Objective:To investigate the relationship between serum progranulin(PGRN),pentraxin 3(PTX3),krebs von den lungen-6(KL-6)and the prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)combined with type Ⅱ respiratory failure(RF)after nasal high-flow humidified oxygen therapy.Methods:160 patients with AECOPD combined with type Ⅱ RF who were treated in Zigong First People's Hospital from June 2022 to June 2024 were retrospectively selected,all patients received nasal high-flow humidified oxygen therapy,and they were divided into death group(38 cases)and survival group(122 cases)according to the prognosis of patients after treatment.The differences of serum PGRN,PTX3 and KL-6 levels and clinical data between two groups before treatment were compared.Logistic regression was applied to analyze the influencing factors of the poor prognosis of patients,and the receiver operating characteristic(ROC)curve was used to analyze the predictive efficacy of related risk factors for the poor prognosis of patients.Results:According to the prognosis evaluation,122 cases(76.25％)were in survival group,and 38 cases(23.75％)were in death group.Compared with survival group,serum PGRN,PTX3,KL-6,C-reactive protein(CRP),arterial partial pressure of carbon dioxide(PaCO2)and the number of AECOPD episodes in the past 1 year before treatment in death group were significantly increased,while the arterial partial pressure of oxygen(PaO2)was significantly decreased,the differences were statistically significant(P＜0.05).Logistic multivariate regression analysis showed that,elevated PGRN(OR=1.138),elevated PTX3(OR=1.182)and elevated KL-6(OR=1.162)were risk factors for death in patients with AECOPD combined with type Ⅱ RF after nasal high-flow humidified oxygen therapy(P＜0.05),and elevated PaO2(OR=0.758)was protective factor(P＜0.05).ROC curve analysis showed that the area under the curve(AUC)of serum PGRN,PTX3 and KL-6 in predicting the death of patients with AECOPD combined with type Ⅱ RF after nasal high-flow humidified oxygen therapy was 0.816,0.731 and 0.695 respectively,the AUC of the combined prediction of the three was 0.893,which was significantly higher than that of the single prediction.Conclusion:The levels of serum PGRN,PTX3 and KL-6 in patients with AECOPD combined with type Ⅱ RF are increased,which have high predictive value for the poor prognosis of patients with AECOPD combined with type Ⅱ RF after nasal high-flow humidified oxygen therapy.

Objective To explore the application value of MRI diaphragmatic navigation technology combined with three dimensional liver acquisition with volume acceleration-flexible(3D LAVA-FLEX)sequence in abdominal enhanced imaging of infants and young children.Methods A retrospective analysis was conducted on imaging data of 84 infants and young children who underwent abdominal enhanced MRI examination in our hospital between January 2021 and December 2023.All 84 infants and young children initially underwent conventional dynamic contrast-enhanced 3D LAVA-FLEX sequence scanning;the delayed phase images obtained were included in the dynamic enhancement group.Subsequently,diaphragmatic navigation combined with 3D LAVA-FLEX sequence examination was implemented,and the obtained images were included in the diaphragm navigation group.Subjective scoring was performed for images in both groups,while the signal to noise ratio(SNR),contrast to noise ratio(CNR),and artifact quantification(AQ)were measured and compared between the two groups.Results The respiratory motion artifacts,the clarity of liver parenchyma enhancement,the clarity of liver vascular enhancement,the clarity of spleen parenchyma enhancement and the overall image quality score in the diaphragm navigation group were higher than those in the dynamic enhancement group,and the differences were statistically significant(P<0.05).There were statistically significant differences in SNR and AQ between the two groups of images(P<0.000 1),while there was no statistically significant difference in CNR between the two groups of images(P>0.05).Conclusion Diaphragmatic navigation technology combined with 3D LAVA-FLEX sequence imaging can improve the image quality of abdominal MRI enhanced imaging in infants and young children,and provide a reference for clinical diagnosis and treatment.

Objective To explore the brain damage of SD rats under different time points of hypobaric hypoxia exposure.Methods A rat high-altitube cerebral edema(HACE)model was constructed by simulating an altitude of 6 000 m in a hypobaric hypoxia animal experimental chamber.Thirty-six SD male rats were randomly divided into the control group and the hypobaric hypoxia exposure 3,7 and 14 d groups,with 9 rats in each group.Except for the control group,the rats in each group were continuously exposed to hypobaric hypoxia for 3,7,and 14 d.At the end of the modeling period,serum was collected by blood sampling via the abdominal aorta,and brain tissue samples were taken.The wet-to-dry ratio(W/D)of brain tissue was calculated,and the levels of relevant oxidative enzymes in serum and brain tissue were measured.The expression levels of hypoxia-inducible factor-1α(HIF-1α)and aquaporin 4(AQP4)mRNAs in brain tissue were detected by real-time fluorescence quantitative polymerase chain reaction.Results The W/D of brain tissues in the control group and the group exposed to hypobaric hypoxia for 3,7 and 14 d were 4.46±0.12,4.98±0.16,5.07±0.18 and 4.95±0.07;the superoxide dismutase contents were(111.86±2.45),(90.73±1.48),(79.64±2.56)and(55.33±1.45)U·g-1;the glutathione contents were(126.91±5.18),(125.26±1.53),(56.20±2.17)and(122.73±1.78)μg·mL-1;the malondialdehyde contents were(230.94±2.00),(362.65±3.28),(407.34±3.47)and(237.50±1.59)nmol·g-1;the relative expression levels of HIF-1 α mRNA were 1.00±0,2.99±0.49,4.72±0.49 and 1.91±0.28;the relative expression levels of AQP4 mRNA were 1.00±0,2.62±0.34,8.38±0.84 and 5.27±0.42,respectively.Statistically significant differences were found between the above indexes in the 3,7 and 14 d of hypobaric hypoxia exposure group compared with the control group(P＜0.05,P＜0.01).Conclusion Different time of hypobaric hypoxia exposure can up-regulate the expression of AQPs proteins in HACE rats and cause the disruption of the blood-brain barrier,and the HACE model constructed in the hypobaric hypoxia chamber with 6 000 m intervention for 7 d was more stable.

Objective:To investigate the relationship between serum progranulin(PGRN),pentraxin 3(PTX3),krebs von den lungen-6(KL-6)and the prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)combined with type Ⅱ respiratory failure(RF)after nasal high-flow humidified oxygen therapy.Methods:160 patients with AECOPD combined with type Ⅱ RF who were treated in Zigong First People's Hospital from June 2022 to June 2024 were retrospectively selected,all patients received nasal high-flow humidified oxygen therapy,and they were divided into death group(38 cases)and survival group(122 cases)according to the prognosis of patients after treatment.The differences of serum PGRN,PTX3 and KL-6 levels and clinical data between two groups before treatment were compared.Logistic regression was applied to analyze the influencing factors of the poor prognosis of patients,and the receiver operating characteristic(ROC)curve was used to analyze the predictive efficacy of related risk factors for the poor prognosis of patients.Results:According to the prognosis evaluation,122 cases(76.25％)were in survival group,and 38 cases(23.75％)were in death group.Compared with survival group,serum PGRN,PTX3,KL-6,C-reactive protein(CRP),arterial partial pressure of carbon dioxide(PaCO2)and the number of AECOPD episodes in the past 1 year before treatment in death group were significantly increased,while the arterial partial pressure of oxygen(PaO2)was significantly decreased,the differences were statistically significant(P＜0.05).Logistic multivariate regression analysis showed that,elevated PGRN(OR=1.138),elevated PTX3(OR=1.182)and elevated KL-6(OR=1.162)were risk factors for death in patients with AECOPD combined with type Ⅱ RF after nasal high-flow humidified oxygen therapy(P＜0.05),and elevated PaO2(OR=0.758)was protective factor(P＜0.05).ROC curve analysis showed that the area under the curve(AUC)of serum PGRN,PTX3 and KL-6 in predicting the death of patients with AECOPD combined with type Ⅱ RF after nasal high-flow humidified oxygen therapy was 0.816,0.731 and 0.695 respectively,the AUC of the combined prediction of the three was 0.893,which was significantly higher than that of the single prediction.Conclusion:The levels of serum PGRN,PTX3 and KL-6 in patients with AECOPD combined with type Ⅱ RF are increased,which have high predictive value for the poor prognosis of patients with AECOPD combined with type Ⅱ RF after nasal high-flow humidified oxygen therapy.

Objective:This study aims to explore the risk factors of Multi-center Investigator-Initiated Clinical Trials (MIITs), and provide a basis for developing study management strategies.Methods:The original draft of MIIT risk evaluation factors was determined through literature analysis and internal discussions of the research group. Thirty five experts were consulted using the Delphi method, and then the MIIT risk evaluation elements were finally determined. Analytic Hierarchy Process (AHP) was used to calculate the weights of each index.Results:The recovery rates of both rounds of expert consultation were 100%, and the degree of expert authority was 0.856. The study ultimately formed an MIIT risk evaluation framework consisting of three first-class indexes, twelve second-class indexes, and thirty-eight third-class indexes. The weight values of the first-class indexes (start-up period, implementation period, and summary period) were 0.209 8, 0.710 6, and 0.079 6, respectively. Meanwhile, the weight values of the second-class indexes and third-class indexes were determined.Conclusions:Exploring the risk evaluation factors of MIIT provides valuable insights into identifying critical risk points, which, in turn, contributes to enhancing MIIT management efficiency, research progress, and quality.

AIM To investigate the stability of salvianolic acid B.METHODS HPLC was adopted in the content determination of salvianolic acid B,after which the chemical stability in different pH of buffer solutions,oxidation stability in different concentrations of H2O2,and biological stability in artificial gastric fluid,artificial intestinal fluid and biological matrices were analyzed,and its degradation kinetics was fitted.RESULTS Salvianolic acid B was stable in acidic and weakly acidic buffer solutions and artificial gastric fluid,which demonstrated poor stability in neutral and alkaline buffer solutions,artificial intestinal fluid,H2O2 and biological matrices.The degradation process of this constituent accorded with the first-order kinetic model in ileum homogenate,and the second-order kinetic model in pH 7.4 buffer solution,artificial intestinal fluid,H2O2 and stomach,duodenum,jejunum,colon homogenates.CONCLUSION Biological matrices,oxidants and alkaline environment can affect the stability of salvianolic acid B.This experimental exhibits important significance for the development and application of salvianolic acid B-related products.

Objective To explore the brain damage of SD rats under different time points of hypobaric hypoxia exposure.Methods A rat high-altitube cerebral edema(HACE)model was constructed by simulating an altitude of 6 000 m in a hypobaric hypoxia animal experimental chamber.Thirty-six SD male rats were randomly divided into the control group and the hypobaric hypoxia exposure 3,7 and 14 d groups,with 9 rats in each group.Except for the control group,the rats in each group were continuously exposed to hypobaric hypoxia for 3,7,and 14 d.At the end of the modeling period,serum was collected by blood sampling via the abdominal aorta,and brain tissue samples were taken.The wet-to-dry ratio(W/D)of brain tissue was calculated,and the levels of relevant oxidative enzymes in serum and brain tissue were measured.The expression levels of hypoxia-inducible factor-1α(HIF-1α)and aquaporin 4(AQP4)mRNAs in brain tissue were detected by real-time fluorescence quantitative polymerase chain reaction.Results The W/D of brain tissues in the control group and the group exposed to hypobaric hypoxia for 3,7 and 14 d were 4.46±0.12,4.98±0.16,5.07±0.18 and 4.95±0.07;the superoxide dismutase contents were(111.86±2.45),(90.73±1.48),(79.64±2.56)and(55.33±1.45)U·g-1;the glutathione contents were(126.91±5.18),(125.26±1.53),(56.20±2.17)and(122.73±1.78)μg·mL-1;the malondialdehyde contents were(230.94±2.00),(362.65±3.28),(407.34±3.47)and(237.50±1.59)nmol·g-1;the relative expression levels of HIF-1 α mRNA were 1.00±0,2.99±0.49,4.72±0.49 and 1.91±0.28;the relative expression levels of AQP4 mRNA were 1.00±0,2.62±0.34,8.38±0.84 and 5.27±0.42,respectively.Statistically significant differences were found between the above indexes in the 3,7 and 14 d of hypobaric hypoxia exposure group compared with the control group(P＜0.05,P＜0.01).Conclusion Different time of hypobaric hypoxia exposure can up-regulate the expression of AQPs proteins in HACE rats and cause the disruption of the blood-brain barrier,and the HACE model constructed in the hypobaric hypoxia chamber with 6 000 m intervention for 7 d was more stable.

Objective To develop and validate a fast Monte Carlo(MC)-based patient-specific quality assurance(PSQA)tool using the treatment log files that is suitable to be used in the online adaptive radiotherapy for pencil beam scanning proton therapy(PBSPT-ART).Methods The proposed tool first used the delivery log file of a PBSPT plan to reversely reconstruct the PBSPT(rPBSPT)plan,and then used an in-house developed graphic processing unit(GPU)-accelerated virtual particle MC(VPMC)dose engine to calculate the dose distribution of the rPBSPT plan.The rPBSPT dose calculated by VPMC was then compared to the rPBSPT dose calculated by another independent MC dose engine(MCsquare),using 3D gamma analysis to verify the accuracy of VPMC calculation.As a demonstration of the feasibility of developed log file-based PSQA,the VPMC calculated dose of the rPBSPT plan was compared to the pre-delivery second check dose of the corresponding PBSPT plan calculated by MCsquare,using 3D gamma analysis.3D gamma analysis employes a criterion of 2 mm/2%/10%.Twenty patients with different disease sites were representatively selected to validate the efficiency and accuracy of the tool.Results The average calculation time of a rPBSPT plan by VPMC was(5.88±4.00)s in the accuracy verification.Compared to MCsquare,the passing rate of the 3D gamma analysis was 99.47%±0.72%.In the proposed PSQA tool demonstration,the passing rate of comparing the VPMC calculated rPBSPT dose to MCsquare calculated second check dose of the corresponding PBSPT plan was 98.91%±0.92%.Conclusion The accuracy and efficiency of the tool can meet the requirements of PSQA in the online PBSPT-ART workflow.

With the rapid development of generative artificial intelligence(GAI)technologies,their widespread application in academic research and writing is continuously expanding the boundaries of sci-entific inquiry.However,this trend has also raised a series of ethical and regulatory challenges,inclu-ding issues related to authorship,content authenticity,citation accuracy,and accountability.In light of the growing involvement of AI in generating academic content,establishing an open,controllable,and trustworthy ethical governance framework has become a key task for safeguarding research integrity and maintaining trust within the academic community.This expert consensus outlines ethical requirements across key stages of AI-assisted academic writing-including topic selection,data management,citation practices,and authorship attribution.It aims to clarify the boundaries and ethical obligations surrounding AI use in academic writing,ensuring that technological tools enhance efficiency without compromising in-tegrity.The goal is to provide guidance and institutional support for building a responsible and sustainable research ecosystem.

BACKGROUND: Generalized pustular psoriasis (GPP), a rare and recurrent autoinflammatory disease, imposes a substantial burden on patients and society. Awareness of GPP in China remains limited. METHODS: This cross-sectional survey, conducted between September 2021 and May 2023 across 14 hospitals in China, included GPP patients of all ages and disease phases. Data collected encompassed demographics, clinical characteristics, economic impact, disease severity, quality of life, and treatment-related complications. Risk factors for GPP recurrence were analyzed. RESULTS: Among 127 patients (female/male ratio = 1.35:1), the mean age of disease onset was 25 years (1st quartile [Q1]-3rd quartile [Q3]: 11-44 years); 29.2% had experienced GPP for more than 10 years. Recurrence occurred in 75.6% of patients, and nearly half reported no identifiable triggers. Younger age at disease onset ( P  = 0.021) and transitioning to plaque psoriasis ( P  = 0.022) were associated with higher recurrence rates. The median diagnostic delay was 8 months (Q1-Q3: 2-41 months), and 32.3% of patients reported misdiagnoses. Comorbidities were present in 53.5% of patients, whereas 51.1% experienced systemic complications during treatment. Depression and anxiety affected 84.5% and 95.6% of patients, respectively. During GPP flares, the median Dermatology Life Quality Index score was 19.0 (Q1-Q3: 13.0-23.5). This score showed significant differences between patients with and without systemic symptoms; it demonstrated correlations with both depression and anxiety scores. Treatment costs caused financial hardship in 55.9% of patients, underscoring the burden associated with GPP. CONCLUSIONS The substantial disease and economic burdens among Chinese GPP patients warrant increased attention. Patients with early onset disease and those transitioning to plaque psoriasis require targeted interventions to mitigate the high recurrence risk.
Humans ; Male ; Female ; Psoriasis/pathology* ; Adult ; Cross-Sectional Studies ; Adolescent ; Child ; Young Adult ; Quality of Life ; Middle Aged ; China/epidemiology* ; Recurrence ; Risk Factors ; Surveys and Questionnaires ; East Asian People