Objective To investigate the protective effects and mechanisms of sulodexide on renal fibrosis induced by prolonged warm ischemia. Methods An in vivo ischemia-reperfusion injury (IRI) model was established in rats, which were randomly divided into Sham group, IRI 60 min group (IRI group), and IRI 60 min + sulodexide group (IRI+SDX group), with 20 rats in each group. Pathological examination was used to evaluate renal tissue injury and fibrosis levels in each group. Immunohistochemistry was performed to detect the expression levels of kidney injury molecule (KIM)-1, intercellular adhesion molecule (ICAM)-1, von Willebrand factor (vWF), transforming growth factor (TGF)-β, α-smooth muscle actin (SMA), and type I collagen (COL-1). Immunofluorescence staining was used to detect CD31 expression. Real-time quantitative polymerase chain reaction was employed to measure the expression of KIM-1, ICAM-1, tumor necrosis factor (TNF)-α, interleukin (IL)-1β, and IL-6 in renal tissues. Transmission electron microscopy was used to observe the structure of the renal glycocalyx. Evans blue dye was injected to assess renal vascular permeability. Rat survival was recorded, and serum levels of syndecan (SDC)-1, heparan sulfate (HS) and serum creatinine were measured. An ex vivo perfusion model was also established, with rats randomly assigned to either the hypothermic oxygenated machine perfusion (HOPE) group or the HOPE+SDX group (five rats per group). Perfusion parameters were recorded after 2 hours of ex vivo perfusion. Results One day after reperfusion, compared with the Sham group, the IRI group exhibited more severe renal tissue injury, higher tubular injury scores, increased expression of KIM-1, ICAM-1 and vWF, decreased CD31 expression, elevated serum levels of SDC-1 and HS, increased vascular permeability, and higher expression of TNF-α, IL-1β and IL-6. Compared with the IRI group, the IRI+SDX group showed reduced renal tissue injury, lower tubular injury scores, decreased expression of KIM-1, ICAM-1 and vWF, increased CD31 expression, lower serum levels of SDC-1 and HS, decreased vascular permeability, and reduced expression of TNF-α, IL-1β and IL-6 (all P < 0.05). Ten days after reperfusion, renal tissue injury was further alleviated in the IRI+SDX group. Twenty-five days after reperfusion, the IRI+SDX group exhibited decreased expression of TGF-β, α-SMA, and COL-1, as well as reduced collagen deposition area (all P < 0.05). Compared with the HOPE group, the HOPE+SDX group showed increased renal perfusion flow and decreased intrarenal vascular resistance (both P < 0.01). Conclusions Sulodexide may alleviates renal IRI and fibrosis caused by prolonged warm ischemia by inhibiting inflammatory responses and protecting vascular endothelial glycocalyx.

Objective:To analyze the value of diffusion tensor imaging (DTI) combined with magnetic resonance spectroscopy (MRS) in the clinical grading and prognosis assessment of brain glioma.Methods:A retrospective analysis was conducted on the clinical data of 72 patients with brain glioma admitted to Yan'an People's Hospital from January 2010 to December 2023. The cohort included 40 males and 32 females, with ages ranging from 25 to 76 years and an average age of (40.3 ± 6.8) years. All patients underwent routine magnetic resonance imaging plain scans, contrast-enhanced ultrasound examination, DTI, and MRS prior to surgery. Measurements were conducted for fractional anisotropy (FA), N-acetyl aspartate (NAA), choline compounds (Cho), and creatinine (Cr). Additionally, the ratios of NAA/Cho, Cho/Cr, and NAA/Cr were calculated. The imaging characteristics of brain glioma were analyzed, and the clinical utility of these indicators for grading and prognosis assessment of brain glioma was evaluated.Results:DTI results of the 72 included patients revealed disruption of the white matter fiber tracts surrounding the tumors. MRS of the 72 included patients showed either approximately normal values or indicated elevated Cho and Cr levels, along with decreased NAA levels. Diffuse mild to moderate enhancement was observed in 35 patients (48.61%), presenting with a patchy pattern that suggested a higher tumor grade. When comparing low-grade gliomas (LGG) and high-grade gliomas (HGG) to the corresponding healthy tissue, significant differences were observed in FA value in the peritumoral edema region [(0.20 ± 0.06) × 10 -3 mm2/s vs. (0.62 ± 0.08) × 10 -3 mm2/s for LGG, and (0.17 ± 0.05) × 10 -3 mm2/s vs. (0.62 ± 0.09) × 10 -3 mm2/s for HGG] , NAA/Cho ratio [(0.36 ± 0.11) vs. (1.41 ± 0.33) for LGG, and (0.19 ± 0.06) vs. (1.42 ± 0.35) for HGG], Cho/Cr ratio [(2.39 ± 0.51) vs. (1.12 ± 0.26) for LGG, and (3.81 ± 0.94) vs. (1.12 ± 0.28) for HGG], and NAA/Cr ratio [(0.75 ± 0.24) vs. (1.52 ± 0.31) for LGG, and (0.38 ± 0.12) vs. (1.52 ± 0.29) for HGG]. All observed differences were statistically significant ( tLGG = 26.56, 19.09, 14.03, 12.42; tHGG = 27.64, 21.90, 17.34, 22.97, all P < 0.05). There were statistically significant differences in FA [(0.20 ± 0.06) × 10 -3 mm2/s vs. (0.17 ± 0.05) × 10 -3 mm2/s], NAA/Cho [(0.36 ± 0.11) vs. (0.19 ± 0.06)], Cho/Cr [(2.39 ± 0.51) vs. (3.81 ± 0.94)], and NAA/Cr [(0.75 ± 0.24) vs. (0.38 ± 0.12)] between LGG and HGG ( t = 2.26, 7.85, 8.17, 7.95, all P < 0.05). Follow-up conducted 6 months to 3 years postoperatively revealed that the Cho/Cr ratio in the death group was significantly higher than that in the survival group [2.172 (1.662, 2.863) vs. 2.729 (2.431, 3.689), U = 2.17, P < 0.05]. However, there were no statistically significant differences in FA, NAA/Cho, and NAA/Cr values between survival and death groups ( P > 0.05). Conclusions:Combined DTI and MRS can reveal specific imaging characteristics of brain gliomas, providing valuable information for clinical grading of brain gliomas. Furthermore, the Cho/Cr ratio is associated with prognosis and may serve as a potential imaging biomarker for predicting the outcome of brain gliomas.

Objective:This study investigated the expression level of phosphatidylserine-specific phospholipase A1(PLA1A)in colorectal can-cer(CRC)and analyzed its correlations with clinicopathological features,prognosis,and immune infiltration.Methods:The expression level of PLA1A in CRC was screened,and the influence of this expression level on patient prognosis was analyzed using bioinformatics methods.A cohort of 192 patients diagnosed with CRC at Shanxi Province Cancer Hospital from January to December 2020 were selected.The PLA1A ex-pression level in those with CRC was determined using immunohistochemistry(IHC)and real-time quantitative reverse transcription PCR(RT-qPCR).The relationship between PLA1A level and the clinicopathological features of the patients with CRC was analyzed using the chi-square test.The expression levels of immune cell markers CD4 and CD8 as well as immunosuppressive checkpoints PD-1,TIM-3,and CTLA-4 in CRC were detected via IHC,and their correlations with PLA1A level were analyzed using the chi-square test.Results:The results of bioinformatics analysis showed that the expression level of PLA1A in CRC tissue was higher than paracancerous tissue,which correlated with overall surviv-al(OS)(P<0.05).The IHC and RT-qPCR results showed that PLA1A expression level was significantly upregulated in CRC tissiue(P<0.05).High PLA1A level was closely associated with the TNM stage,degree of differentiation,and lymph node metastasis(P<0.05).The IHC results demonstrated that PLA1A positively correlated with the infiltrating CD8+T cell level(P<0.05).In addition,the elevated PLA1A levels upregu-lated the expressions of immunosuppressive checkpoints PD-1,TIM-3,and CTLA-4(P<0.05).Conclusions:PLA1A is highly expressed in CRC,which is closely related to immune infiltrating cells and immunosuppressive checkpoints,suggesting that PLA1A plays an important role in immune infiltration in CRC,a finding that provides guidance in the treatment of CRC.

Objective:To investigate the efficacy of cementless long-stem total hip arthroplasty (THA) in the treatment of end-stage osteonecrosis of the femoral head (ONFH) combined with ipsilateral subtrochanteric femoral fractures.Methods:A retrospective case series study was conducted on 18 patients with end-stage ONFH combined with ipsilateral subtrochanteric fractures who were admitted to the 940th Hospital of the Joint Logistics Support Force of the PLA from January 2016 to June 2023, including 8 males (8 hips) and 10 females (10 hips), aged 56-79 years [(69.4±7.0)years]. All the patients had Association Research Circulation Osseous (ARCO) stage IV ONFH combined with ipsilateral subtrochanteric fracture (Seinsheimer types II-IV). Parameters recorded included operation duration, intraoperative blood loss, length of hospital stay, time to partial weight-bearing, and time to full weight-bearing. Vertical offset and leg length discrepancy (LLD) were compared preoperatively and at 1 week postoperatively. Visual analogue scale (VAS) score, hip range of motion (flexion, abduction), and Harris hip score (HHS) were compared preoperatively, at 1 week, 3 months postoperatively, and at the last follow-up. Perioperative complications were observed.Results:All the patients were followed up for 12-70 months [(36.4±16.2)months]. Operation duration was (116.4±18.1)minutes. Intraoperative blood loss was (334.4±121.3)ml. The length of hospital stay was 13.0(10.0, 16.3)days. The time to partial weight-bearing was 5.0(3.0, 7.0)days, with time to full weight-bearing for 5.0(4.0, 5.3)weeks. At 1 week postoperatively, the vertical offset [(58.9±4.1)mm] was significantly increased compared to that preoperatively [(49.3±3.3)mm] ( P<0.01), while the LLD [(4.2±3.1)mm] was significantly reduced compared to that preoperatively [(16.2±5.8)mm] ( P<0.01). At 1 week, 3 months postoperatively and at the last follow-up, the VAS scores [3.0(2.0, 3.3)points, 2.0(1.0, 2.0)points, and 1.0(0.0, 2.0)points] were significantly lower than that preoperatively [6.0(5.0, 6.3)points], and decreased with the passage of follow-up time ( P<0.01); the hip flexion angles [(50.4±6.5)°, (94.3±6.4)°, and (104.7±7.4)°] and hip abduction angles [(21.5±4.4)°, (34.9±4.5)°, and (42.9±4.9)°] were lower than those preoperatively [(32.9±6.4)° and (13.4±4.9)°], and decreased with the passage of follow-up time ( P<0.01); the HHS [(58.1±4.9)points, (83.1±2.9)points, and (90.7±2.6)points] were higher than that preoperatively [(33.4±4.4)points], and increased with the passage of follow-up time ( P<0.01). At the last follow-up, 5 patients were rated as excellent, 11 as good, and 2 as fair according to the HHS criteria, with an overall excellent and good rate of 89%. No perioperative complications were observed, including neurovascular injury, secondary fracture, or infection. One patient developed partial deep vein thrombosis of the lower extremity (the popliteal vein) at 2 weeks after surgery, which recovered completely following treatment with a standard oral administration of rivaroxaban, etc. At the last follow-up, no evidence of malunion, prosthesis loosening, subsidence, or dislocation was observed. Conclusion:The use of cementless long-stem THA in the treatment of end-stage ONFH combined with ipsilateral subtrochanteric fractures has advantages of small trauma, early weight-bearing, early pain relief, improved joint motion and function, and few complications.

Chronic pain is common in clinic.Various image-guided treatment methods can be used to alleviate pain.Interventional MRI(iMRI)has unique advantages for treating and evaluating prognosis of chronic pain.The research progresses in iMRI-guided treatments of chronic pain were reviewed in this article.

Clinical management of hepatocellular carcinoma(HCC)faces challenges such as late detection,high recurrence rate and inefficient traditional treatment.Visualized MR nanoprobes had not only enhanced tumor imaging and improved diagnostic sensitivity,but also enabled targeted delivery of therapeutic genes or drugs,facilitated targeted treatment and real-time assessment for therapeutic effects,thereby advanced the integration of diagnosis and treatment for HCC.The research progresses in visualized MR nanoprobes for diagnosis and treatment of HCC were reviewed in this article.

Clinical management of hepatocellular carcinoma(HCC)faces challenges such as late detection,high recurrence rate and inefficient traditional treatment.Visualized MR nanoprobes had not only enhanced tumor imaging and improved diagnostic sensitivity,but also enabled targeted delivery of therapeutic genes or drugs,facilitated targeted treatment and real-time assessment for therapeutic effects,thereby advanced the integration of diagnosis and treatment for HCC.The research progresses in visualized MR nanoprobes for diagnosis and treatment of HCC were reviewed in this article.

Objective:To analyze the value of diffusion tensor imaging (DTI) combined with magnetic resonance spectroscopy (MRS) in the clinical grading and prognosis assessment of brain glioma.Methods:A retrospective analysis was conducted on the clinical data of 72 patients with brain glioma admitted to Yan'an People's Hospital from January 2010 to December 2023. The cohort included 40 males and 32 females, with ages ranging from 25 to 76 years and an average age of (40.3 ± 6.8) years. All patients underwent routine magnetic resonance imaging plain scans, contrast-enhanced ultrasound examination, DTI, and MRS prior to surgery. Measurements were conducted for fractional anisotropy (FA), N-acetyl aspartate (NAA), choline compounds (Cho), and creatinine (Cr). Additionally, the ratios of NAA/Cho, Cho/Cr, and NAA/Cr were calculated. The imaging characteristics of brain glioma were analyzed, and the clinical utility of these indicators for grading and prognosis assessment of brain glioma was evaluated.Results:DTI results of the 72 included patients revealed disruption of the white matter fiber tracts surrounding the tumors. MRS of the 72 included patients showed either approximately normal values or indicated elevated Cho and Cr levels, along with decreased NAA levels. Diffuse mild to moderate enhancement was observed in 35 patients (48.61%), presenting with a patchy pattern that suggested a higher tumor grade. When comparing low-grade gliomas (LGG) and high-grade gliomas (HGG) to the corresponding healthy tissue, significant differences were observed in FA value in the peritumoral edema region [(0.20 ± 0.06) × 10 -3 mm2/s vs. (0.62 ± 0.08) × 10 -3 mm2/s for LGG, and (0.17 ± 0.05) × 10 -3 mm2/s vs. (0.62 ± 0.09) × 10 -3 mm2/s for HGG] , NAA/Cho ratio [(0.36 ± 0.11) vs. (1.41 ± 0.33) for LGG, and (0.19 ± 0.06) vs. (1.42 ± 0.35) for HGG], Cho/Cr ratio [(2.39 ± 0.51) vs. (1.12 ± 0.26) for LGG, and (3.81 ± 0.94) vs. (1.12 ± 0.28) for HGG], and NAA/Cr ratio [(0.75 ± 0.24) vs. (1.52 ± 0.31) for LGG, and (0.38 ± 0.12) vs. (1.52 ± 0.29) for HGG]. All observed differences were statistically significant ( tLGG = 26.56, 19.09, 14.03, 12.42; tHGG = 27.64, 21.90, 17.34, 22.97, all P < 0.05). There were statistically significant differences in FA [(0.20 ± 0.06) × 10 -3 mm2/s vs. (0.17 ± 0.05) × 10 -3 mm2/s], NAA/Cho [(0.36 ± 0.11) vs. (0.19 ± 0.06)], Cho/Cr [(2.39 ± 0.51) vs. (3.81 ± 0.94)], and NAA/Cr [(0.75 ± 0.24) vs. (0.38 ± 0.12)] between LGG and HGG ( t = 2.26, 7.85, 8.17, 7.95, all P < 0.05). Follow-up conducted 6 months to 3 years postoperatively revealed that the Cho/Cr ratio in the death group was significantly higher than that in the survival group [2.172 (1.662, 2.863) vs. 2.729 (2.431, 3.689), U = 2.17, P < 0.05]. However, there were no statistically significant differences in FA, NAA/Cho, and NAA/Cr values between survival and death groups ( P > 0.05). Conclusions:Combined DTI and MRS can reveal specific imaging characteristics of brain gliomas, providing valuable information for clinical grading of brain gliomas. Furthermore, the Cho/Cr ratio is associated with prognosis and may serve as a potential imaging biomarker for predicting the outcome of brain gliomas.

Chronic pain is common in clinic.Various image-guided treatment methods can be used to alleviate pain.Interventional MRI(iMRI)has unique advantages for treating and evaluating prognosis of chronic pain.The research progresses in iMRI-guided treatments of chronic pain were reviewed in this article.

Objective:This study investigated the expression level of phosphatidylserine-specific phospholipase A1(PLA1A)in colorectal can-cer(CRC)and analyzed its correlations with clinicopathological features,prognosis,and immune infiltration.Methods:The expression level of PLA1A in CRC was screened,and the influence of this expression level on patient prognosis was analyzed using bioinformatics methods.A cohort of 192 patients diagnosed with CRC at Shanxi Province Cancer Hospital from January to December 2020 were selected.The PLA1A ex-pression level in those with CRC was determined using immunohistochemistry(IHC)and real-time quantitative reverse transcription PCR(RT-qPCR).The relationship between PLA1A level and the clinicopathological features of the patients with CRC was analyzed using the chi-square test.The expression levels of immune cell markers CD4 and CD8 as well as immunosuppressive checkpoints PD-1,TIM-3,and CTLA-4 in CRC were detected via IHC,and their correlations with PLA1A level were analyzed using the chi-square test.Results:The results of bioinformatics analysis showed that the expression level of PLA1A in CRC tissue was higher than paracancerous tissue,which correlated with overall surviv-al(OS)(P<0.05).The IHC and RT-qPCR results showed that PLA1A expression level was significantly upregulated in CRC tissiue(P<0.05).High PLA1A level was closely associated with the TNM stage,degree of differentiation,and lymph node metastasis(P<0.05).The IHC results demonstrated that PLA1A positively correlated with the infiltrating CD8+T cell level(P<0.05).In addition,the elevated PLA1A levels upregu-lated the expressions of immunosuppressive checkpoints PD-1,TIM-3,and CTLA-4(P<0.05).Conclusions:PLA1A is highly expressed in CRC,which is closely related to immune infiltrating cells and immunosuppressive checkpoints,suggesting that PLA1A plays an important role in immune infiltration in CRC,a finding that provides guidance in the treatment of CRC.