To address the issues of difficulty in preserving anatomical structures, low realism of generated images, and loss of high-frequency image information in medical image cross-modal translation, this paper proposes a medical image cross-modal translation method based on diffusion generative adversarial networks. First, an unsupervised translation module is used to convert magnetic resonance imaging (MRI) into pseudo-computed tomography (CT) images. Subsequently, a nonlinear frequency decomposition module is used to extract high-frequency CT images. Finally, the pseudo-CT image is input into the forward process, while the high-frequency CT image as a conditional input is used to guide the reverse process to generate the final CT image. The proposed model is evaluated on the SynthRAD2023 dataset, which is used for CT image generation for radiotherapy planning. The generated brain CT images achieve a Fréchet Inception Distance (FID) score of 33.159 7, a structure similarity index measure (SSIM) of 89.84%, a peak signal-to-noise ratio (PSNR) of 35.596 5 dB, and a mean squared error (MSE) of 17.873 9. The generated pelvic CT images yield an FID score of 33.951 6, a structural similarity index of 91.30%, a PSNR of 34.870 7 dB, and an MSE of 17.465 8. Experimental results show that the proposed model generates highly realistic CT images while preserving anatomical accuracy as much as possible. The transformed CT images can be effectively used in radiotherapy planning, further enhancing diagnostic efficiency.
Humans ; Tomography, X-Ray Computed/methods* ; Magnetic Resonance Imaging/methods* ; Image Processing, Computer-Assisted/methods* ; Neural Networks, Computer ; Brain/diagnostic imaging* ; Algorithms ; Radiotherapy Planning, Computer-Assisted ; Generative Adversarial Networks

Epidermal growth factor receptor inhibitor (EGFRI) -related paronychia is a condition clearly related to EGFRI therapy, characterized by periungual erythema, edema, purulent exudates, periungual or subungual granulomatous lesions, and sometimes accompanied by thinning, fragility or even splitting and seperation of nail plates. Inhibition of epidermal function, inflammation and secondary infections, as well as angiogenesis are the core processes in the occurrence and development of EGFRI-related paronychia. This review summarizes epidemiology, pathogenesis, clinical manifestations, prevention and treatment of EGFRI-related paronychia.

Objective:To establish a liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for the determination of N-desalkylquetiapine, hydroxybupropion, N-desmethyl clozapine, N-desmethyl clomipramine, O-desmethyvenlafaxine and dehydro aripiprazole in human plasma.Methods:In June 2023, plasma samples were treated with methanol-acetonitrile (volume ratio of 1∶1) for protein precipitation and then detected by LC-MS/MS. It was separated by C18 column and eluted with 5 mmol/L ammonium acetate water and 5 mmol/L ammonium acetate methanol solution as mobile phase gradient. The metabolites of six psychotropic drugs were qualitatively and quantitatively by using electrospray positive ion multi-reactive ion monitoring scanning mode (MRM) .Results:The linear relationships of six psychotropic drug metabolites were good in the concentration range of 2-100 μg/L. The linear correlation coefficients were 0.9971-0.9999, the limits of quantification of the method were 0.10-6.00 μg/L, and the inter-and intra-day precision were 4.6%-9.8% and 1.5%-8.6%, with the recoveries of the spiked standards ranged from 90.0% to 106.1%.Conclusion:The LC-MS/MS method for the determination of metabolites of six psychotropic drugs in human plasma is simple, rapid and sensitive, and can be used for the qualitative and quantitative determination of metabolites in plasma samples of patients suspected of psychotropic drug poisoning.

Objective To explore the protective effects of genetically modified porcine erythrocyte suspension as a subnormothermic normoxic mechanical perfusate on hypoxic-ischemic brain injury in cynomolgus monkeys caused by traumatic hemorrhage.Methods Cynomolgus monkeys were randomly divided into positive and negative control groups(a total of 3 monkeys,with 3 left cerebral hemispheres as the positive control group and 3 right cerebral hemispheres as the negative control group)and the subnormothermic perfusion group(n=3).The positive control group was directly sampled 1 hour after circulatory arrest,while the negative control group was placed at subnormothermic conditions for 6 hours after circulatory arrest.The subnormothermic perfusion group underwent 6 hours of subnormothermic normoxic mechanical perfusion of the bilateral common carotid arteries of the cynomolgus monkey hypoxic-ischemic brain injury model using genetically modified porcine erythrocyte suspension 1 hour after circulatory arrest.Before perfusion,cross-matching experiments were conducted between the six genetically modified pig and the cynomolgus monkeys.After the start of perfusion,the levels of routine blood indicators in the perfusate were detected at 0,1,2,3,4,5 and 6 hours.Blood oxygen saturation was recorded,and the levels of Na+,K+,Ca2+,glucose and blood pH in the perfusate were measured,as well as the levels of IgG and IgM in the perfusate.After 6 hours of perfusion,the water content of the brain tissue was measured.Nissl staining was performed on the frontal cortex and hippocampal regions,and immunofluorescence staining was used to detect the expression of glial fibrillary acidic protein(GFAP),ionized calcium-binding adapter molecule 1(Iba1)and neuronal nuclear antigen(NEUN).Results The cross-matching results between the six genetically modified pig and the cynomolgus monkeys were negative.The number of red blood cells in the perfusate decreased significantly at 3 hours of perfusion,and the hemoglobin level showed a downward trend at 1,3,5 and 6 hours.The number of white blood cells and platelets decreased at all time points.The blood oxygen saturation in the subnormothermic perfusion group remained stable at 95%-98%,and the levels of blood oxygen saturation,Na+,Ca2+,glucose and pH were stable,while the K+level first increased and then decreased.There was no significant difference in the levels of IgG and IgM before and after perfusion.The water content of brain tissue at the end of perfusion in the subnormothermic perfusion group was significantly higher than that in the positive control group(P<0.001).Nissl staining results showed that compared with the positive control group,the pyramidal neurons in the prefrontal cortex of the subnormothermic perfusion group maintained better morphological integrity,with no significant increase in enlarged and deformed cells.In the hippocampal CA1 region,there was a slight increase in enlarged and deformed cells,and a few cells with undamaged structures showed reduced cell size.In the hippocampal dentate gyrus,fewer granule neurons had compromised structural integrity,with increased cell edema.NEUN immunofluorescence staining showed that compared with the positive control group,the pyramidal neurons in the prefrontal cortex and hippocampal CA1 region of the subnormothermic perfusion group had better morphological states,with clear axons.The granule cells in the hippocampal dentate gyrus were well preserved,but the nuclei were less well protected.GFAP immunofluorescence staining showed that compared with the positive control group,the subnormothermic perfusion group had sparser protrusions that were more tightly associated with neurons.Iba1 immunofluorescence staining showed that compared with the positive control group,the subnormothermic perfusion group had thicker and fewer protrusions.Conclusions Compared with the positive control group,subnormothermic normoxic mechanical perfusion with genetically modified porcine erythrocyte perfusate increases brain tissue edema in cynomolgus monkeys,but better preserves the morphological integrity of neurons and glial cells.The protective effects may be related to the continuous oxygen and energy supply,maintenance of ion homeostasis and perfusate pH,reduced rejection,and low metabolic state of the whole brain.

Objective:To establish a liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for the determination of N-desalkylquetiapine, hydroxybupropion, N-desmethyl clozapine, N-desmethyl clomipramine, O-desmethyvenlafaxine and dehydro aripiprazole in human plasma.Methods:In June 2023, plasma samples were treated with methanol-acetonitrile (volume ratio of 1∶1) for protein precipitation and then detected by LC-MS/MS. It was separated by C18 column and eluted with 5 mmol/L ammonium acetate water and 5 mmol/L ammonium acetate methanol solution as mobile phase gradient. The metabolites of six psychotropic drugs were qualitatively and quantitatively by using electrospray positive ion multi-reactive ion monitoring scanning mode (MRM) .Results:The linear relationships of six psychotropic drug metabolites were good in the concentration range of 2-100 μg/L. The linear correlation coefficients were 0.9971-0.9999, the limits of quantification of the method were 0.10-6.00 μg/L, and the inter-and intra-day precision were 4.6%-9.8% and 1.5%-8.6%, with the recoveries of the spiked standards ranged from 90.0% to 106.1%.Conclusion:The LC-MS/MS method for the determination of metabolites of six psychotropic drugs in human plasma is simple, rapid and sensitive, and can be used for the qualitative and quantitative determination of metabolites in plasma samples of patients suspected of psychotropic drug poisoning.

Objective To explore the protective effects of genetically modified porcine erythrocyte suspension as a subnormothermic normoxic mechanical perfusate on hypoxic-ischemic brain injury in cynomolgus monkeys caused by traumatic hemorrhage.Methods Cynomolgus monkeys were randomly divided into positive and negative control groups(a total of 3 monkeys,with 3 left cerebral hemispheres as the positive control group and 3 right cerebral hemispheres as the negative control group)and the subnormothermic perfusion group(n=3).The positive control group was directly sampled 1 hour after circulatory arrest,while the negative control group was placed at subnormothermic conditions for 6 hours after circulatory arrest.The subnormothermic perfusion group underwent 6 hours of subnormothermic normoxic mechanical perfusion of the bilateral common carotid arteries of the cynomolgus monkey hypoxic-ischemic brain injury model using genetically modified porcine erythrocyte suspension 1 hour after circulatory arrest.Before perfusion,cross-matching experiments were conducted between the six genetically modified pig and the cynomolgus monkeys.After the start of perfusion,the levels of routine blood indicators in the perfusate were detected at 0,1,2,3,4,5 and 6 hours.Blood oxygen saturation was recorded,and the levels of Na+,K+,Ca2+,glucose and blood pH in the perfusate were measured,as well as the levels of IgG and IgM in the perfusate.After 6 hours of perfusion,the water content of the brain tissue was measured.Nissl staining was performed on the frontal cortex and hippocampal regions,and immunofluorescence staining was used to detect the expression of glial fibrillary acidic protein(GFAP),ionized calcium-binding adapter molecule 1(Iba1)and neuronal nuclear antigen(NEUN).Results The cross-matching results between the six genetically modified pig and the cynomolgus monkeys were negative.The number of red blood cells in the perfusate decreased significantly at 3 hours of perfusion,and the hemoglobin level showed a downward trend at 1,3,5 and 6 hours.The number of white blood cells and platelets decreased at all time points.The blood oxygen saturation in the subnormothermic perfusion group remained stable at 95%-98%,and the levels of blood oxygen saturation,Na+,Ca2+,glucose and pH were stable,while the K+level first increased and then decreased.There was no significant difference in the levels of IgG and IgM before and after perfusion.The water content of brain tissue at the end of perfusion in the subnormothermic perfusion group was significantly higher than that in the positive control group(P<0.001).Nissl staining results showed that compared with the positive control group,the pyramidal neurons in the prefrontal cortex of the subnormothermic perfusion group maintained better morphological integrity,with no significant increase in enlarged and deformed cells.In the hippocampal CA1 region,there was a slight increase in enlarged and deformed cells,and a few cells with undamaged structures showed reduced cell size.In the hippocampal dentate gyrus,fewer granule neurons had compromised structural integrity,with increased cell edema.NEUN immunofluorescence staining showed that compared with the positive control group,the pyramidal neurons in the prefrontal cortex and hippocampal CA1 region of the subnormothermic perfusion group had better morphological states,with clear axons.The granule cells in the hippocampal dentate gyrus were well preserved,but the nuclei were less well protected.GFAP immunofluorescence staining showed that compared with the positive control group,the subnormothermic perfusion group had sparser protrusions that were more tightly associated with neurons.Iba1 immunofluorescence staining showed that compared with the positive control group,the subnormothermic perfusion group had thicker and fewer protrusions.Conclusions Compared with the positive control group,subnormothermic normoxic mechanical perfusion with genetically modified porcine erythrocyte perfusate increases brain tissue edema in cynomolgus monkeys,but better preserves the morphological integrity of neurons and glial cells.The protective effects may be related to the continuous oxygen and energy supply,maintenance of ion homeostasis and perfusate pH,reduced rejection,and low metabolic state of the whole brain.

Epidermal growth factor receptor inhibitor (EGFRI) -related paronychia is a condition clearly related to EGFRI therapy, characterized by periungual erythema, edema, purulent exudates, periungual or subungual granulomatous lesions, and sometimes accompanied by thinning, fragility or even splitting and seperation of nail plates. Inhibition of epidermal function, inflammation and secondary infections, as well as angiogenesis are the core processes in the occurrence and development of EGFRI-related paronychia. This review summarizes epidemiology, pathogenesis, clinical manifestations, prevention and treatment of EGFRI-related paronychia.

Objective To investigate the expression levels of serum miR-145 and HMGB3 in patients with gallbladder cancer(GBC)and their correlation with disease progression,verify the effects of miR-145 on HMGB3 expression and the proliferation and ap-optosis of GBC cells,and evaluate its feasibility as a potential diagnostic and prognostic biomarker.Methods Ninety patients with gall-bladder cancer admitted to the First Affiliated Hospital of Hebei North University from September 2018 to June 2022 were selected as the disease group,and 40healthy subjects were selected as the normal control group.The expression levels of serum miR-145 and HMGB3 in two groups were detected.The relationship between different clinicopathological features and the expression levels of miR-145 and HMGB3 was compared.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of serum miR-145 and HMGB3;Kaplan-Meier survival curve was used to evaluate the 3-year survival rate of patients with different miR-145 and HMGB3 ex-pression levels.The effects of miR-145 on proliferation and apoptosis of GBC cells were analyzed by CCK-8 assay and flow cytometry.The protein expression was detected by Western blot.The apoptosis rate of each group was detected by flow cytometry.The direct interac-tion between miR-145 and HMGB3 was verified by double luciferase reporter gene assay.Results The expression level of miR-145 in serum of patients with GBC was significantly decreased(P＜0.05),while the expression level of HMGB3 was significantly increased(P＜0.05).The expressions of serum miR-145 and HMGB3 were correlated with differentiation degree,lymph node metastasis and TNM stage(P＜0.05).ROC curve analysis showed that serum miR-145 and HMGB3had high diagnostic value.Kaplan-Meire survival curve analysis showed that the 3-year survival rate of miRNA-143high expression subgroup was higher than that of low expression sub-group(P＜0.05),and the 3-year survival rate of HMGB3 low expression subgroup was significantly higher than that of high expression subgroup(P＜0.05).Overexpression of miR-145 inhibited the proliferation of GBC cells,significantly increased the expression of Bax protein in BGC-SD cells(P＜0.05),decreased the expression of Bel-2 protein(P＜0.05),decreased the expression of HMGB3 pro-tein(P＜0.05),and increased the apoptosis rate of BGC-SD cells.Double luciferase reporter gene assay showed that HMGB3 was the target of miR-145.Conclusion The downregulation of miR-145 is significantly associated with the upregulation of HMGB3 in GBC,and is related to the severity of the disease.Overexpression of miR-145 can significantly inhibit the proliferation and promote apoptosis of GBC cells,and the mechanism of action may be achieved by directly targeting HMGB3.Therefore,miR-145 and HMGB3may serve as potential biomarkers for the diagnosis and prognosis of GBC,providing a new strategy for molecular targeted therapy of GBC.

Objective Based on ultra-high-performance liquid chromatography-quadrupole time-of-flight tandem mass spectrometry(UPLC-QTOF-MS/MS),a nontarget screening strategy was adopted in analyzing and identifying emerging pollutants(EPs)in tap water across the country,and studying its spatial and temporal distribution characteristics.Methods After extracting tap water samples by solid phase extraction,mobile phases(0.1%aqueous formic acid and methanol solutions)was used to elute the sample on a C18 chromatographic column.The nontarget screening strategy was used to acquire the MS information in full scan mode.We extracted and analyzed the chromatographic and mass spectral peaks,then searched the spectral library to compare the exact mass numbers,and the secondary MS/MS spectra fragment ion information was compared one by one.Finally,the retention time and the mass spectrum data of candidate EPs were identified and analyzed with the data of standard samples.then quantified by the internal standard method.Results A total of 135 EPs were initially screened from tap water across the country and 24 with high chromatographic peak response were finally selected and verified by standard products,including 6 pharmaceuticals,13 pesticides,3 industrial compounds and 2 food additives.Nine of them showed detection rates of more than 60%,such as canrenone,medroxyprogesterone,hydrocortisone acetate,etc.The concentrations of detected pollutants range from ND 422.63 ng/L.And the four contaminants with higher average concentrations were canrenone,medroxyprogesterone,hydrocortisone acetate and tris(2-butoxyethyl)phosphate.Conclusion In this study,a nontarget strategy based on UPLC-QTOF-MS/MS was adopted to screen potential unknown pollutants with no-standards,and explored the overall contamination status of tap water samples.This contributed to more comprehensive understanding of the EPs distribution,and provided technical support for monitoring the EPs in tap water.

Objective:To investigate the clinical characteristics of psoriasis and status quo of medical care for patients in county areas of China.Methods:This study was a cross-sectional investigation. Based on the “Qianxian Wuyin” Project (a national project for upgrating ability for psoriasis care at county level), an online questionnaire survey was conducted in the dermatology departments of 459 county hospitals in 404 pilot administrative counties across China from February to June 2023. The questionnaire included demographic information of patients (gender, ethnicity, age, place of residence, education, marital status), and clinical characteristics of psoriasis (disease course, type, comorbidities, body surface area (BSA) and previous treatment. The Dermatology Life Quality Index (DLQI) and Psoriasis Area and Severity Index (PASI) were applied for assessing the quality of life and disease severity, and completed by patients or guardian and doctors, respectively.Results:A total of 16 935 patients completed the questionnaire. The age of patients was 1-102(44.17±11.58)years, and 71.0% (12 036/16 935) were 30-59 years old. The ratio of male to female was 2.21∶1; 24.3%(4 117/16 935) of patients had high school education; there were 9 940 patients(58.7%) with previous or current smoking and/or alcohol use; 42.8%(7 218/16 855) of patients had a disease course of 1-5 years. There were 15 630 patients(92.3%) with DLQI≥10, 8 346 patients(49.7%) with PASI≥10, 15 017 patients(89.2%) with BSA≥10%. The plaque type was the most common disease type ( n=14 965, 88.7%), and spotting type ranked the second ( n=1 141, 6.8%). The most common initial site was the trunk ( n=12 309, 72.9%). Among the comorbidities, hypertension was the most common one ( n=1 681, 10.0%). There were 7 650 reports of treatment response to conventional topical drug therapy and 3 112 reports of treatment response to systemic drug therapy, with 6 269 (81.9%) and 2 493 (80.1%) reporting poor or no response, respectively. Conclusions:The survey shows that in the county areas of China, the majority of psoriasis patients are severe patients with short course of disease, plaque type is the most common type, and hypertension is the most common comorbidity; and the conventional treatment is less effective for most patients.