1.Current Research Status,Challenges,Differentiation and Treatment Strategies of Traditional Chinese Medicine for Gastroesophageal Reflux Disease
Fengyun WANG ; Mi LYU ; Bingduo ZHOU ; Beihua ZHANG ; Yi WANG ; Tingting XU ; Cong HE ; Xiaokang WANG ; Xin LIU ; Yang WANG ; Kaiyue HUANG ; Lusi XU ; Xudong TANG
Journal of Traditional Chinese Medicine 2026;67(4):392-396
This article systematically reviews the current research status as well as diagnosis and treatment strategies of traditional Chinese medicine (TCM) for gastroesophageal reflux disease (GERD). Studies demonstrate that TCM, based on the "disease-syndrome combination" approach, exhibits multi-target advantages in alleviating symptoms of various GERD subtypes, promoting mucosal repair, regulating emotions, and facilitating the reduction of western medication. To address clinical challenges such as symptom overlap and limited therapeutic efficacy, strategies have been proposed including "treating different diseases with the same method" and integrated regulation based on viscera correlation. Future efforts should focus on elucidating the mechanisms of compound prescriptions, promoting TCM drug development under the "three-combination" evaluation framework that integrates TCM theory, human experience and clinical trial evidence, and optimizing integrated traditional and western medicine models to enhance GERD management.
2.Glycan receptor binding characteristics of GⅡ.5 norovirus capsid proteins
Chinese Journal of Biologicals 2026;39(03):277-281+288
ObjectiveTo analyze the glycan receptor binding characteristics of capsid proteins of GⅡ.5 norovirus(NoV) in order to lay a foundation for the development of antiviral drugs and vaccines for NoV.MethodsThe P proteins of GⅡ.5 N490 and GⅡ.5 12X were expressed in prokaryotic system respectively, purified using glutathione affinity chromatography, and then the binding characteristics of P proteins with saliva and glycan were detected by ELISA. The structure of two GⅡ.5 strains was modeled and the binding amino acids between the P protein and glycan were analyzed based on the epidemic GⅡ.17 KW308.ResultsThe relative molecular mass of the both P proteins of GⅡ.5 N490 and GⅡ.5 12X was 61 000,which were expressed in soluble from in the supernatant, and the purified concentration was 0. 2 mg/mL. The P proteins of two GⅡ.5 strains could bind to most of A, B, O secretory and non-secretory saliva. The P protein of GⅡ.5 N490 exhibited binding to H disaccharide, while the P protein of GⅡ.5 12X showed specific binding to H disaccharide and B trisaccharide. In addition, the model of two GⅡ.5 strains displayed a conformation similar to that of GⅡ.17 KW308. Among the six amino acid sites interacting with glycan, Arg349, Asp378, Gly443 of GⅡ.5 N490 and GⅡ.5 12X were the same as those of G Ⅱ.17 KW308, while Asn375, Glu380 and Phe444 were different from those of G Ⅱ.17 KW308.ConclusionThe two strains of G Ⅱ. 5 exhibit similar binding characteristics in saliva binding patterns with P proteins and both have a wide susceptible population, while the glycan binding patterns are slightly different.
3.Establishment and Preliminary Analysis of GP73 Interactome Using Proximity-dependent Labeling Technology
Mu-Yi LIU ; Chang ZHANG ; Meng-Xin YANG ; Xin-Long YAN ; Lu-Ming WAN ; Cong-Wen WEI
Progress in Biochemistry and Biophysics 2026;53(3):711-723
ObjectiveProtein-protein interactions (PPIs) are fundamental to the execution of biological functions within living cells. However, traditional biochemical methods, such as co-immunoprecipitation (Co-IP), often fail to capture transient, weak, or membrane-associated interactions due to the stringent detergent requirements for cell lysis. Proximity labeling (PL) has emerged in recent years as a transformative technology for mapping the proteomes of specific subcellular compartments and identifying dynamic interactomes in situ. Golgi protein 73 (GP73, also known as GOLPH2), a resident type II Golgi transmembrane protein, is a well-recognized clinical biomarker for liver diseases, including hepatocellular carcinoma (HCC). Despite its clinical significance, the comprehensive physiological and pathological functions of GP73 remain partially understood. This study aims to establish an APEX2-mediated proximity labeling system specifically targeting GP73 to map its interactome in a living cellular environment, thereby providing new insights into its molecular roles and regulatory mechanisms. MethodsTo achieve spatial specificity, we first constructed a stable cell line expressing a fusion protein consisting of GP73 and the engineered soybean peroxidase APEX2. The localization of the GP73-APEX2 fusion protein was validated to ensure it correctly targeted the Golgi apparatus. The proximity labeling reaction was initiated by incubating the cells with biotin-phenol (BP) for 30 min, followed by a brief (1 min) treatment with1 mmol/L hydrogen peroxide (H2O2). This catalytic reaction converts BP into highly reactive, short-lived biotin-phenoxyl radicals that covalently attach to endogenous proteins within a small labeling radius of the GP73-APEX2 enzyme. Subsequently, the cells were quenched, and biotinylated proteins were enriched using high-affinity streptavidin-coated magnetic beads. The captured “neighbor” proteins were subjected to on-bead digestion and analyzed via liquid chromatography-tandem mass spectrometry (LC-MS/MS) for high-throughput identification. Rigorous bioinformatics analysis, including Gene Ontology (GO) enrichment, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis, and protein-protein interaction network mapping, was performed to interpret the biological significance of the identified candidates. ResultsOur results demonstrate the successful establishment of a robust and sensitive APEX2-based proximity labeling system for GP73. We identified a total of 95 high-confidence interacting proteins that were significantly enriched in the GP73 proximity proteome compared to control groups. Bioinformatics analysis revealed that these interactors were predominantly associated with biological processes such as vesicular transport, protein localization, and, most notably, molecular functions related to “ribosome binding” and “translation regulation”. This suggested an unexpected role for the Golgi-resident GP73 in the cellular translation machinery. To validate these findings, we performed targeted biochemical assays which confirmed a direct interaction between GP73 and the subunits of the eukaryotic translation initiation factor 3 (eIF3) complex, specifically EIF3G and EIF3I. Furthermore, functional validation using the surface sensing of translation (SUnSET) assay—a non-radioactive method to monitor protein synthesis—revealed that the overexpression of GP73 significantly promoted global protein translation levels in the cell, whereas its depletion or inhibition resulted in reduced translation efficiency. ConclusionThis study successfully utilized APEX2-mediated proximity labeling to provide the first systematic map of GP73 interactome in living cells. Our findings uncover a novel, unconventional function of GP73 as a regulator of cellular protein translation, likely mediated through its interaction with the eIF3 complex. This discovery significantly broadens our understanding of the biological roles of GP73 beyond its traditional function in the Golgi apparatus and suggests that it may act as a bridge between Golgi-related trafficking and the protein synthesis machinery. Furthermore, the technical framework established in this study provides a valuable template for investigating other complex organelle-associated protein networks and resolving transient macromolecular interactions in various physiological and pathological contexts.
4.A Randomized, Double-blind, Placebo-controlled Clinical Trial of Tengshen Granules for Treatment of Grade 1 Hypertension
Yuru PENG ; Jiaming HUAN ; Laiyun XIN ; Zhenyuan WANG ; Cong WANG ; Yunlun LI
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(21):168-176
ObjectiveTo evaluate the clinical efficacy and safety of Tengshen Granules in the treatment of grade 1 hypertension with the syndrome of severe liver heat and hyperactive Yang combined with mild kidney Yin deficiency. MethodsA total of 120 patients with grade 1 hypertension presenting with severe liver heat and hyperactive Yang combined with mild kidney Yin deficiency were enrolled in a randomized, double-blind, placebo-controlled, parallel-group clinical trial. Patients were randomly assigned to the observation group (Tengshen granules) and the control group (placebo), with 60 cases in each group. On the basis of lifestyle intervention, treatment was administered for 8 weeks followed by a 2-month follow-up. During the study period, traditional Chinese medicine (TCM) syndrome scores, blood pressure, antihypertensive efficacy, blood pressure control rate, and other indicators were recorded and analyzed, and safety was evaluated. ResultsA total of 114 patients completed the trial, including 57 in the control group and 57 in the observation group. Compared with baseline, TCM syndrome scores, systolic blood pressure, and diastolic blood pressure in the observation group were significantly reduced after treatment (P<0.01). Compared with the control group after treatment, systolic blood pressure in the observation group was lower from week 4 of medication (P<0.05), and this difference persisted until 2 months after drug discontinuation. For diastolic blood pressure, the observation group was superior to the control group at week 8 (P<0.01), with no statistically significant differences at other time points. Regarding syndrome improvement, the TCM syndrome scores for severe liver heat and hyperactive Yang combined with mild kidney Yin deficiency showed significant improvement at weeks 6 and 8 of treatment, with the observation group superior to the control group (P<0.05). During the 1-month follow-up after drug discontinuation, the syndrome scores in the observation group remained lower than those in the control group (P<0.01). The total effective rate of antihypertensive efficacy in the observation group was higher than that in the control group (χ2=11.389, P<0.05). In addition, the level of urinary microalbumin in the observation group was lower after treatment than before treatment (P<0.05). ConclusionTengshen granules demonstrate significant clinical efficacy and good safety in the treatment of grade 1 hypertension with severe liver heat and hyperactive Yang combined with mild kidney Yin deficiency. They can effectively reduce blood pressure and improve related TCM syndrome manifestations.
5.A Randomized, Double-blind, Placebo-controlled Clinical Trial of Tengshen Granules for Treatment of Grade 1 Hypertension
Yuru PENG ; Jiaming HUAN ; Laiyun XIN ; Zhenyuan WANG ; Cong WANG ; Yunlun LI
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(21):168-176
ObjectiveTo evaluate the clinical efficacy and safety of Tengshen Granules in the treatment of grade 1 hypertension with the syndrome of severe liver heat and hyperactive Yang combined with mild kidney Yin deficiency. MethodsA total of 120 patients with grade 1 hypertension presenting with severe liver heat and hyperactive Yang combined with mild kidney Yin deficiency were enrolled in a randomized, double-blind, placebo-controlled, parallel-group clinical trial. Patients were randomly assigned to the observation group (Tengshen granules) and the control group (placebo), with 60 cases in each group. On the basis of lifestyle intervention, treatment was administered for 8 weeks followed by a 2-month follow-up. During the study period, traditional Chinese medicine (TCM) syndrome scores, blood pressure, antihypertensive efficacy, blood pressure control rate, and other indicators were recorded and analyzed, and safety was evaluated. ResultsA total of 114 patients completed the trial, including 57 in the control group and 57 in the observation group. Compared with baseline, TCM syndrome scores, systolic blood pressure, and diastolic blood pressure in the observation group were significantly reduced after treatment (P<0.01). Compared with the control group after treatment, systolic blood pressure in the observation group was lower from week 4 of medication (P<0.05), and this difference persisted until 2 months after drug discontinuation. For diastolic blood pressure, the observation group was superior to the control group at week 8 (P<0.01), with no statistically significant differences at other time points. Regarding syndrome improvement, the TCM syndrome scores for severe liver heat and hyperactive Yang combined with mild kidney Yin deficiency showed significant improvement at weeks 6 and 8 of treatment, with the observation group superior to the control group (P<0.05). During the 1-month follow-up after drug discontinuation, the syndrome scores in the observation group remained lower than those in the control group (P<0.01). The total effective rate of antihypertensive efficacy in the observation group was higher than that in the control group (χ2=11.389, P<0.05). In addition, the level of urinary microalbumin in the observation group was lower after treatment than before treatment (P<0.05). ConclusionTengshen granules demonstrate significant clinical efficacy and good safety in the treatment of grade 1 hypertension with severe liver heat and hyperactive Yang combined with mild kidney Yin deficiency. They can effectively reduce blood pressure and improve related TCM syndrome manifestations.
6.The Mechanism of Exercise Regulating Intestinal Flora in The Prevention and Treatment of Depression
Lei-Zi MIN ; Jing-Tong WANG ; Qing-Yuan WANG ; Yi-Cong CUI ; Rui WANG ; Xin-Dong MA
Progress in Biochemistry and Biophysics 2025;52(6):1418-1434
Depression, a prevalent mental disorder with significant socioeconomic burdens, underscores the urgent need for safe and effective non-pharmacological interventions. Recent advances in microbiome research have revealed the pivotal role of gut microbiota dysbiosis in the pathogenesis of depression. Concurrently, exercise, as a cost-effective and accessible intervention, has demonstrated remarkable efficacy in alleviating depressive symptoms. This comprehensive review synthesizes current evidence on the interplay among exercise, gut microbiota modulation, and depression, elucidating the mechanistic pathways through which exercise ameliorates depressive symptoms via the microbiota-gut-brain (MGB) axis. Depression is characterized by gut microbiota alterations, including reduced alpha and beta diversity, depletion of beneficial taxa (e.g., Bifidobacterium, Lactobacillus, and Coprococcus), and overgrowth of pro-inflammatory and pathogenic bacteria (e.g., Morganella, Klebsiella, and Enterobacteriaceae). Metagenomic analyses reveal disrupted metabolic functions in depressive patients, such as diminished synthesis of short-chain fatty acids (SCFAs), impaired tryptophan metabolism, and dysregulated bile acid conversion. For instance, Bifidobacterium longum deficiency correlates with reduced synthesis of neuroactive metabolites like homovanillic acid, while decreased Coprococcus abundance limits butyrate production, exacerbating neuroinflammation. Furthermore, elevated levels of indole derivatives from Clostridium species inhibit serotonin (5-HT) synthesis, contributing to depressive phenotypes. These dysbiotic profiles disrupt the MGB axis, triggering systemic inflammation, neurotransmitter imbalances, and hypothalamic-pituitary-adrenal (HPA) axis hyperactivity. Exercise exerts profound effects on gut microbiota composition, diversity, and metabolic activity. Longitudinal studies demonstrate that sustained aerobic exercise increases alpha diversity, enriches SCFA-producing genera (e.g., Faecalibacterium prausnitzii, Roseburia, and Akkermansia), and suppresses pathobionts (e.g., Desulfovibrio and Streptococcus). For example, a meta-analysis of 25 trials involving 1 044 participants confirmed that exercise enhances microbial richness and restores the Firmicutes/Bacteroidetes ratio, a biomarker of metabolic health. Notably, endurance training promotes Veillonella proliferation, which converts lactate into propionate, enhancing energy metabolism and delaying fatigue. Exercise also strengthens intestinal barrier integrity by upregulating tight junction proteins (e.g., ZO-1, occludin), thereby reducing lipopolysaccharide (LPS) translocation and systemic inflammation. However, excessive exercise may paradoxically diminish microbial diversity and exacerbate intestinal permeability, highlighting the importance of moderate intensity and duration. Exercise ameliorates depressive symptoms through multifaceted interactions with the gut microbiota, primarily via 4 interconnected pathways. First, exercise mitigates neuroinflammation by elevating anti-inflammatory SCFAs such as butyrate, which suppresses NF-κB signaling to attenuate microglial activation and oxidative stress in the hippocampus. Animal studies demonstrate that voluntary wheel running reduces hippocampal TNF‑α and IL-17 levels in stress-induced depression models, while fecal microbiota transplantation (FMT) from exercised mice reverses depressive behaviors by modulating the TLR4/NF‑κB pathway. Second, exercise regulates neurotransmitter dynamics by enriching GABA-producing Lactobacillus and Bifidobacterium, thereby counteracting neuronal hyperexcitability. Aerobic exercise also enhances the abundance of Lactobacillus plantarum and Streptococcus thermophilus, which facilitate 5-HT and dopamine synthesis. Clinical trials reveal that 12 weeks of moderate exercise increases fecal Coprococcus and Blautia abundance, correlating with improved 5-HT bioavailability and reduced depression scores. Third, exercise normalizes HPA axis hyperactivity by reducing cortisol levels and restoring glucocorticoid receptor sensitivity. In rodent models, chronic stress-induced corticosterone elevation is reversed by probiotic supplementation (e.g., Lactobacillus), which enhances endocannabinoid signaling and hippocampal neurogenesis. Furthermore, exercise upregulates brain-derived neurotrophic factor (BDNF) via microbial metabolites like butyrate, promoting histone acetylation and synaptic plasticity. FMT experiments confirm that exercise-induced microbiota elevates prefrontal BDNF expression, reversing stress-induced neuronal atrophy. Fourth, exercise reshapes microbial metabolic crosstalk, diverting tryptophan metabolism toward 5-HT synthesis instead of neurotoxic kynurenine derivatives. Butyrate inhibits indoleamine 2,3-dioxygenase (IDO), a key enzyme in the kynurenine pathway linked to depression. Concurrently, exercise-induced Akkermansia enrichment enhances mucin production, fortifies the gut barrier, and reduces LPS-driven neuroinflammation. Collectively, these mechanisms underscore exercise as a potent modulator of the microbiota-gut-brain axis, offering a holistic approach to alleviating depression through microbial and neurophysiological synergy. Current evidence supports exercise as a potent adjunct therapy for depression, with personalized regimens (e.g., aerobic, resistance, or yoga) tailored to individual microbiota profiles. However, challenges remain in optimizing exercise prescriptions (intensity, duration, and type) and integrating them with probiotics, prebiotics, or FMT for synergistic effects. Future research should prioritize large-scale randomized controlled trials to validate causality, multi-omics approaches to decipher MGB axis dynamics, and mechanistic studies exploring microbial metabolites as therapeutic targets. The authors advocate for a paradigm shift toward microbiota-centric interventions, emphasizing the bidirectional relationship between physical activity and gut ecosystem resilience in mental health management. In conclusion, this review underscores exercise as a multifaceted modulator of the gut-brain axis, offering novel insights into non-pharmacological strategies for depression. By bridging microbial ecology, neuroimmunology, and exercise physiology, this work lays a foundation for precision medicine approaches targeting the gut microbiota to alleviate depressive disorders.
7.Clinical significance of cytokeratin 19 fragment in anti-melanoma differentiation-associated protein-5 antibody positive patients
Wenjuan GUAN ; Lijun LIU ; Panpan ZHANG ; Cong WANG ; Xin ZHANG ; Lijuan ZHANG ; Lishuai HAN ; Yinli ZHANG ; Yujie HE ; Shengyun LIU
Chinese Journal of Rheumatology 2025;29(3):189-196
Objective:To investigate the clinical significance of elevated cytokeratin 19 fragment (CYFRA21-1) in patients with dermatomyositis associated with positive anti-melanoma differentiation-associated gene 5 (MDA5) antibody.Methods:142 consecutive cases with newly onset anti-MDA5(+) (MADEDM)-DM admitted to the first affiliated hospital of Zhengzhou University from June 2018 to October 2021 were enrolled. They were divided into two groups, the low serum CYFRA21-1 group (CYFRA21-1≤4 ng/ml) and the high serum CYFRA21-1 group (CYFRA21-1>4 ng/ml). The clinical manifestations, laboratory tests results, imaging examinations treatment and outcome were collected for statistical analysis. Enumeration data were expressed as the number of cases and percentage (%). Normally distributed parameters were tested by t-test. Parameters with skewed distribution were tested by Mann-Whitney Wilcoxon analysis. Categorical variables were compared by the Chi-square test or Fisher′s exact test. Risk factor analysis was performed using Logistic regression. Cumulative survivals were described by Kaplan-Meier curves. Results:The age of onset in the high CYFRA21-1 group [(56±9)years vs. (50±10) years, t=-3.50, P=0.001] was higher than that in the low CYFRA21-1 group. Fever [63.3% (38/60) vs. 40.2% (33/82), χ2=7.39, P=0.007] was more common in the high CYFRA21-1 group, and arthritis [41.7% (25/60) vs. 69.5%(57/82), χ2=11.01, P=0.001] was less common. Myalgia, myasthenia, rashes, Raynaud′s phenomenon and skin ulcers had no significant difference between the two groups. The WBC count [5.2(4.1, 6.9)×10 9/L vs. 4.3(3.2, 6.2)×10 9/L, Z=-2.57, P=0.010], neutrophil count [4.0(2.9, 5.5)×10 9/L vs. 2.9(2.1, 4.5)×10 9/L, Z=-3.25, P=0.001] and neutrophil/lymphocyte ratio [5.75(3.50, 9.20) vs. 3.55(2.64, 5.41), Z=-3.77, P<0.001] in high CYFRA21-1 group were significantly higher than those in low CYFRA21-1 group. At the same time, LDH [384(302, 519)U/L vs. 318(260, 405)U/L, Z=-2.98, P=0.003], ferritin [1 204(677, 2 039)ng/ml vs. 570(229, 846)ng/ml, Z=-4.78, P<0.001], KL-6 [995(658, 1 491)U/ml vs. 750(563, 1 197)U/ml, Z=-2.49, P=0.013], ESR [36(22, 61)mm/1 h vs. 28(15, 46)mm/1 h, Z=-2.18, P=0.029] and CRP [9.2(4.7, 31.5)mg/L vs. 3.1(1.1, 11.6)mg/L, Z=-3.53, P<0.001] were significantly increased in the high level of CYFRA21-1 group, while serum albumin[(32±5)g/L vs. (35±5)g/L, t=3.92, P<0.001] was significantly decreased. There was no significant difference in the titers of serum anti-MDA5 antibodies between the two groups. The positive rate of anti-RO52 antibody [44(74.6%) vs. 44(53.7%), χ2=6.40, P=0.011] in high CYFRA21-1 group was higher than that in low CYFRA21-1 group. The ground glass opacity (GGO) score [1.75(1.33, 2.42) vs. 1.09(0.67, 1.67), Z=-4.60, P<0.001] based on high resolution CT (HRCT) was also significantly increased in the CYFRA21-1 high level group. Compared with the low CYFRA21-1 group, the high CYFRA21-1 group had a higher probability of RP-ILD [48.3%(29/60) vs. 23.2%(19/82), χ2=9.80, P=0.002] and a higher 6-month mortality rate[48.3%(29/60) vs.13.4%(11/82), χ2=19.70, P<0.001]. Logistic regression analysis showed that age ≥53 years old [ OR(95% CI)=5.197(1.781, 15.165), P=0.003], duration < 2 months [ OR(95% CI)=3.314 (1.058, 10.378), P=0.040], NE/LYMP >5 [ OR(95% CI)=3.443(1.120, 10.586), P=0.031], CRP>5 mg/L[ OR(95% CI)=6.271(1.749, 22.480), P=0.005], CA125>14 U/ml[ OR(95% CI)=7.500 (2.409, 23.345), P=0.001] and CYFRA21-1>4 ng/ml[ OR(95% CI)=3.665(1.258, 10.676), P=0.017] were independent risk factors for death within 6 months in MDA5-DM patients. Kaplan-Meier survival curve showed that the survival rate of the high CYFRA21-1 group was significantly lower than that of the low CYFRA21-1 group( P<0.001). Conclusion:Elevated CYFRA21-1 is an independent risk factor for early mortality in MDA5-DM patients and can serve as a novel serological marker for risk stratification in these patients.
8.Chronic hepatitis B long-term antiviral therapy:Reflections on suboptimal response and low-level viremia
Xin WEI ; Lilong CONG ; Linmei YAO ; Zixuan GAO ; Shuojie WANG ; Ziyu ZHANG ; Xinxin LI ; Shiyu WANG ; Wen DENG ; Minghui LI
Chinese Journal of Experimental and Clinical Virology 2025;39(4):518-525
Chronic hepatitis B(CHB)is one of the major challenges in the global public health field. As of 2022,approximately 254 million people worldwide were infected with the hepatitis B virus(HBV). CHB is one of the main causes of liver cirrhosis and hepatocellular carcinoma(HCC). Nucleos(t)ide analogs(NAs)and interferon therapy can delay the progression of liver fibrosis by inhibiting viral replication,but they cannot completely avoid the problem of heterogeneous treatment responses. Some patients are in a state of low-level viremia(LLV)during treatment. The persistent LLV state can induce chronic inflammation and the progression of liver fibrosis,ultimately increase the risk of HCC. In patients with poor treatment responses,the continuous active viral replication can induce immune disorders,accelerate the evolution of fibrosis to the decompensated stage of liver cirrhosis,and increase the risk of patient death. This article aims to review the definition,mechanisms,and impact on treatment outcomes of LLV and suboptimal response based on the latest research,provide a basis for optimizing antiviral therapy for CHB.
9.Study on artificial intelligence-based ultrasound diagnosis and auxiliary decision-making for ovarian tumors
Chunli QIU ; Yanlin CHEN ; Yuanji ZHANG ; Haotian LIN ; Xiaoyi PAN ; Siying LIANG ; Xiang CONG ; Xin LIU ; Zhen MA ; Cai ZANG ; Xin YANG ; Dong NI ; Guowei TAO
Chinese Journal of Ultrasonography 2025;34(7):608-615
Objective:To apply artificial intelligence(AI)in classifying ovarian tumors on ultrasound images,and compare the diagnostic results of several sonographers with varying seniority levels.Methods:A total of 645 patients diagnosed with adnexal masses via gynecological ultrasound examination at Qilu Hospital of Shandong University from January 2021 to December 2024 were enrolled. Three deep learning architectures,i.e.,Alexnet,Densenet121,and Resnet50 were developed and used to internally test the classification effectiveness of ovarian tumors,while the optimal model was selected for external testing. Two junior sonographers and two senior sonographers were recruited to independently diagnose ovarian tumors in the external test dataset. Subsequently,the benign and malignant results of the model's predictions were disclosed to each sonographer,and their revised diagnoses on the same external test data in combination with the best AI model were recorded.Results:The optimal model achieved an accuracy of 0.941,sensitivity of 0.936,and specificity of 0.944 on the internal test dataset,and maintained robust performance on the external test dataset with accuracy of 0.891,sensitivity of 0.880,and specificity of 0.907. Compared to junior sonographers,the optimal model demonstrated significantly higher sensitivity in discriminating benign from malignant ovarian tumors(0.880 vs. 0.723,0.602;all P<0.05). No statistically significant difference was observed in diagnostic accuracy between the optimal model and senior sonographer 1( P=0.05). With assistance from the optimal model,junior sonographers achieved significant improvements in both sensitivity and specificity(sensitivity:0.723 vs. 0.843,0.602 vs. 0.819;specificity:0.778 vs. 0.833,0.685 vs. 0.741;all P<0.05). Conclusions:The optimal model achieves comparable performance to that of senior sonographers in ovarian tumor classification. With model assistance,the diagnostic performance of junior sonographers is significantly improved.
10.Correlation analysis of serum FM,HDL-C,Hcy,and D-dimer levels with deep vein thrombosis in patients with lower limb fractures before and after surgery
Xin CHEN ; Dafan GUAN ; Cong ZHANG
Journal of Clinical Surgery 2025;33(2):158-161
Objective Analyze the changes in serum levels of fibrinogen monomer(FM),high-density lipoprotein(HDL-C),homocysteine(Hcy),D-dimer(D-D)in patients with lower limb fractures before and after surgery,and analyze their correlation with deep vein thrombosis(DVT).Methods 187 patients with lower limb fractures admitted from July 2020 to June 2023 were divided into DVT group(53 cases)and non DVT group(134 cases)according to the presence or absence of DVT after surgery.Independent sample t-tests were used to compare the levels of serum FM,HDL-C,Hcy,and D-D between the two groups on the day before and after surgery.Spearman correlation analysis was used to investigate the correlation between serum FM,HDL-C,Hcy,D-D and DVT on the day before and after surgery.Receiver operating characteristic(ROC)curves were used to analyze the effects of serum FM,HDL-C,Hcy,and D-D on lower limbs on the day after surgery.The predictive value of postoperative DVT in fracture patients.Results Compared with 1 day before surgery,the serum FM,HDL-C,Hcy,and D-D levels in both groups increased on the day after surgery(P<0.05),and compared with the non DVT group,the DVT group had higher serum FM,HDL-C,Hcy,and D-D levels on the day after surgery(P<0.05).According to Spearman correlation analysis,there was no correlation between preoperative serum FM,HDL-C,Hcy,D-D and DVT on day 1(P>0.05),while postoperative serum FM,HDL-C,Hcy,D-D were positively correlated with DVT on day 1(P<0.05).ROC curve analysis showed that the AUC of FM,HDL-C,Hcy,D-D,and their combined prediction of postoperative DVT in patients with lower limb fractures on the 1st day after surgery were 0.781,0.756,0.754,0.781,and 0.879,respectively.The sensitivity and specificity corresponding to the optimal critical value were:After 1 day of surgery,the FM was 45.3%and 100.0%,the HDL-C was 100.0%and 49.3%,the Hcy was 49.1%/100.0%,and the D-D was 100.0%and 49.3%,respectively.The combined rates of the four were 83.0%and 86.6%.Conclusion Compared with patients with lower limb fractures who did not experience DVT after surgery,patients with lower limb fractures experienced elevated serum levels of FM,HDL-C,Hcy,and D-D.There was a correlation between preoperative and postoperative serum levels of FM,HDL-C,Hcy,and D-D.The combination of serum levels of FM,HDL-C,Hcy,and D-D at 1 day after surgery has a high predictive value for postoperative DVT in patients with lower limb fractures.


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