Objective To explore the relationship between the expression of microRNA-433-3p(miR-433-3p)and β microtubule Ⅴ(TUBB6)in bladder cancer tissue and its pathological characteristics,and its predictive value for postoperative recurrence.Methods From August 2021 to August 2022,116 patients with bladder cancer underwent surgery for cancer tissue and adjacent tissue,and which were divided into recurrence group(43 cases)and non recurrence group(73 cases)according to whether there was local recurrence or distant recurrence and metastasis after surgery.The quantitative real-time polymerase chain reaction(qRT-PCR)was used to detect the mRNA levels of miR-433-3p and TUBB6.The influencing factors of postoperative recurrence of bladder cancer were analyzed by logistic regression.The predictive value of miR-433-3p and TUBB6 in postoperative recurrence of bladder cancer was analyzed by receiver operating characteristic(ROC)curve.Results The level of miR-433-3p in cancer tissue was obviously lower than that in adjacent tissue(P＜0.05),and the level of TUBB6 was obviously higher than that in adjacent tissue(P＜0.05).The level of miR-433-3p was significantly reduced(P＜0.05)in patients with TNM stage Ⅲ+Ⅳ,histological differentiation to low differentiation,and tumor infiltration,while the level of TUBB6 mRNA was significantly increased(P＜0.05).The serum miR-433-3p level in the recurrent group was significantly lower than that in the non recurrent group,,The level of TUBB6 mRNA was higher in the non recurrent group,and the difference was statistically significant(P＜0.05).TNM stage Ⅲ+Ⅳ,tumor infiltration,and high expression of TUBB6 are independent risk factors for postoperative recurrence in patients(P＜0.05),while high expression of miR-433-3p is an independent protective factor(P＜0.05).ROC curve analysis shows that,,the area under curve(AUC)predicted by serum miR-433-3p and TUBB6 levels in combination was significantly higher than that predicted by a single index(Z-miR-433-3p=2.323,Z-TUB6=1.961,P=0.020,0.048),sensitivity of 95.35％,specificity of 82.19％.Conclusion The expression of miR-433-3p and TUBB6 in bladder cancer tissues is closely related to pathological features,and the combination of the two tissues has a higher predictive value for postoperative recurrence.

Objective:To analyze the epidemiological characteristics and spatiotemporal distribution of hepatitis C in Henan province from 2012 to 2022.Methods:The case report data on hepatitis C from counties and districts in Henan between 2012 and 2022 were collected. The distribution characteristics were analyzed by descriptive epidemiological methods, and GeoDa1.2 software was used to perform spatial autocorrelation analysis. The spatiotemporal epidemiological analysis was conducted using SaTScan 10.1 software.Results:A total of 274 485 hepatitis C cases were reported in Henan from 2012 to 2022. The reported annual average incidence rate was 25.84/100 000 and showed an overall downward trend from 2012 to 2022 ( Z=-4.05, P<0.001). More cases were reported in women. The cases were mainly aged 40-69 years and farmers. Spatial autocorrelation analysis showed that the reported cases of hepatitis C present spatial clustering during 2012—2022, and the areas with high incidence were mainly distributed in counties or districts of Zhengzhou, Zhumadian, Xuchang, Zhoukou, and Nanyang. One class I clustering area was detected by spatiotemporal scanning, which mainly covered Xuchang, Pingdingshan and the surrounding counties ( LLR=16 117.73, RR=1.81, P<0.001). Conclusion:The reported cases of hepatitis C in Henan Province show an overall downward trend from 2012 to 2022 and present spatiotemporal clustering. The seasonal regularity of the hepatitis C epidemic is not obvious. People aged 40-69 years old and farmers are the key population for prevention and control.

Objective:To analyze the epidemiological characteristics and spatiotemporal distribution of hepatitis C in Henan province from 2012 to 2022.Methods:The case report data on hepatitis C from counties and districts in Henan between 2012 and 2022 were collected. The distribution characteristics were analyzed by descriptive epidemiological methods, and GeoDa1.2 software was used to perform spatial autocorrelation analysis. The spatiotemporal epidemiological analysis was conducted using SaTScan 10.1 software.Results:A total of 274 485 hepatitis C cases were reported in Henan from 2012 to 2022. The reported annual average incidence rate was 25.84/100 000 and showed an overall downward trend from 2012 to 2022 ( Z=-4.05, P<0.001). More cases were reported in women. The cases were mainly aged 40-69 years and farmers. Spatial autocorrelation analysis showed that the reported cases of hepatitis C present spatial clustering during 2012—2022, and the areas with high incidence were mainly distributed in counties or districts of Zhengzhou, Zhumadian, Xuchang, Zhoukou, and Nanyang. One class I clustering area was detected by spatiotemporal scanning, which mainly covered Xuchang, Pingdingshan and the surrounding counties ( LLR=16 117.73, RR=1.81, P<0.001). Conclusion:The reported cases of hepatitis C in Henan Province show an overall downward trend from 2012 to 2022 and present spatiotemporal clustering. The seasonal regularity of the hepatitis C epidemic is not obvious. People aged 40-69 years old and farmers are the key population for prevention and control.

Objective To explore the relationship between the expression of microRNA-433-3p(miR-433-3p)and β microtubule Ⅴ(TUBB6)in bladder cancer tissue and its pathological characteristics,and its predictive value for postoperative recurrence.Methods From August 2021 to August 2022,116 patients with bladder cancer underwent surgery for cancer tissue and adjacent tissue,and which were divided into recurrence group(43 cases)and non recurrence group(73 cases)according to whether there was local recurrence or distant recurrence and metastasis after surgery.The quantitative real-time polymerase chain reaction(qRT-PCR)was used to detect the mRNA levels of miR-433-3p and TUBB6.The influencing factors of postoperative recurrence of bladder cancer were analyzed by logistic regression.The predictive value of miR-433-3p and TUBB6 in postoperative recurrence of bladder cancer was analyzed by receiver operating characteristic(ROC)curve.Results The level of miR-433-3p in cancer tissue was obviously lower than that in adjacent tissue(P＜0.05),and the level of TUBB6 was obviously higher than that in adjacent tissue(P＜0.05).The level of miR-433-3p was significantly reduced(P＜0.05)in patients with TNM stage Ⅲ+Ⅳ,histological differentiation to low differentiation,and tumor infiltration,while the level of TUBB6 mRNA was significantly increased(P＜0.05).The serum miR-433-3p level in the recurrent group was significantly lower than that in the non recurrent group,,The level of TUBB6 mRNA was higher in the non recurrent group,and the difference was statistically significant(P＜0.05).TNM stage Ⅲ+Ⅳ,tumor infiltration,and high expression of TUBB6 are independent risk factors for postoperative recurrence in patients(P＜0.05),while high expression of miR-433-3p is an independent protective factor(P＜0.05).ROC curve analysis shows that,,the area under curve(AUC)predicted by serum miR-433-3p and TUBB6 levels in combination was significantly higher than that predicted by a single index(Z-miR-433-3p=2.323,Z-TUB6=1.961,P=0.020,0.048),sensitivity of 95.35％,specificity of 82.19％.Conclusion The expression of miR-433-3p and TUBB6 in bladder cancer tissues is closely related to pathological features,and the combination of the two tissues has a higher predictive value for postoperative recurrence.

Objective:To analyze the correlation between chemokine CX3C ligand 1 (CX3CL1), CX3C chemokine receptor 1 (CX3CR1) and heart function grade, prognosis in patients with chronic heart failure (CHF).Methods:The clinical data of 200 patients with CHF from June 2021 to June 2023 in General Hospital of Eastern Theater of the Chinese People′s Liberation Army and Wuhan Asia Heart Hospital were retrospectively analyzed, and all patients received standardized treatment for heart failure. The baseline clinical data were recorded; the levels of CX3CL1 and CX3CR1 were detected by enzyme linked immunosorbent assay; the heart function grade was evaluated by New York Heart Association (NYHA) heart function grade method. The patients were followed up until December 2023, the patients were divided into poor prognosis group (all-cause death and readmission due to heart failure) and good prognosis group based on their prognosis. Pearson method was used for correlation analysis. Multivariate Logistic regression analysis was used to analyze the independent risk factors of poor prognosis in patients with CHF.Results:Among the 200 patients, NYHA heart function grade Ⅰ to Ⅱ was in 80 cases, Ⅲ to Ⅳ in 120 cases. The levels of CX3CL1 and CX3CR1 in patients with NYHA heart function grade Ⅲ to Ⅳ were significantly higher than those in patients with NYHA heart function grade Ⅰ to Ⅱ: (3.34 ± 0.45) mg/L vs. (2.45 ± 0.26) mg/L and (8.71 ± 0.92) mg/L vs. (2.53 ± 0.35) mg/L, and there were statistical differences ( t = 15.99 and 57.34, P<0.01). The proportion of age<60 years old, rate of coronary heart disease, CX3CL1, CX3CR1, body mass index and high-sensitivity C-reactive protein in poor prognosis group (40 cases) were significantly higher than those in good prognosis group (160 cases): 82.50% (33/40) vs. 10.62% (17/160), 90.00% (36/40) vs. 68.12% (109/160), (3.26 ± 0.77) mg/L vs. (2.25 ± 0.27) mg/L, (8.35 ± 2.01) mg/L vs. (2.48 ± 0.31) mg/L, (26.80 ± 3.55) kg/m 2 vs. (24.74 ± 2.76) kg/m 2 and (9.31 ± 2.19) mg/L vs. (3.58 ± 2.28) mg/L, the rate of smoking history and left ventricular ejection fraction were significantly lower than those in good prognosis group: 37.50% (15/40) vs. 46.88% (75/160) and (30.14 ± 5.77)% vs. (59.40 ± 6.58)%, and there were statistical differences ( P<0.01). Pearson correlation analysis result showed that the CX3CL1 and CX3CR1 were positively correlated with NYHA heart function grade ( r = 0.29 and 0.34, P<0.05), and negatively correlated with prognosis ( r = - 0.54 and - 0.36, P<0.05). Multivariate Logistic regression analysis result showed that the CX3CL1 and CX3CR1 were the independent risk factors of poor prognosis in patients with CHF ( OR = 2.110 and 1.566, 95% CI 0.445 to 3.125 and 0.270 to 3.455, P<0.01). Conclusions:The CX3CL1 and CX3CR1 are closely related to the heart function grade in patients with CHF. At the time of CHF patient admission, it may be considered to combine the two indicators for preliminary evaluation of and provide targeted interventions to improve prognosis.

Objective:To investigate the surgical treatment methods of femoral artery pseudoaneurysm combined with infectious wounds and to evaluate the clinical effects.Methods:The retrospective observational research method was used. Twelve patients with femoral artery pseudoaneurysm combined with infectious wounds who met the inclusion criteria were admitted to Nanjing University of Chinese Medicine Wuxi Integrated Traditional Chinese and Western Medicine Hospital (Affiliated Hospital of Jiangnan University) from October 2014 to September 2022, including 6 males and 6 females, aged from 46 to 78 years. In the primary operation, debridement, tumor resection, and artery suture/venous grafting to repair the artery/artery ligation were performed, and the wound area after tumor resection ranged from 4.0 cm×1.5 cm to 12.0 cm×6.5 cm. Wounds that could be sutured were treated with tension reduction suture and extracutaneous continuous vacuum sealing drainage (VSD), while large wounds that could not be sutured were treated with VSD to control infection. In the secondary operation, tension reduction suture was performed to repair the wounds that could be sutured; large wounds were repaired with adjacent translocated flaps with area of 9.0 cm×5.0 cm to 15.0 cm×7.0 cm. Additionally, when the length of the exposed femoral artery was equal to or over 3.0 cm, the wounds were repaired with additional rectus femoris muscle flap with length of 15.0 to 18.0 cm. The donor areas of the flaps were directly sutured. The wound with artery ligation was treated with stamp skin grafting and continuous VSD. The bacterial culture results of the wound exudate samples on admission were recorded. The intraoperative blood loss, the location of femoral artery rupture, the artery treatment method, and the wound repair method in the primary operation were recorded, and the durations of catheter lavage, catheter drainage, and VSD treatment, and the drainage volume after the operation were recorded. The repair method of wounds in the secondary operation, the durations of catheter drainage and VSD treatment, and the total drainage volume after the operation were recorded. The survivals of flap/muscle flap/stamp skin grafts were observed, and the wound healing time was recorded. Follow-up after discharge was performed to evaluate the quality of wound healing and the walking function and to check whether the pulsatile mass disappeared. B-ultrasound or computed tomography angiography (CTA) was performed again to observe potential pseudoaneurysm recurrence and evaluate the patency of blood flow of the femoral artery.Results:The bacterial culture results of wound exudate samples of all the patients were positive on admission. The blood loss was 150 to 750 mL in the primary operation. The arterial ruptures were located in the femoral artery in 8 cases, in the external iliac artery in 2 cases, and in the femoral arteriovenous fistula in 2 cases. Six cases received direct artery suture, 4 cases received autologous great saphenous vein grafting to repair the artery, 1 case received autologous great saphenous vein bypass surgery, and 1 case received artery ligation. The primary wound suture was performed in 4 cases, along with catheter lavage for 3 to 5 days, catheter drainage for 4 to 6 days, VSD treatment for 5 to 7 days, and a total drainage volume of 80 to 450 mL after the surgery. In the secondary operation, the wounds were sutured directly in 3 cases along with catheter drainage for 2 to 3 days, the wound was repaired with scalp stamp skin graft and VSD treatment for 5 days in 1 case, the wounds were repaired with adjacent translocated flaps in 2 cases with catheter drainage for 2 to 3 days, and the wounds were repaired with rectus femoris muscle flaps+adjacent translocated flaps in 2 cases with catheter drainage for 3 to 5 days . The total drainage volume after the secondary operation ranged from 150 to 400 mL. All the skin flaps/muscle flaps/skin grafts survived after operation. The wound healing time ranged from 15 to 36 days after the primary operation. Follow-up of 2 to 8 months after discharge showed that the wounds of all patients healed well. One patient who underwent femoral artery ligation had calf amputation due to foot ischemic necrosis, and the rest of the patients regained normal walking ability. The pulsatile mass disappeared in inguinal region of all patients. B-ultrasound or CTA re-examination in 6 patients showed that the blood flow of femoral artery had good patency, and there was no pseudoaneurysm recurrence.Conclusions:Early debridement, tumor resection, and individualized artery treatment should be performed in patients with femoral artery pseudoaneurysm combined with infected wounds. Besides, proper drainage and personalized repair strategy should be conducted according to the wound condition to achieve a good outcome.

Objective:To investigate the effect of usage of transthoracic echocardiography(TTE) on the prognosis of patients after acute kidney injury (AKI) in intensive care unit (ICU).Methods:The clinical data of patients with AKI in the Medical Information Mart for Intensive Care (MIMIC-Ⅲ v1.4) database was collected retrospectively, and the patients were divided into TTE group (with TTE within 24 hours of AKI diagnosis) and No-TTE group (without TTE examination or first TTE examination was more than 24 hours after AKI diagnosis). Propensity score matching (PSM) was utilized to balance the baseline variables between the two groups and Cox regression analysis was used to evaluate the independent risk factors for 28-day all-cause mortality (the primary outcome). Moreover, after PSM, the effects of TTE usage on the second outcomes (including the volumes of intravenous fluid and urine output in the first, second and third 24-hour after the diagnosis of AKI; the total number of mechanical ventilation-free days, renal replacement therapy-free days and vasopressor-free days within 28 days after ICU admission; use of diuretics after the diagnosis of AKI; reduction in serum creatinine within 48 hours after the diagnosis of AKI; and the length of ICU stay and hospital stay) were also evaluated.Results:Among 23 945 eligible AKI patients, 3 365 patients (14.1%) patients received TTE within 24 hours after the diagnosis of AKI and finally there were 3 361 patients in TTE group and No-TTE group included in this study after PSM based on the ratio of 1∶1. After PSM, all variables in the two groups were well balanced (standardized mean difference<0.1, respectively). Before and after PSM, patients in TTE group had lower 28-day all-cause mortality compared with patients in No-TTE group (10.76% vs 13.04%, χ2=13.535, P<0.001; 10.65% vs 18.80%, χ2=88.932, P<0.001), and Kaplan-Meier survival curves also revealed that patients in the TTE group had higher cumulative survival rate compared with patients in No-TTE group (Log-rank χ2=15.438, P<0.001; Log-rank χ2=75.360, P<0.001, respectively). Multivariate Cox regression analysis showed that TTE was an independent influencing factor for 28-day all-cause mortality before and after PSM ( HR=0.80, 95% CI 0.73-0.89, P<0.001; HR=0.58, 95% CI 0.51-0.65, P<0.001). And all subgroup analyses showed the similar results. Compared with patients in the No-TTE group, patients in the TTE group had higher volume of intravenous fluid on the first day and the second day after the diagnosis of AKI (both P<0.01). Patients in the TTE group had higher volume of urine output on the first day and the third day after the diagnosis of AKI (both P<0.01). The patients in the TTE group had a significantly lower duration of vasopressor-free and mechanical ventilation-free (both P<0.01). The usage of diuretic was significantly higher in the TTE group compared with that in the No-TTE group (54.1% vs 44.2%, χ2=65.609, P<0.001). With respect to serum creatinine, the reduction in serum creatinine within 48 hours after the diagnosis of AKI was higher in the TTE group than that in the No-TTE group [36.6(23.0, 97.2) μmol/L vs 30.1(14.2, 61.9) μmol/L, Z=-9.549, P<0.001]. Moreover, TTE group had shorter ICU stay than that in the No-TTE group [5.03(3.40, 8.90) d vs 5.37(3.77, 10.00) d, Z=-6.589, P<0.001]. There were no significant difference between the two groups in other secondary outcomes (all P>0.05). Conclusions:Timely TTE utilization after AKI incident is associated with better clinical outcomes for ICU patients.

Objective:To investigate the blood-brain barrier (BBB) permeability changes in the deep white matter (DWM) during hypoperfusion caused by asymptomatic cerebral artery stenosis.Methods:The CT perfusion weighted imaging (CTP) images of 36 patients with asymptomatic severe stenosis and unilateral internal carotid artery or middle cerebral artery, admitted to our hospital from January 2017 to April 2020, which revealed the prolongation of contrast medium delayed contrast medium max-time (Tmax), were analyzed. The regions of interest (ROIs) in the DWM of CTP images at the body of lateral ventricle and centrum semiovale, were drawn respectively: the anterior DWM (ROIa), middle DWM (ROIm), and posterior DWM (ROIp) in the stenotic side of maximum intensity projection maps; DWM with normal-appeared Tmax (ROI1), DWM with relatively delayed Tmax (ROI2), and DWM with obviously delayed Tmax (ROI3) in the stenotic side of Tmax maps; and their mirrored ROI on the healthy side. Statistical analysis was used to compare the value differences of Tmax, cerebral blood flow (CBF) and transfer constant (Ktrans) between/among the ROIs.Results:As compared with the mirrored ROI in the healthy side, respectively, the ROIa and ROIm in the stenotic side had significantly prolonged Tmax, significantly decreased CBF, and significantly increased Ktrans at the body of lateral ventricle ( P<0.05). As compared with the mirrored ROI in the healthy side, respectively, the ROIa and ROIp in the stenotic side had significantly prolonged Tmax, significantly decreased CBF, and significantly increased Ktrans at the centrum semiovale ( P<0.05). As compared with the mirrored ROI in the healthy side, respectively, the ROI2 and ROI3 in the stenotic side had significantly prolonged Tmax, significantly decreased CBF, and significantly increased Ktrans at the body of lateral ventricle and centrum semiovale ( P<0.05). In the stenotic side at the body of lateral ventricle, as compared with the mirrored ROIp, the ROIa and ROIm had significantly prolonged Tmax, significantly decreased CBF, and significantly increased Ktrans ( P<0.05). In the stenotic side at the body of lateral ventricle and centrum semiovale, as compared with the mirrored ROI1, the ROI2 and ROI3 had significantly prolonged Tmax, significantly decreased CBF, and significantly increased Ktrans ( P<0.05). Conclusion:The BBB permeability of DWM in the regions with delayed contrast medium Tmax is augmented when asymptomatic cerebral artery stenosis causes cerebral hypoperfusion.

Objective:To assess the accuracy and practicability of HaiMed refractory wound artificial intelligence assisted system in wound measurement.Methods:Twenty patients with chronic wounds who were diagnosed and treated from January 2019 to August 2019 in the Plastic Surgery Department of Peking University Third Hospital, including 12 males and 8 females, aged 20-76 years old. The cases included 9 poorly healed wounds, 6 diabetic foot wounds, 4 cases of pressure sores, and 1 case of tumor wounds. The traditional transparent film method and HaiMed system were used to measure the wound area of 20 cases. A paired t-test was performed on the measurement result of the two groups of wound area, and the accuracy and stability of the HaiMed system were statistically analyzed by Spearman simple correlation analysis, Bland-Altman evaluation and coefficient of variation. P<0.05 indicated that the difference was statistically significant. Results:Compared with traditional measurement tools, HaiMed system had no statistically significant difference in wound area measurement ( t=1.997, P=0.060). The Spearman correlation coefficient ( r=0.998) of the two method was consistent. Bland-Altman’s evaluation showed that all scattered points fell within the 95% consistency limit, and the HaiMed system was accurate and reliable. The minimum coefficient of variation of the transparent film hem method group was 0.41%, the maximum was 4.03%, and the average was 1.67%; the coefficient of variation of the HaiMed group was minimum 0.15%, the maximum was 2.31%, and the average was 0.60%. The two had good consistency, and the HaiMed system had higher stability than traditional measurement method. Conclusions:HaiMed system measures the wound area with high accuracy and good stability, especially for superficial wounds. It can be easily and quickly evaluated. HaiMed system is a new and reliable wound measurement tool.