicy: OR=1.510, 95%CI: 1.028-2.218; greasy: OR=3.023, 95%CI: 2.015-4.537 ), feeling nervous/anxious (occasionally: OR=1.891, 95%CI: 1.087-3.289; frequently: OR=2.487, 95%CI: 1.337-4.626 ), smoking ( occasionally: OR=1.906, 95%CI: 1.067-3.405; frequently: OR=1.983, 95%CI: 1.050-3.746), family history of hair loss ( OR=1.506, 95%CI: 1.075-2.110 ), perming/dyeing hair ( occasionally: OR=1.795, 95%CI: 1.280-2.517; frequently: OR=3.282, 95%CI: 1.736-6.204), self-perceived oily hair/scalp in the past three months (slightly increased: OR=1.980, 95%CI: 1.477-2.653; significantly increased: OR=5.347, 95%CI: 2.956-9.670) were factors affecting self-reported hair loss among university students. Conclusion The proportion of self-reported hair loss was 44.61% among university students in Hangzhou City, and hair loss was predominantly mild. A family history of hair loss, nervousness/anxiety, diet habits, smoking and frequency of perm/dyeing hair may affect hair loss among university students.

Objective To evaluate necessity of colonoscopy in symptomatic subjects with colorectal neoplasia screening score.Methods Data of consecutive patients who underwent routine colonoscopy between October 2015 and December 2015 were prospectively collected.APCS score and HKCS score were used to evaluate the detection rate of colorectal tumors in groups of different risks and to predict the necessity of colonoscopy in symptomatic subjects.Results There were 815 subjects with mean age of 51.2± 14.8 years.Colorectal neoplasia and advanced neoplasia were identified in 170 (20.9％) and 43 (5.3％) cases.APCS score was classified as average risk (AR),moderate risk (MR) and high risk (HR),which included 234,400 and 161 cases,respectively.The detection rates of colorectal neoplasia in AR,MR and HR groups were 9.5％,20.0％ and 41.0％,respectively,and those of advanced neoplasia were 0％,5.5％ and 13.0％,respectively.Detection rate of colorectal neoplasia in the HR group showed 6.7 times of that in the AR group (95％CI:3.9-11.2).HKCS score was classified as AR and HR,which included 633 and 182 cases in the present study.The detection rates of colorectal neoplasia in these groups were 16.3％ and 36.8％,and those of advanced neoplasia were 3.2％ and 12.6％.Detection rate of colorectal neoplasia in HR group was 3.0 times of that in AR group (95％CI:2.1-4.3).Conclusion APCS score and HKCS score are both suitable for evaluating the necessity of colonoscopy in symptomatic subjects.It is necessary for HR patients to undergo colonoscopy to detect colorectal neoplasia,however,AR patients evaluated by APCS score can delay colonoscopy to economize medical resources and avoid unnecessary complications.

Objective To explore the necessity of colonoscopy in young patients with chronic constipation.Methods Data of patients aged 18-50 underwent colonoscopy at Tianjin Medical University General Hospital with chronic constipation as the sole indication between April 2003 and May 2014 were analyzed.Endoscopic and pathologic reports were analyzed.Results During the study period,a total of 563 patients were included,who were aged 18-50 with chronic constipation as the sole indication,of which 260 patients were aged 18-35,and 303 patients were aged 36-50.No lesion was found during colonoscopy in 167 (29.7％) patients,whereas in other 396 (70.3 ％) patients positive findings were reported,including polyps in 45 patients (of which 13 were with multiple polyps),adenomas in 20(17 in distal colon,3 in proximal colon).In patients aged 18-35,3 cases of adenomas(3/260,1.2％) were found,of which 1 patient (1/260,0.4％)had advanced adenoma.In patients aged 36-50,17 cases of adenomas(17/303,5.6％) were found,of which 4 (4/303,1.3％) were advanced ones.Colorectal cancers were found in 2 patients (0.7％,2/303),both in patients aged 36-50.The detection rate for colorectal neoplasms (including adenoma and cancer) in patients with chronic constipation aged 18-35 was significantly lower than that in patients aged 36-50[1.2％(3/260) VS 6.3％(19/303),P=0.002,95％CI:0.05-0.60].Conclusion The detection rate for colorectal neoplasms in patients aged 18-35 years with chronic constipation is relatively low,and colonoscopy is not recommended for them.

Objective To assess the results of colonoscopy surveillance in 5 years after polypectomy of non-advanced colorectal adenoma and to identify its risk factors. Methods Patients undergoing colonosco-py and followed up with colonoscopy within 5 years between January 2003 and December 2013 were retro-spectively analyzed.No substance or only small quantity of clear water left in the intestinal tract and colono-scopes accessing ileocecus were regarded as complete examination. The initial colonoscopy was regarded as the baseline colonoscopy. Patients with non-advanced adenomas were assigned to the case group and those without were to the control group. Data of clinical characteristics and colorectal findings were estimated and risk factors were identified. Results A total of 828 patients were included,374 patients in the case group and 454 in the control group on baseline colonoscopy.The case group had a low incidence of advanced adeno-mas at a 1 to 5 years interval when compared with the control group,both with adequate baseline examination [1. 5%(5/ 326)VS 2. 2%(9/ 408),P = 0. 51]. The detection rates of advanced adenomas on follow-up colonoscopy at 1 to 3 years and 3 to 5 years in case group were 1. 7%(3/ 178)and 1. 4%(2/ 148),respec-tively(P>0. 05).Regression analysis showed age≥50 years old and being male were the independent risk factors for advanced adenomas recurrence within 5 years follow-up. No colon cancer was found in 828 patients during the follow-up. Conclusion Surveillance colonoscopy intervals within 5 years is of little benefit to pa-tients who had adequate polypectomy. Too early reexaminations due to concerns about advanced adenomas recurrence can be avoided.

Objective To assess the value of noninvasive MR imaging biomarkers in evaluating the early efficacy of anti?angiogenesis drugs. Methods Subcutaneous colon cancer xenograft models in thirty nude mice were established. The mice were randomly divided into three groups (n=10 for each): avastin injection group (dose 10 mg/kg), fluorouracil group (dose 150 mg/kg), physiological saline group (dose 20 mg/kg). Dynamic contrast?enhanced (DCE?MRI) and multiple b value diffusion weighted imaging (muti?b?value DWI) were acquired before or 1 h, 24 h and 48 h after the treatment. The parameters of contrast transfer coefficient (Ktrans), reflux constant (Kep), plasma volume fraction (Vp), extravascular extracellular volume fraction (Ve) and various apparent diffusion coefficients (ADCs) (ADC10b, ADChigh and ADCperf) were measured. Forty eight hours after the treatment, the mice were sacrificed following MRI. Aimmunohistochemical examination determined microvessel density (MVD) and proliferating cell nuclear antigen (PCNA) score. A repeated measures analysis of variance was used to compare the difference between the quantitative parameters among the three groups. A multivariate variance analysis was performed to compare the difference between the parameters at the same time point among the three groups. The correlation between MRI quantitative parameters with MVD and PCNA score were analyzed by Pearson and Spearman correlation analysis respectively. Factor analysis method summarized MRI quantitative parameters. Results One hour after the treatment, the parameters of Ktrans, Kep, ADC10b, ADChigh and ADCperf value immediately changed, they were(0.009 ± 0.005)/s,(0.042 ± 0.031)/s,(0.043 ± 0.002)× 10?3 mm2/s,(0.031 ± 0.005)× 10?3 mm2/s,(0.089 ± 0.006)× 10?3 mm2/s, Ktrans, Kep, ADC10b and ADChigh values all had significant differences in the three groups (F=42.058, 25.979, 9.870 and 8.511, respectively, all P<0.05). There were also statistical difference in the change trend of the above parameters among the three groups (F=22.108, 7.280, 65.698 and 19.900, respectively, all P<0.05). The change trend of ADCperf showed significant difference among the three groups (F=38.780, P<0.01). Ktrans, Kep and ADCperf positively correlated with the MVD count and PCNA score (r values were 0.421 to 0.811, both P<0.01), while ADC10b showed a negative correlation (r=-0.656 and-0.560, both P<0.01), ADChigh had negative correlation with the PCNA score (r=-0.568, P<0.05). Ktrans, Vp, Kep and ADCperf were classified as tumor microcirculation factor, whereas ADC10b and ADChigh were normalized for cell metabolism factor through the factor analysis. Conclusions Combination of DCE?MRI and muti?b?value DWI can reflect the early changes of drug therapy from the aspects of tumor microcirculation and cell metabolism. Ktrans, Kep, ADCperf, ADC10b and ADChigh can be taken as noninvasive imaging biomarkers to quantify the early efficacy of anti?angiogenesis drugs.