Objective： The aim of this study is to explore the predictive value of biparametric magnetic resonance imaging(bpMRI)for pelvic lymph node metastasis in prostate cancer patients with PSA≤20 μg/L and establish a nomogram. Methods： The imaging data and clinical data of 363 patients undergoing radical prostatectomy and pelvic lymph node dissection in the First Affiliated Hospital of Nanjing Medical University from July 2018 to December 2023 were retrospectively analyzed. Univariate analysis and multivariate logistic regression were used to screen independent risk factors for pelvic lymph node metastasis in prostate cancer, and a nomogram of the clinical prediction model was established. Calibration curves were drawn to evaluate the accuracy of the model. Results： Multivariate logistic regression analysis showed extrocapusular extension (OR=8.08,95%CI=2.62－24.97, P<0.01), enlargement of pelvic lymph nodes (OR=4.45,95%CI=1.16－17.11,P=0.030), and biopsy ISUP grade(OR=1.97,95%CI=1.12－3.46, P=0.018)were independent risk factors for pelvic lymph node metastasis. The C-index of the prediction model was 0.834, which indicated that the model had a good prediction ability. The actual value of the model calibration curve and the prediction probability of the model fitted well, indicating that the model had a good accuracy. Further analysis of DCA curve showed that the model had good clinical application value when the risk threshold ranged from 0.05 to 0.70.Conclusion： For prostate cancer patients with PSA≤20 μg/L, bpMRI has a good predictive value for the pelvic lymph node metastasis of prostate cancer with extrocapusular extension, enlargement of pelvic lymph nodes and ISUP grade≥4.
Humans ; Male ; Prostatic Neoplasms/diagnostic imaging* ; Lymphatic Metastasis ; Retrospective Studies ; Nomograms ; Prostate-Specific Antigen/blood* ; Lymph Nodes/pathology* ; Pelvis ; Predictive Value of Tests ; Prostatectomy ; Lymph Node Excision ; Risk Factors ; Magnetic Resonance Imaging ; Logistic Models ; Middle Aged ; Aged

The commonly used mechanical thrombectomy devices were introduced in terms of the working principle,advantages,disadvantages and clinical effects.The complications by mechanical thrombectomy devices used for thrombosis clearance were summarized,and the causes were analyzed and some countermeasures were put forward accordingly.It's pointed out mechanical thrombectomy devices would be improved in intelligence,automation,precision,individualization and remote control in the future.[Chinese Medical Equipment Journal,2025,46(8):79-85]

Aim To establish a simple and practical method for visualizing neurovascular coupling in the mouse barrel cortex in vivo.Methods Male C57BL/6J mice received stereotaxic in-jections of pAAV-hSyn-jGCaMP7s-WPRE into the barrel cortex to monitor neuronal activity.Three weeks post-injection,a crani-al window was implanted,and TRITC-Dextran 155 ku was ad-ministered intravenously to visualize the vasculature and blood flow dynamics.A custom-built whisker stimulator was used to e-voke controlled neuronal excitation.Two-photon microscopy was employed to monitor neuronal and vascular responses to whisker stimulation in real-time.Results Neuronal calcium signals and plasma signals were clearly observed using two-photon microsco-py.Whisker stimulation led to a significant increase in neuronal calcium signals in the barrel cortex,indicating effective neuronal activation.This neuronal excitation was accompanied by a syn-chronous increase in blood vessel diameter,blood flow velocity and overall blood flow.Conclusions This study successfully establishes a three-dimensional visualization framework(spatial,temporal,and functional)for in vivo visualization of neurovascu-lar coupling in the mouse barrel cortex,which provides a useful tool for investigating the pathophysiological mechanisms of neuro-vascular dysfunction and evaluating the efficacy of potential ther-apies.

The commonly used mechanical thrombectomy devices were introduced in terms of the working principle,advantages,disadvantages and clinical effects.The complications by mechanical thrombectomy devices used for thrombosis clearance were summarized,and the causes were analyzed and some countermeasures were put forward accordingly.It's pointed out mechanical thrombectomy devices would be improved in intelligence,automation,precision,individualization and remote control in the future.[Chinese Medical Equipment Journal,2025,46(8):79-85]

Aim To establish a simple and practical method for visualizing neurovascular coupling in the mouse barrel cortex in vivo.Methods Male C57BL/6J mice received stereotaxic in-jections of pAAV-hSyn-jGCaMP7s-WPRE into the barrel cortex to monitor neuronal activity.Three weeks post-injection,a crani-al window was implanted,and TRITC-Dextran 155 ku was ad-ministered intravenously to visualize the vasculature and blood flow dynamics.A custom-built whisker stimulator was used to e-voke controlled neuronal excitation.Two-photon microscopy was employed to monitor neuronal and vascular responses to whisker stimulation in real-time.Results Neuronal calcium signals and plasma signals were clearly observed using two-photon microsco-py.Whisker stimulation led to a significant increase in neuronal calcium signals in the barrel cortex,indicating effective neuronal activation.This neuronal excitation was accompanied by a syn-chronous increase in blood vessel diameter,blood flow velocity and overall blood flow.Conclusions This study successfully establishes a three-dimensional visualization framework(spatial,temporal,and functional)for in vivo visualization of neurovascu-lar coupling in the mouse barrel cortex,which provides a useful tool for investigating the pathophysiological mechanisms of neuro-vascular dysfunction and evaluating the efficacy of potential ther-apies.

Objective To study the effect of reactive oxygen species(ROS)/p38 MAPK cascade reaction on the formation of kidney stones(KS)in rats and explore the mechanism.Methods Fifty SD rats were randomly divided into control group(normal feeding),N-acetylcysteine(NAC)group(intraperitoneally injected 200 mg/kg NAC),KS group(constructed calcium oxalate KS model),KS+NAC group(constructed calcium oxalate KS model,intraperitoneally injected 200 mg/kg NAC),KS+NAC+tunicamycin(TM)group(constructed calcium oxalate KS model,intraperitoneally injected 200 mg/kg NAC and 1 mg/kg TM),with 10 rats in each group.After 4 weeks of administration,24 hours urine volume and oxalic acid(Ox)of each group were measured,serum creatinine(Cr),urea nitrogen(BUN)and uric acid(UA)levels were detected by automatic biochemical analyzer.HE staining and Von Kossa staining were used to observe the histopathological changes and crystal deposition of the kidney.TUN EL staining was used to detect apoptosis of renal tissue cells.The activity of superoxide dismutase(SOD)and the content of malondialdehyde(MDA)in renal tissue were measured by the kit.DHE fluorescent probes detected the levels of reactive oxygen species(ROS)in kidney tissue.Immunohistochemical staining was used to detect the expressions of microtubule-associated protein 1 light chain 3 B(LC3B)and glucose regulatory protein 78(GRP78)in renal tissue,and the protein expression of LC3 Ⅱ/LC3 Ⅰ,Beclin1,GRP78,CCAAT/enhancer binding protein homologous protein(CHOP)in renal tissue was determined by Western blotting.Results Compared with the KS group,Ox in KS+NAC group decreased(P＜0.05),BUN,Cr and UA levels decreased(P＜0.05),renal tubule dilatation and calcium oxalate crystallization decreased,TUNEL positive cell rate decreased(P＜0.05),SOD activity increased and MDA content decreased(P＜0.05),ROS levels decreased(P＜0.05),LC3B and GRP78 positive staining levels decreased(P＜0.05),the relative protein expressions of p-p38 MAPK/p38 MAPK,LC3 Ⅱ/LC3 Ⅰ,Beclin1,GRP78 and CHOP were down-regulated(P＜0.05).Compared with the KS+NAC group,Ox in KS+NAC+TM group increased(P＜0.05),BUN,Cr and UA levels also increased(P＜0.05),renal tubule dilated significantly,calcium oxalate crystals increased,TUNEL positive cell rate increased(P＜0.05),SOD activity decreased and MDA content increased(P＜0.05),ROS levels increased(P＜0.05),LC3B and GRP78 positive staining levels increased(P＜0.05),the relative protein expressions of p-p38 MAPK/p38 MAPK,LC3 Ⅱ/LC3 Ⅰ,Beclin1,GRP78 and CHOP were also up-regulated(P＜0.05).Conclusion ROS/p38 MAPK cascade is involved in promoting KS formation in rats,which is related to the activation of endoplasmic reticulum stress-mediated autophagy pathway.

Objective To investigate the incidence rate,clinical characteristics,and prognosis of neonatal stroke in Shenzhen,China.Methods Led by Shenzhen Children's Hospital,the Shenzhen Neonatal Data Collaboration Network organized 21 institutions to collect 36 cases of neonatal stroke from January 2020 to December 2022.The incidence,clinical characteristics,treatment,and prognosis of neonatal stroke in Shenzhen were analyzed.Results The incidence rate of neonatal stroke in 21 hospitals from 2020 to 2022 was 1/15 137,1/6 060,and 1/7 704,respectively.Ischemic stroke accounted for 75％(27/36);boys accounted for 64％(23/36).Among the 36 neonates,31(86％)had disease onset within 3 days after birth,and 19(53％)had convulsion as the initial presentation.Cerebral MRI showed that 22 neonates(61％)had left cerebral infarction and 13(36％)had basal ganglia infarction.Magnetic resonance angiography was performed for 12 neonates,among whom 9(75％)had involvement of the middle cerebral artery.Electroencephalography was performed for 29 neonates,with sharp waves in 21 neonates(72％)and seizures in 10 neonates(34％).Symptomatic/supportive treatment varied across different hospitals.Neonatal Behavioral Neurological Assessment was performed for 12 neonates(33％,12/36),with a mean score of(32±4)points.The prognosis of 27 neonates was followed up to around 12 months of age,with 44％(12/27)of the neonates having a good prognosis.Conclusions Ischemic stroke is the main type of neonatal stroke,often with convulsions as the initial presentation,involvement of the middle cerebral artery,sharp waves on electroencephalography,and a relatively low neurodevelopment score.Symptomatic/supportive treatment is the main treatment method,and some neonates tend to have a poor prognosis.

As artificial intelligence technology rapidly advances, its deployment within the medical sector presents substantial ethical challenges. Consequently, it becomes crucial to create a standardized, transparent, and secure framework for processing medical data. This includes setting the ethical boundaries for medical artificial intelligence and safeguarding both patient rights and data integrity. This consensus governs every facet of medical data handling through artificial intelligence, encompassing data gathering, processing, storage, transmission, utilization, and sharing. Its purpose is to ensure the management of medical data adheres to ethical standards and legal requirements, while safeguarding patient privacy and data security. Concurrently, the principles of compliance with the law, patient privacy respect, patient interest protection, and safety and reliability are underscored. Key issues such as informed consent, data usage, intellectual property protection, conflict of interest, and benefit sharing are examined in depth. The enactment of this expert consensus is intended to foster the profound integration and sustainable advancement of artificial intelligence within the medical domain, while simultaneously ensuring that artificial intelligence adheres strictly to the relevant ethical norms and legal frameworks during the processing of medical data.
Artificial Intelligence/legislation & jurisprudence* ; Humans ; Consensus ; Computer Security/standards* ; Confidentiality/ethics* ; Informed Consent/ethics*

OBJECTIVE: To detect the gene mutations in patients with myeloid malignancies by high-throughput sequencing and explore the correlation between gene mutations and prognosis. METHODS: A retrospective analysis was performed on 56 patients with myeloid malignancies who were hospitalized in the department of hematology, Peking University International Hospital from January 2020 to May 2021. The genetic mutations of the patients were detected by next-generation sequencing technology, and the correlation between the genetic mutations and prognosis of myeloid malignancies was analyzed. RESULTS: In 56 patients, the number of mutated genes detected in a single patient is 0-9, with a median of 3. Sequencing results showed that the most common mutated genes were RUNX1(21.4%), TET2(17.9%), DNMT3A(17.9%), TP53(14.3%) and ASXL1(14.3%), among which the most common mutations occurred in the signaling pathway-related genes (23.3%) and the transcription factor genes (18.3%). 84% of the patients carried multiple mutated genes (≥2), and correlation analysis showed there were obvious co-occurring mutations between WT1 and FLT3, NPM1 and FLT3-ITD, and MYC and FLT3. TP53 mutation was more common in MDS patients.The overall survival time of patients with NRAS mutation was significantly shortened (P =0.049). The prognosis of patients with TP53 mutation was poor compared with those without TP53 mutation, but the difference wasn't statistically significant (P =0.08). CONCLUSION The application of next-generation sequencing technology is of great significance in myeloid malignancies, which is helpful to better understand the pathogenesis of the disease, to judge the prognosis and to find possible therapeutic targets.
Humans ; Leukemia, Myeloid, Acute/genetics* ; Nucleophosmin ; Prognosis ; Retrospective Studies ; High-Throughput Nucleotide Sequencing ; Myeloproliferative Disorders ; Mutation

Objective: To investigate the association between the urinary arsenic level and serum total testosterone in Chinese men aged 18 to 79 years. Methods: A total of 5 048 male participants aged 18 to 79 years were recruited from the China National Human Biomonitoring (CNHBM) from 2017 to 2018. Questionnaires and physical examinations were used to collect information on demographic characteristics, lifestyle, food intake frequency and health status. Venous blood and urine samples were collected to detect the level of serum total testosterone, urinary arsenic and urinary creatinine. Participants were divided into three groups (low, middle, and high) based on the tertiles of creatinine-adjusted urinary arsenic concentration. Weighted multiple linear regression was fitted to analyze the association of urinary arsenic with serum total testosterone. Results: The weighted average age of 5 048 Chinese men was (46.72±0.40) years. Geometric mean concentration (95%CI) of urinary arsenic, creatinine-adjusted urinary arsenic and serum testosterone was 22.46 (20.08, 25.12) μg/L, 19.36 (16.92, 22.15) μg/g·Cr and 18.13 (17.42, 18.85) nmol/L, respectively. After controlling for covariates, compared with the low-level urinary arsenic group, the testosterone level of the participants in the middle-level group and the high-level group decreased gradually. The percentile ratio (95%CI) was -5.17% (-13.14%, 3.54%) and -10.33% (-15.68%, -4.63). The subgroup analysis showed that the association between the urinary arsenic level and testosterone level was more obvious in the group with BMI<24 kg/m² group (P_interaction=0.023). Conclusion: There is a negative association between the urinary arsenic level and serum total testosterone in Chinese men aged 18 to 79 years.
Humans ; Male ; Arsenic/urine* ; Creatinine ; East Asian People ; Testosterone/blood* ; Urinalysis ; Adolescent ; Young Adult ; Adult ; Middle Aged ; Aged