Objective: To evaluate the feasibility of dynamic contrast-enhanced MRI (DCE-MRI) in differentiating tumor deposits (TDs) from metastatic lymph nodes (MLNs) in rectal cancer. Materials and Methods: A retrospective analysis was conducted on 70 patients with rectal cancer, including 168 lesions (70 TDs and 98 MLNs confirmed by histopathology), who underwent pretreatment MRI and subsequent surgery between March 2019 and December 2022. The morphological characteristics of TDs and MLNs, along with quantitative parameters derived from DCE-MRI (K trans , kep, and v e) and DWI (ADCmin, ADCmax, and ADCmean), were analyzed and compared between the two groups.Multivariable binary logistic regression and receiver operating characteristic (ROC) curve analyses were performed to assess the diagnostic performance of significant individual quantitative parameters and combined parameters in distinguishing TDs from MLNs. Results: All morphological features, including size, shape, border, and signal intensity, as well as all DCE-MRI parameters showed significant differences between TDs and MLNs (all P < 0.05). However, ADC values did not demonstrate significant differences (all P > 0.05). Among the single quantitative parameters, v e had the highest diagnostic accuracy, with an area under the ROC curve (AUC) of 0.772 for distinguishing TDs from MLNs. A multivariable logistic regression model incorporating short axis, border, v e, and ADC mean improved diagnostic performance, achieving an AUC of 0.833 (P = 0.027). Conclusion The combination of morphological features, DCE-MRI parameters, and ADC values can effectively aid in the preoperative differentiation of TDs from MLNs in rectal cancer.

Objective To construct radiomics-semantic models to predict the treatment resistance of chemoradiotherapy in brain gliomas based on MRI and clinical data of multicenter patients.Methods Among 2 108 brain gliomas patients from five medical institutions,132 patients had residual gliomas after surgery.The clinical risk factors and multimodal MRI were collected.All patients were divided into training set(n=95)and validation set(n=37).The treatment response of gliomas after standardized chemoradiotherapy were divided into resistant and non-resistant types.The semantic features of MRI were evaluated by two radiologists.Three different segmentation regions of interest(ROI)were delineated to extract radiomics features.And that three groups of radiomics models were con-structed based on different sequence MRIs.The radiomics model with the best predictive efficacy in each group was selected and combined with MRI semantic features,three radiomics-semantic models(combined models)were established.Finally,a MRI semantic model,three groups of radiomics models and three combined models were developed.Results Comparisons between the different models showed that the radiomics-semantic model based on pre-operative T2-fluid attenuated inversion recovery(FLAIR)sequence,had the best predictive efficacy,the area under the curve(AUC)in the training and validation sets were 0.866[95％confidence interval(CI)0.790-0.942]and 0.810(95％CI 0.667-0.952),respectively.The radiomics-semantic model based on postoperative T1 WI sequence performed the second best,with the AUC of the training and validation sets being 0.812(95％CI 0.726-0.898)and 0.711(95％CI 0.541-0.881),respectively.Conclusion The combined models based on MRI radiomics and semantic features are able to predict the treatment resistance of chemoradiotherapy in brain gliomas patients,and may be used as an important basis for optimizing treatment.

To formulate an expert consensus on the principles of preoperative hair removal and provide scientific guidance for standardized removal of hair before surgical procedures so as to reduce the incidence of surgical site infections.METHODS Led by the Hospital Management Institute of National Health Commission of the People's Republic of China,this consensus was reached with the joint efforts from the expects of relevant fields such as surgeries,interventional therapies,nursing,and infection prevention and control.The consensus facilitates the classification and evaluation of literatures by following the evidence grade formulated by Oxford Evidence-based Medicine Center and focuses on the association of preoperative hair removal with surgical site infection,it reaches the evidence grade of expert consensus and recommendation intensity by integrating with discussions on meetings and clinical experience of the expects from relevant fields.RESULTS A total of 6 items of consensus were reached by summarizing the latest evidence on the aspects including the indications for preoperative hair removal,tools,range,timing and places.CONCLUSION The consensus,to some extent,make supplements to and complete the exiting regulations and standards.It provides guidance for the medical institutions to carry out the preoperative hair removal.

Objective To explore the correlation between fasting blood glucose(FBG)level and fractional flow reserve(FFR)in patients with borderline coronary artery disease,and to clarify its potential influence on FFR measurement.Methods From August 2020 to August 2023,the data of 135 patients with coronary atherosclerotic heart disease who received coronary angiography and FFR evaluation in the Fourth Affiliated Hospital of Harbin Medical University were retrospectively collected.According to the exclusion and inclusion criteria,85 cases of borderline diseased vessels of single coronary artery with stenosis degree of 50％-80％were screened out,and they were divided into FBG≥6.1 mmol/L group(47 cases)and FBG＜6.1 mmol/L group(38 cases).The baseline data,angiographic and functional indexes of the two groups were compared,and the correlation between FBG and FFR was analyzed.Results Compared with the FBG＜6.1 mmol/L group,the FBG≥6.1 mmol/L group had a higher proportion of FFR negative results(72.3％vs.23.7％,P＜0.001),and the FFR measurement values were generally increased[0.84(0.80,0.90)vs.0.75(0.68,0.80),P＜0.001],with statistically significant differences.Pearson correlation analysis was performed on all lesions,and FFR＞0.80(negative result)was positively correlated with FBG≥6.1 mmol/L(r=0.484,P＜0.001).Conclusions Among the patients with borderline coronary artery disease(50％-80％stenosis)included in this study,FBG≥6.1 mmol/L is significantly correlated with FFR＞0.80.For patients with borderline coronary lesions with elevated FBG,the influence of blood glucose factors should be carefully considered in clinical interpretation of FFR results.

Objective:Micro-and nanostructures with sharp disordered and rounded ordered features were fabricated on titanium surfaces,respectively,and their osteogenic potential was evaluated both in vitro and in vivo.Methods:Sharp disordered titanium surfaces(SLA-Ti)and rounded ordered titanium surfaces(Laser-Ti)were prepared using sandblast acid etching and high-repeti-tion-rate femtosecond laser,respectively.Smooth titanium(Ti)was used as the control group,SLA-Ti and Laser-Ti were used as the experimental groups.Characterization was conducted using scanning electron microscopy coupled with hydrophilicity assess-ments.The adhesion,elongation,and osteogenic differentiation capabilities of osteoblasts in vitro were evaluated through cell mor-phology observations,cytoskeletal fluorescence staining,cell viability assays,and PCR experiments.Osteogenic potential in vivo of rabbits was assessed through Micro CT scans and histological staining(HE and Masson).Results:The surface of Laser-Ti exhibits a rounded,ordered,multi-scale micro-and nano-morphology with the best hydrophilicity(P＜0.01).In vitro,it promotes cell adhe-sion,extension,and osteogenic differentiation,while in vivo,it enhances bone regeneration around the implants.Overall,a trend of Laser-Ti＞SLA-Ti＞Ti is observed,with a higher bone volume fraction(BV/TV)(P＜0.05),greater trabecular thickness(Tb.Th)(P＜0.05),an increased number of trabeculae(Tb.N)(P＜0.05),and a larger area of bone around the implants(P＜0.05).Conclusion:The rounded ordered micro-and nano-structures fabricated using high-repetition-rate fem-tosecond laser demonstrate enhanced osteoinductive capac-ity both in vitro and in vivo.

Objective:To investigate the clinical efficacy of Zhuangdan Yanshi Decoction combined with dapoxetine hydrochlo-ride in the treatment of premature ejaculation with cholestasis and phlegm disturbance.Methods:A total of 120 patients diagnosed with premature ejaculation and treated in the Andrology Outpatient Department of Shaanxi Provincial Hospital of Traditional Chinese Medicine from March to December in 2022 were selected and randomly divided into treatment group and control group,with 60 cases in each group.The incubation period of intravaginal ejaculation(IELT),the Diagnostic Scale of Premature Ejaculation(PEDT),the Premature Ejaculation Assessment Scale(PEP),the 5-item Sexual Function Evaluation of Chinese Premature Ejaculation Patients(CIPE-5)and the improvement of traditional Chinese medicine symptom scores were compared before and after the treatment.And the adverse reactions were recorded as well.Results:A total of 105 cases were ultimately included,with 55 cases in the treatment group and 50 cases in the control group.Measurable improvements in IELT,PEDT scores,PEP scores,CIPE scores and TCM symptom scores had been found after treatment in both of two groups(P＜0.05).Moreover,the improvement in the treatment group was superi-or to that in the control group(P＜0.05).The total effective rate in the treatment group was 89.1％,which was higher than that(84％)in the control group,with no statistically significant difference between the two groups(P＞0.05).The incidence of adverse reactions in the treatment group was 9.1％,which was 24％in the control group.There was significantly difference between two groups(P＜0.05).Conclusion:The combination therapy with Zhuangdan Yanshi Decoction and dapoxetine hydrochloride for premature ejaculation associated with cholestasis and phlegm disturbance syndrome is definite,and it can reduce the side effects of drugs,which is better than oral dapoxetine hydrochloride alone.

Objective:To investigate the dynamic characteristics of human papillomavirus (HPV) genomic integration during cervical lesion progression and the clinical value of HPV integration detection in stratify HPV-positive women, and to explore its molecular mechanisms in cervical carcinogenesis.Methods:A prospective cohort study was designed to enroll high-risk HPV (HR-HPV) positive women who underwent cervical cancer screening in Drum Tower Hospital Affiliated to Nanjing University Medical School and Nanjing Maternity and Child Health Care Hospital from July 2022 to July 2024. Cervical exfoliated cells samples were collected, and HPV whole genome targeted capture and high-throughput sequencing technology were used. The HPV integration patterns, host gene functional region distribution and pathway enrichment characteristics of 157 samples with different cervical lesions grades were analyzed, including 31 cases of normal cervix, 40 cases of cervical intraepithelial neoplasia (CIN) Ⅰ, 32 cases of CIN Ⅱ, 42 cases of CIN Ⅲ, and 12 cases of cervical cancer.Results:HR-HPV integration was detected in 80.2% (126/157) of the 157 HR-HPV positive samples. The incidence of HR-HPV integration in cervical cancer patients was 12/12, which was higher than that in normal women (77%, 24/31). The incidence of HPV16 integration was significantly higher in high-grade lesions, and the incidence of HPV16 integration was 43% (18/42) in CIN Ⅲ patients and 8/12 in cervical cancer patients ( P<0.001). A total of 14 438 integration events were detected in 126 samples with HPV integration. The integration sites were mainly distributed in the host intergenic region (51.0%, 7 359/14 438) and intronic region (38.1%, 5 494/14 438), and the integration frequency of viral L1 gene was the highest (28.4%, 4 498/16 781). Functional enrichment analysis showed that HPV integration-related host genes were significantly enriched in transport of small molecules,cyclic guanosine monophosphate (cGMP)-protein kinase G (PKG) signaling pathway, and purine ribonucleotide biosynthetic process, which synergistically drove carcinogenesis through multiple mechanisms. Conclusions:HPV integration events are significantly associated with the progression of cervical lesions. HPV integrated detection based on cervical exfoliated cells is expected to optimize the current screening strategy, reduce excessive intervention of HPV positive women and facilitate their accurate triage management.

Aim To investigate the effect of N6-methy-ladenosine(m6A)demethylase ALKBH5 on the prolif-eration and migration of cardiac fibroblasts(CFs)in-duced by high glucose.Methods Primary CFs were isolated from neonatal mouse hearts and identified u-sing optical and confocal microscopy.Cell activation was induced using a high-glucose medium(33 mmol·L-1 glucose).An ALKBH5 overexpression model was established by transfecting CFs with an ALKBH5 ex-pression vector in a high-glucose medium.The expres-sion of ALKBH5 in CFs was assessed through immuno-fluorescence staining,Western blot and RT-qPCR.Changes in m6A levels were evaluated using Dot blot a-nalysis.Additionally,Alterations in the expression of proliferating cell nuclear antigen(PCNA)and collagenⅠ,a pivotal fibrosis indicator,were measured using Western blot.The proliferation and migration ability of CFs were assessed through EdU staining and Transwell migration assay,respectively.Results Following treatment with high glucose,the expression of ALKBH5 in CFs notably decreased,while m6A level increased.This was accompanied by a significant increase in the expression of the proliferation marker PCNA and the fi-brosis marker collagen Ⅰ.Additionally,there was a sig-nificant improvement in the ability of proliferation and migration.Overexpression of ALKBH5 resulted in a significant decrease in the expressions of PCNA and collagen Ⅰ,leading to the inhibition of both proliferation and migration in CFs.Conclusion Overexpression of ALKBH5 suppresses the expression of PCNA and colla-gen Ⅰ,consequently reducing the proliferation and mi-gration of CFs,potentially through m6A methylation modification.

Objective To explore the functional connectivity(FC)changes of hippocampus and amygdala in type 2 diabetes mellitus(T2DM)patients with erectile dysfunction(DMED),and the central pathological neural mechanisms underlying DMED.Methods 61 T2DM patients who visited Department of Endocrinology,Nanjing First Hospital,Nanjing Medical University from January 2020 to December 2021 were selected and divided into a simple T2DM group(n=30)and a combined DMED group(n=31).Another 47 healthy individuals were selected as control group(NC).The international erectile function scale(IIEF-5)was used to evaluate the erectile function.Resting-state functional magnetic resonance imaging(rs-fMRI)data were acquired from all participants.MRI data were preprocessed by the DPABI software package.Bilateral hippocampus and amygdala were selected as regions of interest(ROI)and the whole brain FC values were calculated.The FC values of brain regions between groups were tested by two-sample t-test with REST software package.Results Left hippocampus as ROI:compared with the NC group,FC values of the left superior temporal gyrus increased in the T2DM group,FC values of the left superior frontal gyrus,left inferior temporal gyrus,left posterior central gyrus and rectus gyrus decreased in the DMED group.Compared with the T2DM group,FC values of the left inferior parietal gyrus,left supramarginal gyrus,left middle occipital gyrus and right posterior central gyrus decreased in the DMED group.Right hippocampus as ROI:compared with the NC group,FC values of the right middle temporal gyrus and right rolandic operculum increased while FC values of the right calcarine fissure decreased in the T2DM group;FC values of bilateral anterior cingulate gyrus,right middle temporal gyrus and left rectus gyrus decreased in the DMED group.Compared with the T2DM group,FC values of the left middle frontal gyrus,left inferior parietal gyrus and right inferior temporal gyrus decreased in the DMED group.Left amygdala as ROI:compared with the NC group,FC values in the left parahippocampal gyrus,left fusiform gyrus and right insula increased in the T2DM group;FC value of the left middle temporal gyrus decreased in the DMED group.Compared with the T2DM group,FC values of the left middle frontal gyrus and left supramarginal gyrus decreased in the DMED group.Right amygdala as ROI:compared with the NC group,FC values of the left insula,right parahippocampal gyrus,right superior temporal gyrus and right supramarginal gyrus increased while FC values in the right caudate decreased in the T2DM group;FC values of the right middle frontal gyrus,left rectus gyrus and left middle occipital gyrus decreased in the DMED group.Compared with the T2DM group,FC values of the left middle frontal gyrus and left inferior parietal gyrus decreased in the DMED group.Conclusions DMED patients have abnormalities in the hippocampus,amygdala and other brain regions,especially the frontal lobe functional cortex,which may be related to changes in their brain function.

Aim To investigating the effects and mech-anisms of chlorogenic acid(CGA)on neutrophil(NEU)function and the formation of neutrophil extra-cellular traps(NETs).Methods NEU was isolated and purified from mouse bone marrow by using density gradient centrifugation method;NEU were cultivated with CGA,and the suitable concentration of CGA with NEU were explored through CCK-8 method;To observ-ing the impact of CGA on the function of NEU,we measured the migration ability of NEU,and the levels of myeloperoxidase(MPO),neutrophil elastase(NE),and matrix metalloproteinase 9(MMP-9);The histone H3 of NETs and the DNA skeleton of NEU were stained with immunofluorescence,and the cell-free DNA(cf-DNA)released by NEU was detected to ob-serve the structure of NETs;In addition,the levels of reactive oxygen species(ROS)were also examined to determine whether CGA affects the production of ROS during the release of NETs from NEU.Results There was a significant inhibitory effect on the activity of NEU at a concentration of 100,200,400 μmol·L-1 of CGA(P＜0.01);When compared with the blank group,the effects of CGA(100,200,400 μmol·L-1)on the migration ability of NEU and the ability to se-crete MPO,NE,and MMP-9 were increased(P＜0.05),the release of histone H3,DNA backbone and cf-DNA was significantly increased(P＜0.01),and the ROS produced by the cells was also significantly in-creased(P＜0.01).And the above effects are concen-tration-dependent within a certain range.Conclusion CGA can enhance the function of NEU and promote the formation of NETs,which may be related to the in-crease of intracellular ROS levels.