Purpose: The aim of this study was to investigate the feasibility of an intelligent handheld ultrasound (US) device for assisting non-expert general practitioners (GPs) in detecting carotid plaques (CPs) in community populations. Methods: This prospective parallel controlled trial recruited 111 consecutive community residents. All of them underwent examinations by non-expert GPs and specialist doctors using handheld US devices (setting A, setting B, and setting C). The results of setting C with specialist doctors were considered the gold standard. Carotid intima-media thickness (CIMT) and the features of CPs were measured and recorded. The diagnostic performance of GPs in distinguishing CPs was evaluated using a receiver operating characteristic curve. Inter-observer agreement was compared using the intragroup correlation coefficient (ICC). Questionnaires were completed to evaluate clinical benefits. Results: Among the 111 community residents, 80, 96, and 112 CPs were detected in settings A, B, and C, respectively. Setting B exhibited better diagnostic performance than setting A for detecting CPs (area under the curve, 0.856 vs. 0.749; P<0.01). Setting B had better consistency with setting C than setting A in CIMT measurement and the assessment of CPs (ICC, 0.731 to 0.923). Moreover, measurements in setting B required less time than the other two settings (44.59 seconds vs. 108.87 seconds vs. 126.13 seconds, both P<0.01). Conclusion Using an intelligent handheld US device, GPs can perform CP screening and achieve a diagnostic capability comparable to that of specialist doctors.

This study aims to screen epitope antigens targeting the receptor binding domain(RBD)of porcine epidemic diarrhea virus(PEDV)based on its amino acid sequence(GenBank accession number:AKN45969.1),prepare PEDV RBD polyclonal antibody,and perform their identification.Bioinformatics analysis software was used to predict the potential antigenic epitopes of PEDV RBD and sequence comparison with porcine coronavirus strains was performed,the selected dominant antigen epitopes were then conjugated with keyhole limpet hemocyanin(KLH),to synthesize pep-tides directly and immunize mice to generate specific antibody,Western blot technique and indirect immunofluorescence assay were utilized to identify the specificity of the antibodies,and indirect ELISA method was further applied to determine the antibody potency.Results showed the selected PEDV RBD dominant epitope sequence shared 100％similarity with 18 other PEDV strains,while exhibiting low sequence similarity with 11 TGEV strains(27.8％—29.3％)and 16 PDCoV strains(10.5％—13.4％),indicating good epitope conservation.Western blot showed that the specificity of the prepared peptide antibody specifically recognized the PEDV RED protein overexpressed in Ex-pi293F cells and overexpressed in baculovirus system,and at the same time,the antibody was still able to detect the PEDV S protein expressed in PEDV-infected Vero cells at a 1∶2 000 dilution,while it did not react with TGEV-and PDCoV-infected ST cells,indicating that the good specificity of the peptide antibody.ELISA revealed that the potency of specific antibodies in mouse serum could reach up to 1∶25 600.The above results indicate that bioinformatics techniques were suc-cessfully utilized to predict antigenic epitopes of PEDV RBD protein,and specific PEDV RBD pep-tide antibodies were prepared.

Purpose To explore the value of contrast-enhanced CT habitat imaging(HI)in preoperative non-invasive visualization for predicting pathological grading of clear cell renal carcinoma(ccRCC).Materials and Methods A retrospective analysis was conducted on enhanced CT images and clinical data from 240 patients with pathologically confirmed ccRCC at Xijing Hospital,the Fourth Military Medical University from January 2020 to December 2023.All patients were randomly divided into training and test sets at a 7:3 ratio and classified into low-grade group(International Society of Urological Pathology Ⅰ-Ⅱ)and high-grade group(International Society of Urological Pathology Ⅲ-Ⅳ)based on postoperative pathology.Using wash-in and wash-out parametric maps,the tumors were segmented into three perfusion-based habitat subregions(low,medium and high)via K-means clustering,and the volume fraction of each subregion was calculated.Predictive factors were selected from habitat features and clinical variables(including sex,age,tumor size,etc.)using Logistic regression.Three models were constructed:a clinical model,a habitat imaging model and a combined clinical-habitat model.Model performance was evaluated using receiver operating characteristic curve,calibration curve and decision curve analysis.Results Habitat 3 exhibited higher wash-in and wash-out gradients compared to Habitats 1 and 2,indicating hyper perfusion.Its proportion was significantly higher in the low-grade group than in the high-grade group(Z=-7.71,-5.11,both P<0.01).Multivariate Logistic regression identified hypertension,maximum tumor diameter and platelet-to-lymphocyte ratio as independent risk factors for high-grade ccRCC,while the proportion of Habitat 3 was a protective factor(OR=0.297,95％CI 0.184-0.479).The combined clinical-habitat model demonstrated the highest predictive performance[area under the curve(AUC)=0.938],significantly outperforming the clinical model(AUC=0.801,Z=-3.832,P<0.01)and the habitat imaging model(AUC=0.895,Z=-2.157,P=0.031).Conclusion The clinical-habitat imaging model achieves the highest predictive performance for ccRCC pathological grading.Contrast-enhanced CT habitat imaging provides significant incremental value in predicting ccRCC pathological grading,showing potential to guide precision medicine in clinical practice.

Objective To propose a multiple regression-variational auto-encoders(MR-VAE)model to realize precise and non-invasive prediction of intra-abdominal pressure(IAP)in critically ill patients.Methods At first,a dataset was constructed by retrospectively analysing baseline characteristics and clinical indicators of 100 critically ill patients admitted to the Intensive Care Unit of Daping Hospital of Army Medical University between 30 August 2019 and 30 March 2021.Then,a MR-VAE prediction model was developed by integrating a feedforward neural network for supervised regression onto a variational autoencoder(VAE)framework and incorporating multiple regression strategies to mitigate feature interference.Finally,the MR-VAE model had its performance evaluated by its comparison with five classical models including support vector machines(SVM),convolutional neural networks(CNN),Scikit-learn integrated model(SIM),multi-layer perceptron(MLP)and K-nearest neighbors(KNN),and its prediction accuracy verified by testing the data of 10 randomly selected patients.Results The MR-VAE model behaved the best when compared with the five classical models,with a mean squared error(MSE)of 0.207,a root mean square error(RMSE)of 0.454,a mean absolute error(MAE)of 0.361,a median absolute deviation(MAD)of 0.243,an explained variance score(EVS)of 0.814 and a R2of 0.823,which also outperformed the five models in fitting performance,convergence and final loss.In random sample testing,the MR-VAE model exhibited high consistency between predicted and actual values.Conclusion The MR-VAE model proposed can accurately predict IAP,which has great potential in reducing the repeated measurements of IAP in critically ill patients and providing new ideas for the early diagnosis and treatment of IAH.

Adipose-derived stem cells(ASCs)have become important seed cells in tissue engineering,because of their unique advantages.Extensive research has been conducted to determine the ideal method of cryopreservation for ASCs.In this review,we summarize the basic cryobiology and cryopreservation protocols for ASCs,and look forward to future research into cryopreservation protocols for ASCs.

AIM To establish the quantitative models for gallic acid,mononucleoside,loganin,resveratrol,and rhein in Yishen Xiezhuo Mixture.METHODS HPLC was adopted in the content determination of various effective components,after which the near-infrared spectroscopy(NIRS)data were collected in 128 batches of samples and pretreatment was conducted,competitive adaptive reweighting sampling(CARS)algorithm was used for screening wavelength,partial least square method(PLS)regression analysis was performed.RESULTS There were no significant differences between the predicted values obtained by PLS models and measured values obtained by HPLC for various effective components(P＞0.05).CONCLUSION The quantitative models established by NIRS combined with chemometrics display good predictive performance,which can be used for the rapid determination of effective components in Yishen Xiezhuo Mixture,and provide a reference for the rapid monitoring of other traditional Chinese medicine preparations in production processes.

Aim To investigate the protective effect of Gualou Guizhi granules(GLGZG)on neuronal injury induced by LPS-activated microglia based on Notch signaling pathway.Methods LPS-activated microglia were co-cultured with neurons to construct neuron inju-ry models,and the cells were divided into the control group,model group,Notch inhibitor(DAPT)group,GLGZG(50,100,200 mg·L-1)group,DAPT+100 mg·L-1GLGZG group.After intervention,the activity of HT22 cells was detected by CCK-8 method,and rel-ative mRNA expression was detected by real-time PCR.The relative protein expression was detected by Western blot.Results Compared with the model group,after GLGZG intervention,the cell activity was significantly improved,GLGZG decreased IL-6,IL-12,Bax,Notch 1,caspase-3,Delta-1,NICD,RBPSUH,HES1 expression,and increased Bcl-2 expression(P＜0.05).Compared with the model group,the NICD,RBPSUH and HES1 mRNA and protein expressions significantly decreased after DAPT treatment(P＜0.05),and there was no superposition effect with GLG-ZG.Conclusion GLGZG may play a neuroprotective role by inhibiting inflammatory factors and apoptosis,and inhibiting Notch signaling pathway.

OBJECTIVE To construct the drug utilization evaluation criteria for Dezocine injection,so as to provide reference for the rational drug use in medical institutions.METHODS On the basis of evidence methodology,relevant guidelines/expert consensus,systematic reviews/meta-analysis were consulted;the evaluation criteria framework for Dezocine injection was established after screening evidence.Delphi method was employed,whereby 28 clinicians and clinical pharmacists from secondary and above-level medical institutions across eight provinces,including Tianjin,Beijing and Shandong,were selected to participate in two rounds of questionnaire surveys.The final indicators were determined based on the experts'enthusiasm coefficient,authority coefficient,and degree of coordination.RESULTS The effective recovery rate of questionnaire was 100%in the first round and 92.86%in the second round;expert authority coefficient was 0.82 in the first round and 0.81 in the second round;the coordination degree of experts in the first round was 0.29,and in the second round was 0.31(P＜0.001).Drug utilization evaluation standard system for Dezocine injection was formed finally,including three dimensions of medication indications,medication process and medication results,with a total of 11 first-level indicators(such as indications,usage and dosage)and 33 second-level indicators(such as labor analgesia and the management of severe pain following major or moderate surgeries combined with other analgesic drugs).The average importance scores for each indicator ranged from 4.08 to 5.00 points,with an overall average score of 4.61 points and coefficient of variation ranging from 0 to 0.19.CONCLUSIONS The drug utilization evaluation criteria for Dezocine injection established based on evidence-based methodology and Delphi method is authoritative and scientific,which provides a reference for subsequent evaluation of the rationality of clinical medication.

Contrast-free percutaneous coronary intervention demonstrates significant value in reducing contrast-associated risks.This article reports a case of a patient with iodine contrast allergy and complex coronary artery disease(involving the left main stem,left anterior descending artery,and diagonal branch),who successfully underwent contrast-free percutaneous coronary intervention(PCI)through the integration of CT angiography(CCTA),intravascular ultrasound(IVUS),and fractional flow reserve(FFR)technology.Preoperative CCTA delineated the anatomy and planned the procedural approach.Intraoperatively,IVUS assessed plaque burden and vascular remodeling,precisely guiding stent selection and positioning.FFR was combined to evaluate the functional significance of the left main stem lesion and the ischemic significance of the specific stenosis in the left anterior descending artery.Post-procedural assessment evaluated stent result and the degree of flow limitation in the diagonal branch.Through"structure-function"dual optimization,revascularization of the left anterior descending artery was achieved using a single-stent strategy,avoiding intervention on the left main stem.This case confirms that multi-modality imaging techniques can safely manage complex lesions,significantly reduce contrast volume,and are suitable for high-risk patients with allergies or renal insufficiency.Future efforts should focus on standardizing technical protocols and accumulating evidence-based evidence to facilitate the clinical implementation of contrast-free interventions.

Objective To investigate the role of the GPR120 gene in the progression of sepsis,explore the molecular mechanisms through which GPR120 gene regulates NOD-,LRR-and pyrin domain-containing protein 3(NLRP3)inflammasome activation and macrophage polarization.Methods The blood and pleural fluid samples were collected from the sepsis patients and the control group.The expression of inflammatory factors and the associated proteins were detected by flow cytometry and ELISA.C57BL/6 mice and monocyte-macrophage cell line(Raw264.7)were treated with lipopolysaccharide(LPS)to construct the sepsis models.After the intervention of GPR120 agonist TUG891,the expression of GPR120 gene,NLRP3 inflammasome protein and macrophage polarization protein were detected between the control group and the sepsis group.Results The expression of inflammatory factors,such as IL-1β in the serum of septic patients,significantly increased compared with the control(P<0.001).And the expression of inflammasome proteins such as NLRP3,Caspase-1 and IL-1β in the pleural fluid also increased(all P<0.05).In vivo,LPS could induce severe inflammation in lung tissue,the GPR120 gene expression decreased in lung tissue,and inflammatory factors were up-regulated in mouse serum(P<0.01).The inflammasome-associated protein and M1 type polarization of macrophages were enhanced,the TUG891 could reduce the inflammatory response,inhibit the NLRP3 inflammasome activating,and promote the M2 polarization of macrophages(P<0.01).In vitro,LPS could inhibit the intracellular GPR120 expression.The inflammatory factors secreted more in LPS-induced sepsis cells.TUG891 could promote the up-regulation of GPR120 protein and alleviate the secretion of inflammatory factors(P<0.05).Conclusion In sepsis,GPR120 gene activation could inhibit the NLRP3 inflammasome activation,promote macrophage polarization,and reduce the inflammatory damage,thereby delay the rapid progression of sepsis.