ObjectiveTo investigate the effect of laminin subunit α3 （LAMA3） on the epithelial-mesenchymal transition （EMT）， invasion， and metastasis abilities of pancreatic cancer （PC）. MethodsA comprehensive analysis was performed for tumor- and EMT-related databases to identify the EMT genes associated with PC， especially LAMA3. The methods of qRT-PCR and Western blot were used to measure the expression level of LAMA3 in PC tissue and cell lines； immunofluorescence assay was used to determine the localization of LAMA3 in PANC-1 cells； Transwell assay was used to investigate the effect of LAMA3 on the invasion and migration abilities of PC cells. The t-test was used for comparison of continuous data between groups. ResultsThe analysis of the TCGA database identified 3 EMT-related oncogenes for PC， i.e.， LAMA3， AREG， and SDC1. The LASSO-Cox regression model showed that LAMA3 had the most significant impact on the prognosis of PC （risk score=0.256 1×LAMA3+0.043 1×SDC1+0.071 4×AREG）. The Cox model and nomogram showed that the high expression of LAMA3 was an independent risk factor for the poor prognosis of PC （hazard ratio=1.32， 95% confidence interval： 1.07‍ ‍—‍ 1.62， P<0.01）. Experimental results showed that there was a significant increase in the expression of LAMA3 in pancreatic cancer tissue compared with the normal pancreatic tissue. Compared with the HPDE cell line， there were varying degrees of increase in the expression of LAMA3 in pancreatic cancer AsPC-1， BxPC-3， PANC-1， MIA PaCa-2， and SW1990 cell lines， with the highest expression level in PANC-1 cells. The enrichment analysis showed that LAMA3 was associated with the biological processes and signaling pathways such as EMT， collagen metabolism， extracellular matrix degradation， the TGF-β pathway， and the PI3K pathway. After the knockdown of LAMA3， there were significant reductions in the expression levels of N-Cadherin， Vimentin， and Snail， while there was a significant increase in the expression level of E-Cadherin. Transwell assay showed that there were significant reductions in the invasion and migration abilities of PANC-1 cells after the knockdown of LAMA3. ConclusionLAMA3 is highly expressed in PC and can promote the EMT， invasion， and migration of PC cells， and therefore， LAMA3 may be used as a novel diagnostic marker and a new therapeutic target for PC.

Objective To explore the influencing factors of coronary artery lesion severity in patients with acute coronary syndrome (ACS). Methods Clinical data of ACS patients admitted to Zhongshan Hospital, Fudan University from December 2017 to December 2019 were consecutively collected. The modified Gensini score was used to assess the severity of coronary artery lesions. Univariate and multivariate linear regression analyses were performed to identify independent factors associated with coronary artery lesion severity. Results A total of 1 689 ACS patients were included, with an average age of (64.04±11.45) years; 1 353 (80.11%) were male, and the mean modified Gensini score was (8.12±4.03). Multivariate linear regression analysis revealed that sex (β＝0.97, P＝0.001), age (β＝0.03, P＝0.021), estimated glomerular filtration rate (eGFR; β＝－0.03, P＜0.001), low-density lipoprotein cholesterol (LDL-C; β＝0.58, P＜0.001), apolipoprotein A1 (Apo A1; β＝－1.28, P＝0.012), lipoprotein(a) [Lp(a); β＝0.001, P＝0.033], and glycated hemoglobin A_1C (HbA_1C; β＝0.45, P＜0.001) were independent influencing factors of the modified Gensini score. Conclusions Metabolic indicators, including Apo A1, LDL-C, HbA_1C, and Lp(a), may serve as risk factors for coronary artery lesion severity in ACS patients, with Apo A1 demonstrating the strongest impact.

Objective:To investigate the clinical characteristics and prognosis of silicosis complicated with cavity-pulmonary tuberculosis.Methods:The clinical data of 63 patients with silicosis complicated with cavity-pulmonary tuberculosis (group A) and silicosis patients (group B) admitted to Yantaishan Hospital from July 2018 to July 2022 were collected and analyzed.Results:Patients in group A were all male, and the common symptoms were cough, expectoration, chest tightness, shortness of breath, and hemoptysis. CT cavity lesions involving the lung, often occurs in the lung after the tip section, after the back section and basal segment, thick-walled cavity, may be accompanied by satellite lesions, endobronchial spread focal, pneumothorax, pleural effusion, etc. 1225 cases of group B patients haemoptysis of 59 patients, cavity in 3 patients, haemoptysis and/or cavity rate was lower than that in group A, the difference was statistically significant ( P<0.05) . In group A, CT reexamination 6-24 months after anti-tuberculosis treatment showed that 52 cases (82.5%) had cavity reduction/healing, 8 cases (12.7%) had recurrence, and 3 cases (4.8%) had damaged lung (2 died) . Conclusion:Silicosis patients with hemoptysis and/or CT in cavity should be more vigilant about combined tuberculosis, anti-tuberculosis treatment and/or dynamic CT follow-up helps laboratory diagnosis negative patients.

Invasive pulmonary aspergillosis is the most common type of pulmonary aspergillosis. This paper reported a patient with pulmonary aspergillosis secondary to obstructive pulmonary disease and other underlying diseases. The clinical manifestations included wheezing, cough, fever and wheezing rale in the lungs. Diagnosis was ultimately confirmed through pathogens targeted next generation sequencing and pathological examination of respiratory coughs. Following comprehensive treatment that included antifungal therapy, the patient was cured and discharged with a good prognosis.

Objective:To investigate the clinical characteristics and prognosis of silicosis complicated with cavity-pulmonary tuberculosis.Methods:The clinical data of 63 patients with silicosis complicated with cavity-pulmonary tuberculosis (group A) and silicosis patients (group B) admitted to Yantaishan Hospital from July 2018 to July 2022 were collected and analyzed.Results:Patients in group A were all male, and the common symptoms were cough, expectoration, chest tightness, shortness of breath, and hemoptysis. CT cavity lesions involving the lung, often occurs in the lung after the tip section, after the back section and basal segment, thick-walled cavity, may be accompanied by satellite lesions, endobronchial spread focal, pneumothorax, pleural effusion, etc. 1225 cases of group B patients haemoptysis of 59 patients, cavity in 3 patients, haemoptysis and/or cavity rate was lower than that in group A, the difference was statistically significant ( P<0.05) . In group A, CT reexamination 6-24 months after anti-tuberculosis treatment showed that 52 cases (82.5%) had cavity reduction/healing, 8 cases (12.7%) had recurrence, and 3 cases (4.8%) had damaged lung (2 died) . Conclusion:Silicosis patients with hemoptysis and/or CT in cavity should be more vigilant about combined tuberculosis, anti-tuberculosis treatment and/or dynamic CT follow-up helps laboratory diagnosis negative patients.

Invasive pulmonary aspergillosis is the most common type of pulmonary aspergillosis. This paper reported a patient with pulmonary aspergillosis secondary to obstructive pulmonary disease and other underlying diseases. The clinical manifestations included wheezing, cough, fever and wheezing rale in the lungs. Diagnosis was ultimately confirmed through pathogens targeted next generation sequencing and pathological examination of respiratory coughs. Following comprehensive treatment that included antifungal therapy, the patient was cured and discharged with a good prognosis.

Objective This study aimed to reveal critical genes regulating peri-implantitis during its development and construct a diagnostic model by using random forest(RF)and artificial neural network(ANN).Methods GSE-33774,GSE106090,and GSE57631 datasets were obtained from the GEO database.The GSE33774 and GSE106090 da-tasets were analyzed for differential expression and functional enrichment.The protein-protein interaction networks(PPI)and RF screened vital genes.A diagnostic model for peri-implantitis was established using ANN and validated on the GSE33774 and GSE57631 datasets.A transcription factor-gene interaction network and a transcription factor-micro-RNA(miRNA)regulatory network were also established.Results A total of 124 differentially expressed genes(DEGs)involved in the regulation of peri-implantitis were screened.Enrichment analysis showed that DEGs were mainly associated with immune receptor activity and cytokine receptor activity and were mainly involved in processes such as leukocyte and neutrophil migration.The PPI and RF screened six essential genes,namely,CD38,CYBB,FCGR2A,SELL,TLR4,and CXCL8.The receiver oper-ating characteristic curve(ROC)indicated that the ANN model had an excellent diagnostic performance.FOXC1,GA-TA2,and NF-κB1 may be essential transcription factors in peri-implantitis,and hsa-miR-204 may be a key miRNA.Con-clusion The diagnostic model of peri-implantitis constructed by RF and ANN has high confidence,and CD38,CYBB,FCGR2A,SELL,TLR4,and CXCL8 are potential diagnostic markers.FOXC1,GATA2,and NF-κB1 may be essential transcription factors in peri-implantitis,and hsa-miR-204 plays a vital role as a critical miRNA.

Objective This study aims to investigate the role of genes related to fatty acid metabolism in periodon-titis through machine learning and bioinformatics methods.Methods Periodontitis datasets GSE10334 and GSE-16134 were downloaded from the GEO database,and the fatty acid metabolism-related gene sets were obtained from the GeneCards database.Differentially expressed fatty acid metabolism-related genes(DEFAMRGs)in periodontitis were screened using the"limma"R package.Functional enrichment and pathway analyses were conducted.Recursive Feature Elimination,Least Absolute Shrinkage and Selection Operator,and Boruta algorithm were used to determine hub DEFAMRGs and construct diagnostic models with internal and external validation.Subtypes of periodontitis relat-ed to hub DEFAMRGs were constructed using consis-tency clustering analysis.CIBERSORT was used to ana-lyze immune cell infiltration in gingival tissues and ex-plore the correlation between hub DEFAMRGs and im-mune cells.Results A total of 113 periodontitis DE-FAMRGs were screened out as a result.The enrichment analysis results indicate that DEFAMRGs are mainly associat-ed with immune inflammatory responses and immune cell chemotaxis.Finally,8 hub DEFAMRGs(BTG2,CXCL12,FABP4,CLDN10,PPBP,RGS1,LGALSL,and RIF1)were identified and a diagnostic model(AUC=0.967)was con-structed,based on which periodontitis was divided into two subtypes.In addition,there is a significant correlation be-tween hub DEFAMRGs and different immune cell populations,with mast cells and dendritic cells showing higher cor-relation.Conclusion This study provides new insights and ideas for the occurrence and development mechanism of periodontitis and proposes a diagnostic model based on hub DEFAMRGs to provide new directions for diagnosis and treatment.

Objective To explore efficacy and safety of integrated traditional Chinese and western medicine in the treatment of intrahepatic cholestasis of pregnancy(ICP).Methods Clinical data of 151 pregnant women with ICP received treatment at Affiliated Hospital of Hangzhou Normal University from January 2020 to June 2022 were retrospectively analyzed.According to the differences in treatment plans,all patients were divided into control group(100 cases)and observation group(51 cases).Control group received basic therapy,including ursodeoxycholic acid capsules and adenosylmethionine for injection.Observation group was given Yinchenhao decoction with modified for one week on the basis of treatment in control group.Serum indicators of laboratories,itching status,maternal and infant outcomes,and safety between two groups were compared.Results After treatment,serum total bilirubin,alanine transaminase,aspartate transaminase,total bile acid levels,itching score in two groups were significantly lower than those before treatment,and observation group was lower than control group(P<0.05).Itch relief rate in observation group was significantly higher than that in control group,and itch control time in observation group was significantly shorter than that in control group(P<0.05).Incidence rate of cesarean section,amniotic fluid turbidity and postpartum hemorrhage in observation group were significantly lower than those in control group,and gestational age at termination of pregnancy in observation group was significantly higher than that in control group(P<0.05).After treatment,ratio of peak systolic and end diastolic flow velocity of the umbilical artery in two groups were significantly lower than that before treatment,and observation group was lower than control group(P<0.05).No drug allergic reactions occurred during treatment of two groups,and there were no serious complications such as placental abruption or stillbirth.Conclusion Compared to a single western medicine therapy,combination of Chinese and western medicine has a better effect on treating ICP.It can greatly improve levels of serum bile acids,bilirubin and liver enzymes,reduce itching,and improve maternal and infant outcomes.It has minimal side effects,and has good safety.

Objective:To explore the effect and safety of endoscopic tubular musculoskeletal tumor surgery (ETMS) technology in spinal tumors.Methods:Clinical data were retrospectively collected from 18 spinal tumor patients who were treated with ETMS technology at Tianjin Medical University Cancer Institute and Hospital ( n=16) or the Affiliated Hospital of Qingdao University ( n=2) from November 2022 to December 2023. The total cohort included 11 males and 7 females, with the age at 60.3±8.6 years (range of 41-76). Two cases were diagnosed with benign tumors, four patients were diagnosed with spinal hematologic malignancies while other 12 cases were patients with spinal metastases. After localization under the C-arm X-ray machine, the spinal endoscopic channel is established using dilators. Soft tissue is dissected under endoscopic guidance to create an artificial cavity. Subsequently, the saline medium relied upon by the spinal endoscopic technique is removed, and posterior decompression and tumor curettage are performed using tubular techniques. Frankel grade classification and paraplegia index were used to evaluate the improvement of postoperative function and the VAS score was performed in pain scoring. The surgical complications and tumor evaluation were observed by postoperative outpatient and telephone follow-up. Results:The ETMS technology was successfully completed in all 18 patients with the mean operation time of 240.3±80.2 min. The median of intraoperative bleeding was 200.0(172.5, 350.0) ml and the mean postoperative drainage was 131.4±69.5 ml. The median value of postoperative hospitalization days was 6.0(4.0, 10.25) d. The paraplegia index decreased from 1.5(0, 3.0) preoperatively to 0(0, 1.25) postoperatively ( Z=-2.599, P=0.009). All the patients presented an improvement in Frankel grading after surgery except for one patient (downgrading from grade E to grade D). There was significantly difference in Frankel grading between preoperative and postoperative groups ( Z=2.812, P=0.005). The median value of preoperative VAS score was up to 5.5(4.0, 7.0) while the median value at postoperative, one month after surgery and three months after surgery were 1.5(1.0, 2.25), 1.0(0, 1.0) and 0(0, 1.0), respectively (χ 2=44.641, P<0.001). The 3-month postoperative VAS improvement rate was 91.2% (range 75%-100%). During a mean follow-up period of 7.6±6.2 months, none of the 18 patients presented surgical complications or tumor recurrence at surgical region. Only one patient died at 3.2 months after surgery until the last follow-up due to respiratory failure after lung tumor progression. The mean survival of the total cohort was up to 13.3 [95% CI (11.5, 15.0)] months. The 16 cases with spinal metastases or spinal hematological malignancies had a mean survival of 13.2 [95% CI (11.3, 15.0)] months. Conclusion:The ETMS technology presented good efficacy and safety in treatment of spinal tumors with low blood supply and with diameter less than 5cm.