Objective To investigate the impact of donor kidney histopathological lesions on the risk of BK virus (BKV) infection and progression after kidney transplantation. Methods A retrospective analysis was conducted on the clinical data of 326 kidney transplant recipients from deceased donors at the Department of Kidney Transplantation, the First Affiliated Hospital of Zhengzhou University, from January 2019 to June 2020. The recipients were divided into two groups based on whether BKV infection occurred after kidney transplantation: the BKV infection group (145 cases) and the non-BKV infection group (181 cases). The correlation between donor kidney histopathological findings from zero-hour biopsy and BKV infection, as well as the impact on the risk and progression of BKV infection, was analyzed. Results The incidence of BKV infection among the 326 kidney transplant recipients was 44.5% (145/326). The clearance rate of BKV after infection was 82.1% (119/145), while 17.9% (26/145) progressed to BKV viremia. Among the 326 qualified kidney biopsy specimens, 32 cases showed mild tubular atrophy, 324 cases had mild acute tubular injury, 27 cases exhibited mild hyaline arteriosclerosis, 10 cases had moderate to severe hyaline arteriosclerosis, 7 cases showed mild interstitial inflammation, 23 cases had mild interstitial fibrosis, 6 cases exhibited mild arterial intimal fibrosis, and 1 case had moderate to severe arterial intimal fibrosis. Multivariate logistic regression analysis revealed that male recipients, donor age and tubular atrophy were independent risk factors for BKV infection (all P<0.05). Tubular atrophy was also an independent risk factor for the progression from BKV uria to BKV viremia (P<0.05). Conclusions Donor kidney histopathological lesions have a certain impact on BKV infection and progression after kidney transplantation. Patients with more severe tubular atrophy in donor kidneys have a higher risk of BKV infection after kidney transplantation and are more likely to progress to BKV viremia.

OBJECTIVE: To investigate whether adding 1 transverse screw (TS) to the triangular parallel cannulated screw (TPCS) fixation has a mechanical stability advantage for Pauwels type Ⅲ femoral neck fractures by conducting finite element analysis on four internal fixation methods. METHODS: Based on CT data of a healthy adult male volunteer's femur, three Pauwels type Ⅲ femoral neck fracture models (Pauwels angle 70°, Pauwels angle 80°, and Pauwels angle 70° combined with bone defect) were constructed using Mimics 21.0 software and SolidWorks 2017 software. Four different internal fixation models were built at the same time, including TPCS, TPCS+TS, three cross screws (TCS), and TPCS+medial buttress plate (MBP). The mechanical stability of different models under the same load was compared by finite element analysis. RESULTS: The femoral model established in this study exhibited a maximum stress of 28.62 MPa, with relatively higher stress concentrated in the femoral neck. These findings were comparable to previous studies, indicating that the constructed femoral finite element model was correct. The maximum stress of internal fixation in finite element analysis showed that TCS was the lowest and TPCS+MBP was the highest in Pauwels angle 70° and 80° models, while TPCS+TS was the lowest and TCS was the highest in Pauwels angle 70° combined with bone defect model. The maximum displacement of internal fixation in each fracture model was located at the top of the femoral head, with TCS having the highest maximum displacement of the femur. The maximum stress of fracture surface in finite element analysis showed that TCS was the lowest and TPCS was the highest in the Pauwels angle 70° model, while TPCS+MBP was the lowest and TPCS/TCS were the highest in the Pauwels angle 80° model and the Pauwels angle 70° combined with bone defect model, respectively. The maximum displacement of fracture surfece analysis showed that TPCS+MBP was the lowest and TCS was the highest in Pauwels angle 70° and 80° models, while TPCS+TS was the lowest and TCS was the highest in Pauwels angle 70° combined with bone defect model. CONCLUSION For Pauwels type Ⅲ femoral neck fractures, the biomechanical stability of TPCS+TS was superior to that of TPCS alone and TCS, but it has not yet reached the level of TPCS+MBP.
Finite Element Analysis ; Humans ; Femoral Neck Fractures/diagnostic imaging* ; Bone Screws ; Fracture Fixation, Internal/instrumentation* ; Male ; Bone Plates ; Stress, Mechanical ; Biomechanical Phenomena ; Tomography, X-Ray Computed ; Adult ; Femur Neck/surgery*

Immunotherapy has become a pivotal modality in clinical cancer treatment. However, its effectiveness is limited to a small subset of patients due to the low antigenicity, impaired innate response, and various adaptive immune resistance mechanisms of the tumor microenvironment (TME). Accumulating evidence reveals the critical roles of metal elements in shaping immunity against tumor progression and metastasis. The marriage of metalloimmunotherapy and nanotechnology further presents new opportunities to optimize the physicochemical and pharmacokinetic properties of metal ions in a precise spatiotemporal control manner. Several metallodrugs have demonstrated encouraging immunotherapeutic potential in preliminary studies and are currently undergoing clinical trials at different stages, yet challenges persist in scaling up production and addressing long-term biosafety concerns. This review delineates how metal materials modulate biological activities across diverse cell types to orchestrate antitumor immunity. Moreover, it summarizes recent progress in smart drug delivery-release systems integrating metal elements, either as cargo or vehicles, to enhance antitumor immune responses. Finally, the review introduces current clinical applications of nanomedicines in metalloimmunotherapy and discusses potential challenges that impede its widespread translation into clinical practice.

Objective:To introduce the clinical application of three-dimensional(3D) printed titanium alloy prosthesis in the reconstruction of mandibular defects.Methods:Three patients with extensive mandibular defects, who were either ineligible for or refused autologous bone transplantation were selected from the Oral and Maxillofacial-Head and Neck Oncology Department at School & Hospital of Stomatology, Wuhan University between April 2019 and December 2021. Preoperative oral and maxillofacial CT scanning was performed, followed by a virtual surgical plan and the design and manufacture of titanium mandibular prosthesis as well as the surgery guide-plate. Repair of mandibular defects using 3D printed titanium mandibular prosthesis. Follow-up after surgery to evaluate the patient’s functional and cosmetic recovery.Results:The study included three male patients aged 27, 10 years and 8 months, and 74 years, respectively. Two cases involved recurrent mandibular tumors postoperatively, and one case involved mandibular defects following gingival tumor surgery that affected the patient’s facial appearance and eating. All surgeries were successfully completed, with postoperative outpatient follow-ups at 36, 32, and 6 months, respectively. Follow-up indicated that the facial contours were basically symmetrical, the degree of mouth opening was normal, and the occlusion on the healthy side was essentially normal. No exposure, loosening, or fracturing of the prostheses was observed.Conclusion:3D printed titanium mandibular prosthesis can effectively restore the facial contour and mandibular function of patients.

Objective:To introduce the clinical application of three-dimensional(3D) printed titanium alloy prosthesis in the reconstruction of mandibular defects.Methods:Three patients with extensive mandibular defects, who were either ineligible for or refused autologous bone transplantation were selected from the Oral and Maxillofacial-Head and Neck Oncology Department at School & Hospital of Stomatology, Wuhan University between April 2019 and December 2021. Preoperative oral and maxillofacial CT scanning was performed, followed by a virtual surgical plan and the design and manufacture of titanium mandibular prosthesis as well as the surgery guide-plate. Repair of mandibular defects using 3D printed titanium mandibular prosthesis. Follow-up after surgery to evaluate the patient’s functional and cosmetic recovery.Results:The study included three male patients aged 27, 10 years and 8 months, and 74 years, respectively. Two cases involved recurrent mandibular tumors postoperatively, and one case involved mandibular defects following gingival tumor surgery that affected the patient’s facial appearance and eating. All surgeries were successfully completed, with postoperative outpatient follow-ups at 36, 32, and 6 months, respectively. Follow-up indicated that the facial contours were basically symmetrical, the degree of mouth opening was normal, and the occlusion on the healthy side was essentially normal. No exposure, loosening, or fracturing of the prostheses was observed.Conclusion:3D printed titanium mandibular prosthesis can effectively restore the facial contour and mandibular function of patients.

Objective:To investigate the relationship between health promoting behavior and frailty in elderly patients with proliferative diabetic retinopathy(PDR),and the mediating effects of self-efficacy and loneliness.Methods:In an eye hospital of Anhui Province,214 elderly patients with PDR were selected from May 2021 to Nov 2022 by convenient sampling method.The Frailty Scale,Chinese Version of Health-Promoting Lifestyle Profile-Ⅱ,Self-Efficacy Scale and Simplified Loneliness Scale were used in this survey.Bootstrap method of Process software was used to analyze the mediating effect of self-efficacy on the relationship between health promoting behaviors and frailty in elderly PDR patients and the moderating effect of loneliness on the relationship between self-efficacy and frailty.Results:A total of 220 questionnaires were distributed and 214 valid questionnaires were returned,with valid response rate of 97.27% .Moderated mediation effect analysis suggested that health-promoting behaviors negatively predicted frailty(β=-0.508,P＜0.01).Health promoting behaviors and self-efficacy had significant predictive effects on frailty(β=-0.191 and-0.433,P＜0.01),and health promoting behaviors also had a significant predictive effect on self-efficacy(β=0.063,P＜0.01).Self-efficacy played a partially mediating role between health promoting behaviors and frailty,and the mediating effect accounted for 14.76% of the total effect.The product term of loneliness and self-efficacy significantly predicted frailty(β=0.255,P＜0.01),the mediating effect of self-efficacy on frailty was moderated by loneliness.Conclusions:The health-promoting behaviors of elderly patients with PDR affect frailty through self-efficacy,and loneliness moderates the relationship between self-efficacy and frailty.The moderated mediation model is established.

Objective To investigate the effect of the long non-coding RNA(lncRNA)SNAI3-AS1 on the malignant biological behavior of prostate cancer(PC)cells by regulating the microRNA(miR)-367-3p/high-mobility group box protein 4(SOX4)axis.Methods Real-time polymerase chain reaction(PCR)was used to detect SNAI3-AS1,miR-367-3p,and SOX4 mRNA expressions in human PCa cell lines DU 145,LNCap,and PC-3,normal prostate epithelial cell line RWPE-1,PC tissue,and adjacent cancer tissues.LNCap in the loga-rithmic growth phase were collected and assigned to the blank,negative control(vector),SNAI3-AS1 overexpression(vector SNAI3-AS1),small interfering RNA negative control(siRNA)(si-NC),si-SNAI3-AS1 group,si-SNAI3-AS1+inhibitor negative control(NC inhibitor),and si-SNAI3-AS1+miR-367-3p inhibitor groups.Clone formation,transwell,and Hoechst33258 staining were used to detect cell clone formation ability,migration,invasion,and apoptosis,respectively.Real-time PCR was used to detect SNAI3-AS1,miR-367-3p,and SOX4 mRNA expressions in LNCap.Western blotting was used to detect SOX4 protein expression in LNCap,and double luciferase was used to verify the targeting relationship between miR-367-3p and SNAI3-AS1 and SOX4.Results SNAI3-AS1 and SOX4 mRNA expressions increased in DU 145,LNCap,PC-3,and PC tissues,whereas miR-367-3p expression significantly decreased(P＜0.05).Compared with the blank and vector groups,the SNAI3-AS1 and SOX4 mRNA and protein expression,clone number,invasion,and migration in the vector SNAI3-AS1 group increased,whereas miR-367-3p expression and apoptosis decreased(P＜0.05).Compared with the blank and si-NC groups,the SNAI3-AS1 and SOX4 mRNA and protein expression,clone number,invasion,and migration in si-SNAI3-AS1 group decreased,whereas miR-367-3p expression and apoptosis increased(P＜0.05).Compared with the si-SNAI3-AS1+NC inhibitor group,the SOX4 mRNA and protein expression,clone number,invasion,and migration in si-SNAI3-AS1+miR-367-3p inhibitor group increased,whereas miR-367-3p expression and apoptosis decreased(P＜0.05);however,SNAI3-AS1 expression had no statistically significant difference(P＞0.05).miR-367-3p had a targets SNAI3-AS1 and SOX4.Conclusion SNAI3-AS1 inhibits the development of malignant behavior in PC cells by upregulating the miR-367-3p/SOX4 axis.

Objective To observe the value of artificial intelligence(AI)knowledge graph and image classification for quality control(QC)of chest posterior-anterior position X-ray radiograph(abbreviated as chest film).Methods Totally 9 236 chest films from 595 medical institutions in Anhui province imaging cloud platform were retrospectively enrolled.QC knowledge graph containing 21 classification labels were constructed.Firstly,QC of chest films based on the above knowledge graph were performed by 10 technicians for 2 rounds of single person and 1 round of multi person,and the results were recorded as A,B and C,respectively.Then AI algorithms were used to classify and evaluate based on knowledge graph,and the result was recorded as D.Finally,a QC expert reviewed results C and D to determine the final QC results and taken those as references to analyze the efficiency of the above 4 QC.Results The area under the curve(AUC)of AI algorithm for QC of chest films were all ≥0.780,with an average value of 0.939.The average precision of QC for chest films of A,B,C and D was 81.15％,85.47％,91.65％and 92.21％,respectively.Conclusion AI knowledge graph and image classification technology could be effectively used for QC of chest posterior-anterior position X-ray radiograph.

Purpose To explore the effect of compressed sensing(CS)technique with different acceleration factors on the quality of cardiac magnetic resonance cine sequences and feasibility of clinical application.Materials and Methods From January to July 2021,40 healthy volunteers were prospectively recruited for cardiac magnetic resonance cine imaging in Hefei First People's Hospital.Four scan protocols of volunteers were designed:SENSE 2 and CS-cine sequences with acceleration factors of 3,4 and 8.The imaging slices include four chamber heart,short axis heart,left ventricular two chamber heart and three chamber heart.Subjective score of image quality,left ventricular cardiac function and 16-segment myocardial thickness of SENSE 2 and CS3,CS4 and CS8 were compared and analyzed.Results Taking SENSE 2 image as the standard score of 5,the scores of CS3 and CS4 were above 3,and the scores of CS8 were below 3.There was no significant difference between the scores of four chamber heart and short axis heart images of CS3 and SENSE 2 sequence(all P>0.05).There were statistically significant differences in the subjective scores of image quality between the left ventricular two chamber heart and three chamber heart groups of each sequence(all P<0.05).There was no statistically significant difference in left ventricular function(left ventricular ejection fraction,left ventricular end systolic volume,left ventricular end diastolic volume,left ventricular stroke volume,left ventricular end-diastolic mass)(F=0.027,0.182,0.057,0.140,0.545)and myocardial thickness(F=0.052-7.366)among the four imaging schemes(all P>0.05).Conclusion Cardiac cine based on compressed sensing technology have good application prospects.With the increase of acceleration factors,the scanning time gradually decreases,and the corresponding image quality will also decrease.When the acceleration factor is 4,that is,the scanning time of the conventional cine sequence is reduced by 50%,the left ventricular function and myocardial thickness can still be accurately measured,and the image quality basically meets the diagnostic requirements.

Purpose Develop deep learning models to assess the clarity of chest X-ray images and validate the model's effectiveness by comparing it with the subjective evaluations of radiologists.Materials and Methods A retrospective collection of 9 135 chest X-ray images from 590 hospitals in Anhui Province,spanning from June 2015 to August 2022,was organized involving multiple radiologists who repeatedly evaluated the clarity of the images using a five-level scoring system.Individual assessments were designated as A and B,whereas the collective result of multiple assessments was designated as C.By constructing a deep learning model based on ResNet-50,image clarity evaluations of chest X-ray images were performed,we used the result C as the training and testing data for the model.The model's evaluation results were denoted as D.A radiology quality control expert conducted an audit assessment of the model's evaluation results and the multi-person assessments of physicians,serving as the reference standard for image clarity.Their assessment results were labeled as E.Statistical analysis,including Spearman's rank correlation coefficient,root mean square error(RMSE)and accuracy was employed to evaluate the effectiveness of the model.Results Compared with the reference standard E,D achieved an average accuracy of 0.85,exceeding the accuracy of C,which stood at 0.84.The ρ values for A,B,C,D and E were 0.58(0.54,0.62),0.59(0.55,0.63),0.74(0.71,0.77)and 0.80(0.78,0.82),respectively.The model exhibited the highest correlation with E.The ρ between A and B was 0.45(0.41,0.49),indicating a lower correlation between two individual subjective assessments of image clarity.The RMSE values for A,B,C,D and E were 0.99,0.94,0.72,and 0.71,respectively.The model's RMSE was lower than that of manual assessments.Conclusion This research model is capable of accurately assessing the clarity of chest X-ray images,and reducing the subjective interference of manual evaluation through deep learning methods,thereby providing an effective and objective evaluation tool for the assessment of clarity in clinical radiographic images.