ObjectiveTo elucidate the effects of autonomic neuromodulators [calcium chloride (CaCl₂)-acetylcholine (ACh)] on atrial electrical remodeling and histopathological changes in rats, thereby providing evidence for further investigation into the pathological mechanisms by which autonomic imbalance induces atrial fibrillation (AF). MethodsTen 8-week-old male Sprague-Dawley (SD) rats were randomly divided into experimental and control groups, with 5 rats in each group. The experimental group received daily tail vein injections of a CaCl₂-ACh mixed solution for 28 days, while the control group received an equal volume of saline. Surface electrocardiograms were recorded before and after daily administration. On day 28 of administration, under isoflurane inhalation anesthesia, echocardiography was performed, and then the rats were euthanized by exsanguination under isoflurane anesthesia for tissue collection. Body weight and heart weight of rats were measured, and electrophysiological parameters including AF inducibility, conduction velocity, and conduction dispersion in isolated rat hearts were monitored using the MappingLab multichannel electrophysiological mapping system. HE staining was performed to evaluate atrial tissue architecture and inflammatory cell infiltration. The expression levels of matrix metalloproteinase 9 (MMP-9) and interleukin-1 beta (IL-1β) were analyzed by Western blotting. Masson staining was used to quantitatively analyze the proportional distribution of collagen fibers and myocardial fibers, and to calculate the area of collagen deposition, thereby evaluating the degree of myocardial fibrosis. Wheat germ agglutinin (WGA) staining was used to evaluate morphological changes of cardiomyocytes. Dihydroethidium (DHE) staining was used to detect the level of oxidative stress in atrial myocytes. Terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) staining was used to detect atrial cell apoptosis. ResultsCompared with the control group, the experimental group showed obvious arrhythmias on electrocardiograms. Echocardiography after 28 days of administration revealed significant structural remodeling in the experimental group, with a marked increase in left atrial anteroposterior diameter (P < 0.05), and also showed cardiac dysfunction, with significant decreases in left ventricular ejection fraction and left ventricular fractional shortening (P < 0.01). Compared with the control group, the experimental group showed a significantly increased heart weight-to-body weight ratio (P < 0.05), a markedly higher AF inducibility (P < 0.001), a significantly slowed atrial conduction velocity (P < 0.05), an uneven isochronal map with irregular directions, and a significantly increased conduction dispersion (P < 0.01). HE staining showed that atrial myocytes in the experimental group were disorganized, with slight inflammatory cell infiltration. Western blotting showed that the expression levels of MMP-9 and IL-1β in the atrial tissue of the experimental group were significantly upregulated (P < 0.05). Masson staining showed a significant increase in collagen deposition and a significant increase in fibrosis area in the atrial tissue of the experimental group (P < 0.001). WGA staining showed that cardiomyocytes in the experimental group were significantly hypertrophied compared with the control group (P < 0.05). DHE staining and TUNEL staining revealed that the level of oxidative stress in atrial myocytes (P < 0.001) and the apoptotic rate (P < 0.01) were both significantly increased. Conclusion Daily tail vein injections of the autonomic neuromodulator CaCl₂-ACh mixed solution for 28 days can successfully induce AF in rats, accompanied by significant atrial structural remodeling, electrical remodeling, and oxidative stress.

OBJECTIVE To explore the association of Helicobacter pylori infection with the expression levels of Ki67,caudal type homeobox transcription factor 2(CDX-2)and p53 protein in the gastric cancer patients so as to provide bases for improvement of prognosis of the gastric cancer patients.METHODS Totally 113 patients who were diagnosed with gastric cancer by gastroscopic examination and were treated in Shijiazhuang People's Hospital from Jan.2020 to Jan.2024 were assigned as the gastric cancer group,84 of whom were complicated with H.py-lori infection(the Hp-positive group),and 29 were negative for Hp(the Hp-negative group).Meanwhile,125 patients who had chronic atrophic gastritis were assigned as the non-gastric cancer group.The gastric mucosa tis-sue specimens were collected through gastroscopy,and the expression levels of Ki67,CDX-2 and p53 protein were detected.RESULTS The positive rate of H.pylori infection of the gastric cancer group was 74.34％,higher than 54.40％of the non-gastric cancer group(P＜0.05).The positive rate of H.pylori was higher in the gastric canc-er patients with lymphatic metastasis,infiltration depth of T3 to T4 and TNM stage of Ⅲ to Ⅳ stage than in the gastric cancer patients without lymphatic metastasis,infiltration depth of T1 to T2 and TNM stage of Ⅰ to Ⅱ stage(P＜0.05).The positive expression rates of gastric mucosa tissue Ki67,CDX-2 and p53 protein of the gastric cancer group were respectively 69.91％,52.21％and 79.65％,higher than 47.20％,0 and 24.00％of the non-gastric cancer group,there were significant differences(P＜0.05).The positive expression rates of gastric mucosa tissue Ki67,CDX-2 and p53 protein of the Hp-positive group were higher than those of the Hp-negative group(P＜0.05).CONCLUSION The gastric cancer is associated with the H.pylori infection and the expressions of Ki67,CDX-2 and p53.The H.pylori infection may lead to the abnormal expressions of Ki67,CDX-2 and p53 in gastric mucosa tissues of the gastric cancer patients,which is also associated with the clinicopathologic features.

Objective To explore the value of shear wave elastography(SWE)combined with carbohydrate antigen 15-3(CA15-3)in differentiating benign and malignant breast imaging and reporting data system(BI-RADS)category 4 breast masses.Methods Ninety patients with breast tumors confirmed by surgical pathology at the Affiliated Hospital of Yunnan University from December 2021 to June 2024 were enrolled,all with BI-RADS category 4 breast masses.The patients were divided into a benign group(n=42)and a malignant group(n=48)according to whether the breast masses were benign or malignant.All of them underwent SWE examination,and serum CA15-3 levels were determined using electrochemiluminescence method.Serum CA15-3 levels and SWE parameters[elasticity standard deviation(ESD),mean elasticity value(Emean),maximum elasticity value(Emax)and the ratio of breast mass elasticity to same-layer low fat elasticity(Eratio)]were compared between the two groups.The area under the receiver operating characteristic curve(AUC)was used to evaluate the diagnostic performance of serum CA15-3 levels,SWE parameters,and their combination for benign and malignant BI-RADS category 4 breast masses.Results The SWE parameters(ESD,Emean,Emax,and Eratio)and serum CA15-3 levels in the malignant group were significantly higher than those in the benign group(P<0.05).The AUC values of ESD,Emean,Emax,Eratio,and serum CA15-3 levels for the diagnosis of benign and malignant BI-RADS category 4 breast masses were 0.718(95%CI:0.613-0.824),0.791(95%CI:0.701-0.881),0.721(95%CI:0.615-0.826),0.721(95%CI:0.613-0.830)and 0.793(95%CI:0.702-0.885),respectively.Notably,SWE parameters combined with serum CA15-3 levels achieved an AUC value of 0.953(95%CI:0.917-0.992).Conclusion The combination of CA15-3 and SWE exhibits high efficiency in diagnosing the benign and malignant nature of BI-RADS category 4 breast masses.

OBJECTIVE To explore the association of Helicobacter pylori infection with the expression levels of Ki67,caudal type homeobox transcription factor 2(CDX-2)and p53 protein in the gastric cancer patients so as to provide bases for improvement of prognosis of the gastric cancer patients.METHODS Totally 113 patients who were diagnosed with gastric cancer by gastroscopic examination and were treated in Shijiazhuang People's Hospital from Jan.2020 to Jan.2024 were assigned as the gastric cancer group,84 of whom were complicated with H.py-lori infection(the Hp-positive group),and 29 were negative for Hp(the Hp-negative group).Meanwhile,125 patients who had chronic atrophic gastritis were assigned as the non-gastric cancer group.The gastric mucosa tis-sue specimens were collected through gastroscopy,and the expression levels of Ki67,CDX-2 and p53 protein were detected.RESULTS The positive rate of H.pylori infection of the gastric cancer group was 74.34％,higher than 54.40％of the non-gastric cancer group(P＜0.05).The positive rate of H.pylori was higher in the gastric canc-er patients with lymphatic metastasis,infiltration depth of T3 to T4 and TNM stage of Ⅲ to Ⅳ stage than in the gastric cancer patients without lymphatic metastasis,infiltration depth of T1 to T2 and TNM stage of Ⅰ to Ⅱ stage(P＜0.05).The positive expression rates of gastric mucosa tissue Ki67,CDX-2 and p53 protein of the gastric cancer group were respectively 69.91％,52.21％and 79.65％,higher than 47.20％,0 and 24.00％of the non-gastric cancer group,there were significant differences(P＜0.05).The positive expression rates of gastric mucosa tissue Ki67,CDX-2 and p53 protein of the Hp-positive group were higher than those of the Hp-negative group(P＜0.05).CONCLUSION The gastric cancer is associated with the H.pylori infection and the expressions of Ki67,CDX-2 and p53.The H.pylori infection may lead to the abnormal expressions of Ki67,CDX-2 and p53 in gastric mucosa tissues of the gastric cancer patients,which is also associated with the clinicopathologic features.

Objective To explore the value of shear wave elastography(SWE)combined with carbohydrate antigen 15-3(CA15-3)in differentiating benign and malignant breast imaging and reporting data system(BI-RADS)category 4 breast masses.Methods Ninety patients with breast tumors confirmed by surgical pathology at the Affiliated Hospital of Yunnan University from December 2021 to June 2024 were enrolled,all with BI-RADS category 4 breast masses.The patients were divided into a benign group(n=42)and a malignant group(n=48)according to whether the breast masses were benign or malignant.All of them underwent SWE examination,and serum CA15-3 levels were determined using electrochemiluminescence method.Serum CA15-3 levels and SWE parameters[elasticity standard deviation(ESD),mean elasticity value(Emean),maximum elasticity value(Emax)and the ratio of breast mass elasticity to same-layer low fat elasticity(Eratio)]were compared between the two groups.The area under the receiver operating characteristic curve(AUC)was used to evaluate the diagnostic performance of serum CA15-3 levels,SWE parameters,and their combination for benign and malignant BI-RADS category 4 breast masses.Results The SWE parameters(ESD,Emean,Emax,and Eratio)and serum CA15-3 levels in the malignant group were significantly higher than those in the benign group(P<0.05).The AUC values of ESD,Emean,Emax,Eratio,and serum CA15-3 levels for the diagnosis of benign and malignant BI-RADS category 4 breast masses were 0.718(95%CI:0.613-0.824),0.791(95%CI:0.701-0.881),0.721(95%CI:0.615-0.826),0.721(95%CI:0.613-0.830)and 0.793(95%CI:0.702-0.885),respectively.Notably,SWE parameters combined with serum CA15-3 levels achieved an AUC value of 0.953(95%CI:0.917-0.992).Conclusion The combination of CA15-3 and SWE exhibits high efficiency in diagnosing the benign and malignant nature of BI-RADS category 4 breast masses.

Objective:To analyze the changes in the incidence trend of liver cancer in Taizhou of Jiangsu Province, from 2012 to 2020 and provide reference for tumor prevention and control and management.Methods:Liver cancer incidence data from 2012 to 2020 were extracted from the Taizhou Center for Disease Control and Prevention's tumor registry system. Demographic data were used to calculate the crude incidence rate, age-standardized incidence rate (ASIR), Chinese age-standardized incidence rate (CASIR; based on China's 2010 standard population), and world age-standardized incidence rate (WASIR; based on Segi's world standard population). The Joinpoint regression model was applied to identify inflection points in liver cancer incidence trends during 2012-2020, and annual percentage change (APC) with average annual percentage change (AAPC) were calculated.Results:In 2020, the crude incidence ratio (CIR) of liver cancer in Taizhou was 34.6 per 100 000, with CASIR and WASIR at 19.6 per 100 000 and 14.9 per 100 000, respectively. From 2012 to 2020, the male-to-female ratio of new liver cancer cases was 2.94∶1 (10 455 males vs. 3 559 females), with male incidence consistently higher than female. Overall liver cancer incidence in Taizhou initially increased and then decreased after 2017 (2012-2017: APC=6.4%, P=0.014; 2017-2020: APC=-9.5%, P=0.035), peaking at a CASIR of 26.2 per 100 000 in 2017. The trend in male incidence mirrored the overall pattern, rising before 2017 and declining thereafter (2012-2017: APC=6.2%, P=0.005; 2017-2020: APC=-9.0%, P=0.016). Female incidence remained relatively stable (2012-2016: APC=11.0%, P=0.054; 2016-2020: APC=-6.5%, P=0.130). Conclusions:Liver cancer incidence in Taizhou increased before 2017 and declined thereafter, with 2017 as the turning point. Amid population aging, liver cancer remains a persistent public health challenge requiring sustained attention.

[Purpose]To analyze the trends of incidence and age at onset of leukemia in Jiangsu cancer registration areas from 2009 to 2019.[Methods]The continuous monitoring data of leukemia from 2009 to 2019 were collected from 16 cancer registries in Jiangsu Province.All datasets were checked and evaluated based on data quality control criteria and were included in the analysis.Crude incidence rate(CIR),age-standardized incidence rate by Chinese standard population(ASIRC),the average annual percentage change(AAPC),the standardized average age at onset,the changes in the age structure of incidence and the changes in the birth cohort by year were calculated.[Results]The incidence rate of leukemia significantly increased from 5.22/105 in 2009 to 7.88/105 in 2019,with a significant upward trend(for CIR,AAPC=4.95％,95％CI:3.82％～6.09％;for ASIRC,AAPC=2.97％,95％CI:1.52％～4.43％).The incidence rates were in-creased in all age groups and increased with the birth cohort by years.There was a tendency of backward shift for the age composition of the population,with the increasing of composition for those over 60 years old.The mean age at onset increased from 48.62 years old in 2009 to 57.96 years old in 2019,with a backward shift in the mean age(β=0.773,P＜0.001),and the mean age at onset increased with the year only in rural areas after standardization(β=0.428,P=0.017).[Conclusion]Leukemia incidence rate in Jiangsu Province increased from 2009 to 2019,and the age at onset has shifted backwards.It's important to strengthen the early prevention and control of leukemia.

Objective:To analyze the changes in the incidence trend of liver cancer in Taizhou of Jiangsu Province, from 2012 to 2020 and provide reference for tumor prevention and control and management.Methods:Liver cancer incidence data from 2012 to 2020 were extracted from the Taizhou Center for Disease Control and Prevention's tumor registry system. Demographic data were used to calculate the crude incidence rate, age-standardized incidence rate (ASIR), Chinese age-standardized incidence rate (CASIR; based on China's 2010 standard population), and world age-standardized incidence rate (WASIR; based on Segi's world standard population). The Joinpoint regression model was applied to identify inflection points in liver cancer incidence trends during 2012-2020, and annual percentage change (APC) with average annual percentage change (AAPC) were calculated.Results:In 2020, the crude incidence ratio (CIR) of liver cancer in Taizhou was 34.6 per 100 000, with CASIR and WASIR at 19.6 per 100 000 and 14.9 per 100 000, respectively. From 2012 to 2020, the male-to-female ratio of new liver cancer cases was 2.94∶1 (10 455 males vs. 3 559 females), with male incidence consistently higher than female. Overall liver cancer incidence in Taizhou initially increased and then decreased after 2017 (2012-2017: APC=6.4%, P=0.014; 2017-2020: APC=-9.5%, P=0.035), peaking at a CASIR of 26.2 per 100 000 in 2017. The trend in male incidence mirrored the overall pattern, rising before 2017 and declining thereafter (2012-2017: APC=6.2%, P=0.005; 2017-2020: APC=-9.0%, P=0.016). Female incidence remained relatively stable (2012-2016: APC=11.0%, P=0.054; 2016-2020: APC=-6.5%, P=0.130). Conclusions:Liver cancer incidence in Taizhou increased before 2017 and declined thereafter, with 2017 as the turning point. Amid population aging, liver cancer remains a persistent public health challenge requiring sustained attention.

[Purpose]To analyze the trends of incidence and age at onset of leukemia in Jiangsu cancer registration areas from 2009 to 2019.[Methods]The continuous monitoring data of leukemia from 2009 to 2019 were collected from 16 cancer registries in Jiangsu Province.All datasets were checked and evaluated based on data quality control criteria and were included in the analysis.Crude incidence rate(CIR),age-standardized incidence rate by Chinese standard population(ASIRC),the average annual percentage change(AAPC),the standardized average age at onset,the changes in the age structure of incidence and the changes in the birth cohort by year were calculated.[Results]The incidence rate of leukemia significantly increased from 5.22/105 in 2009 to 7.88/105 in 2019,with a significant upward trend(for CIR,AAPC=4.95％,95％CI:3.82％～6.09％;for ASIRC,AAPC=2.97％,95％CI:1.52％～4.43％).The incidence rates were in-creased in all age groups and increased with the birth cohort by years.There was a tendency of backward shift for the age composition of the population,with the increasing of composition for those over 60 years old.The mean age at onset increased from 48.62 years old in 2009 to 57.96 years old in 2019,with a backward shift in the mean age(β=0.773,P＜0.001),and the mean age at onset increased with the year only in rural areas after standardization(β=0.428,P=0.017).[Conclusion]Leukemia incidence rate in Jiangsu Province increased from 2009 to 2019,and the age at onset has shifted backwards.It's important to strengthen the early prevention and control of leukemia.

Objective To investigate the effectiveness of electro-ultrasound therapy in preventing postoperative re-adhesion in patients with moderate to severe intrauterine adhesion(IUA)who have undergone transcervical resection of adhesions(TCRA).Methods A total of 105 patients with IUA admitted to the Fifth Affiliated Hospital of Zhengzhou University from November 2022 to December 2023 were selected as the research objects.The subjects were divided into two groups based on whether they received electro-ultrasound therapy postoperatively:Control group(n=56)and electro-ultrasound group(n=49).Pre-and post-treatment conditions of endometrial thickness,uterine cavity volume,volumetric blood flow parameters and hemodynamic parameters of arteries in different parts of the uterus(uterine arteries,sub-endometrium,intra-endometrial)were compared between two groups,The pregnancy status of two groups within one year after the treatment was followed-up.Results After treatment,both groups showed significant improvement in endometrial thickness,uterine cavity volume,volumetric blood flow parameters,and hemodynamic parameters of arteries in different parts of the uterus(uterine arteries,sub-endometrium,intra-endometrial)compared to their pre-treatment values in the same group(P＜0.05),with electro-ultrasound group showing more pronounced improvement(P＜0.05).Within one year after treatment,the pregnancy rate of electro-ultrasound group was higher than that of control group(P＜0.05).Conclusion Electro-ultrasound therapy helps prevent re-adhesion following TCRA in patients with intrauterine adhesions,contributing positively to the improvement of clinical efficacy.