Cardiovascular disease(CVD),as one of the diseases with the highest morbidity and mor-tality rates globally,has always been a focus of med-ical research.In recent years,with a deeper under-standing of the pathogenesis of CVD,novel metabol-ic drugs have demonstrated great potential in its treatment.These novel drugs regulate multiple as-pects of cardiovascular metabolism,including reduc-ing blood glucose and lipid levels,inhibiting inflam-matory responses,and protecting vascular endothe-lial cells,thereby providing new strategies for the prevention and treatment of CVD.In terms of lower-ing blood glucose levels,SGLT2 inhibitors,GLP-1 re-ceptor agonists,DPP-4 inhibitors,and Metformin,as clinically commonly used drugs,have been prov-en to be beneficial for the prevention and treat-ment of CVD,regardless of the presence or absence of diabetes.For lipid regulation,PCSK9 inhibitors and Ezetimibe,as newly developed lipid-lowering drugs,not only reduce serum low-density lipopro-tein cholesterol levels but also directly protect the cardiovascular system from damage.The develop-ment and application of these drugs have not only improved the treatment outcomes of CVD but also provided patients with more therapeutic options.

Cardiovascular disease(CVD),as one of the diseases with the highest morbidity and mor-tality rates globally,has always been a focus of med-ical research.In recent years,with a deeper under-standing of the pathogenesis of CVD,novel metabol-ic drugs have demonstrated great potential in its treatment.These novel drugs regulate multiple as-pects of cardiovascular metabolism,including reduc-ing blood glucose and lipid levels,inhibiting inflam-matory responses,and protecting vascular endothe-lial cells,thereby providing new strategies for the prevention and treatment of CVD.In terms of lower-ing blood glucose levels,SGLT2 inhibitors,GLP-1 re-ceptor agonists,DPP-4 inhibitors,and Metformin,as clinically commonly used drugs,have been prov-en to be beneficial for the prevention and treat-ment of CVD,regardless of the presence or absence of diabetes.For lipid regulation,PCSK9 inhibitors and Ezetimibe,as newly developed lipid-lowering drugs,not only reduce serum low-density lipopro-tein cholesterol levels but also directly protect the cardiovascular system from damage.The develop-ment and application of these drugs have not only improved the treatment outcomes of CVD but also provided patients with more therapeutic options.

Objective To investigate the efficacy of high-resolution computed tomography (HRCT)imaging radiomics for the classification and diagnosis of rheumatoid arthritis associated interstitial lung disease(RA-ILD).Methods A total of 261 patients diagnosed with RA-ILD admitted in our hospital from January 2019 to July 2023 were recruited in this study.There were 143 cases of usual interstitial pneumonia (UIP )and 118 cases of nonspecific interstitial pneumonia (NSIP).All the patients underwent HRCT.A U-net deep learning lung segmentation model was applied to obtain HRCT images for automatic lung segmentation,and 1688 imaging histologic features were extracted from each lung segmentation. Variance thresholding,univariate feature selection,and least absolute shrinkage and selection operator (LASSO ) were used for feature dimensionality reduction step by step,and various machine learning algorithms were conducted to construct the RA-ILD diagnostic histology model.The diagnostic value of each model was compared using receiver operating characteristic (ROC)curve and area under curve (AUC),and the accuracy,sensitivity and specificity of the models were evaluated.Results Feature screening finally identified 18 best features from the HRCT images of RA-ILD patients.Statistical difference was found in the distribution of Radiomics score (Radscore)between the UIP and NSIP patients in both the training and test sets (P<0.01 ).Among the 5 imaging histology models,the support vector machine (SVM)algorithm had an AUC value of 0.943 (95％CI:0.916～0.966),a sensitivity of 0.787 and a specificity of 0.912,respectively for the training set,and an AUC value of 0.909 (95％CI:0.849～0.969),a sensitivity of 0.625 and a specificity of 0.897,respectively for the testing set.Conclusion Our constructed RA-ILD classification and diagnosis model performs well,and the model based on SVM algorithm shows the best potential in classifying and diagnosing RA-ILD.

The incidence and mortality of lung cancer rank first among all malignant tumors in China. With the popularization of high resolution computed tomography (CT) in clinic, chest CT has become an important means of clinical screening for early lung cancer and reducing the mortality of lung cancer. Imaging findings of early lung adenocarcinoma often show partial solid nodules with ground glass components. With the development of imaging, the relationship between the imaging features of some solid nodules and their prognosis has attracted more and more attention. At the same time, with the development of 3D-reconstruction technology, clinicians can improve the accuracy of diagnosis and treatment of such nodules.This article focuses on the traditional imaging analysis of partial solid nodules and the imaging analysis based on 3D reconstruction, and systematically expounds the advantages and disadvantages of both.
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Adenocarcinoma of Lung/pathology* ; Humans ; Image Processing, Computer-Assisted ; Lung Neoplasms/pathology* ; Solitary Pulmonary Nodule/pathology* ; Tomography, X-Ray Computed

BACKGROUND: At present, the research progress of targeted therapy for epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) gene mutations in lung adenocarcinoma is very rapid, which brings new hope for the treatment of advanced lung adenocarcinoma patients. However, the specific imaging and pathological features of EGFR and ALK gene mutations in adenocarcinoma are still controversial. This study will further explore the correlation between EGFR, ALK gene mutations and imaging and pathological features in invasive lung adenocarcinoma. METHODS: A total of 525 patients with lung adenocarcinoma who underwent surgery in our center from January 2018 to December 2019 were included. According to the results of postoperative gene detection, the patients were divided into EGFR gene mutation group, ALK gene mutation group and wild group, and the EGFR gene mutation group was divided into exon 19 and exon 21 subtypes. The pathological features of the mutation group and wild group, such as histological subtype, lymph node metastasis, visceral pleural invasion (VPI) and imaging features such as tumor diameter, consolidation tumor ratio (CTR), lobulation sign, spiculation sign, pleural retraction sign, air bronchus sign and vacuole sign were analyzed by univariate analysis and multivariate Logistic regression analysis to explore whether the gene mutation group had specific manifestations. RESULTS: EGFR gene mutation group was common in women (OR=2.041, P=0.001), with more pleural traction sign (OR=1.506, P=0.042), and had little correlation with lymph node metastasis and VPI (P>0.05). Among them, exon 21 subtype was more common in older (OR=1.022, P=0.036), women (OR=2.010, P=0.007), and was associated with larger tumor diameter (OR=1.360, P=0.039) and pleural traction sign (OR=1.754, P=0.029). Exon 19 subtype was common in women (OR=2.230, P=0.009), with a high proportion of solid components (OR=1.589, P=0.047) and more lobulation sign (OR=2.762, P=0.026). ALK gene mutations were likely to occur in younger patients (OR=2.950, P=0.045), with somking history (OR=1.070, P=0.002), and there were more micropapillary components (OR=4.184, P=0.019) and VPI (OR=2.986, P=0.034) in pathology. CONCLUSIONS The EGFR and ALK genes mutated adenocarcinomas have specific imaging and clinicopathological features, and the mutations in exon 19 or exon 21 subtype have different imaging features, which is of great significance in guiding the clinical diagnosis and treatment of pulmonary nodules.
Adenocarcinoma of Lung/genetics* ; Aged ; Anaplastic Lymphoma Kinase/genetics* ; ErbB Receptors/genetics* ; Female ; Genes, erbB-1 ; Humans ; Lung Neoplasms/pathology* ; Mutation ; Tomography, X-Ray Computed/methods*

Objective:To investigate the effects of chronic stress during pregnancy on depressive behavior and DNA methylation of insulin-like growth factor-2 ( IGF-2 )/long non-coding RNA ( lncRNA ) H19 in hippocampus of female offspring rats.Methods:A total of 32 SPF female SD rats were divided into model group and control group according to the random number table. The rats in the model group were treated with chronic unpredictable mild stress (CUMS) to establish the depression model, and the rats in the control group were fed normally.On the 7th day of stress stimulation, all female rats mated with male rats. One day before stress stimulation and 1, 7, 14, 21, 28 days after stress stimulation, blood samples were collected from the inner canthus vein of the rats to determine the plasma corticosterone concentration. Eight female pups were randomly selected from each group on postnatal day 28(PND28) and postnatal day 42 (PND42). Plasma corticosterone concentration was measured after angular vein blood collection. At PND42, the depression-like behavior of female pups in the two groups was measured by sucrose preference test, tail suspension test and forced swimming test. The expression of IGF-2/H19 and related transferases in hippocampus of offspring rats was detected by RT-PCR and Western blot. Methyl target technology was used to capture and sequence 19 CpG sites of IGF-2 differentially methylated region(DMR) fragment 2, 8 CpG sites in H19 imprinting control region (ICR) fragment 1 and 15 CpG sites in H19-ICR fragment 2, and calculate the methylation level of each CpG site. SPSS 26.0 was used for statistical analysis of relevant data by repeated measurement ANOVA, t test and non-parametric test. Results:(1) The data of plasma corticosterone content of the two groups of female rats at different times were analyzed by repeated measurement variance.The results showed that the the interaction effect between time and group was not significant ( F=2.997, P=0.066), and the main effect of time was significant ( F=4.44, P=0.010). The main effect of group was significant ( F=41.40, P=0.001). According to the independent effect analysis of factors between groups, on the 14th, 21st, and 28th days of stress, the plasma corticosterone concentration of the model group was higher than that of the control group (all P<0.001). (2) In the sucrose preference test, the total liquid consumption (11.10(10.38, 11.58) mL, 13.55(12.00, 15.77) mL, Z=-3.055, P=0.002), 1% sucrose water consumption ((5.50±1.30) mL, (8.56±2.04) mL, t=-3.582, P=0.003) and 1% sucrose preference percentage ( (51.35±8.69) %, (62.11±8.05) %, t=-2.576, P=0.022) of female pups in the model group were significantly lower than those in the control group. (3) The duration of immobility in tail suspension test ((126.95±39.89) s, (54.30±25.00) s, t=4.375, P=0.001) and forced swimming test ((7.97±6.66) s, (1.85±2.12) s, t=2.478, P=0.037) of female offspring in the model group were longer than those in the control group. (4) The expression of IGF-2 mRNA ((0.46±0.24), (1.00±0.00), t=3.821, P=0.019) and H19 mRNA ((0.60±0.25), (1.00±0.00), t=3.574, P=0.007) in hippocampus of female pups in the model group were lower than those of control group. The relative expression of IGF-2 protein in female offspring of model group was lower than that in control group ((0.77±0.04), (1.00±0.00), t=9.876, P=0.01). The relative expression of CCTC-binding factor (CTCF) mRNA ((1.29±0.12), (1.00±0.00), t=-4.850, P=0.003) and protein ((1.90±0.28), (1.00±0.00), t=-5.513, P=0.005) were higher than those in the control group. (5) The methylation levels of three CpG sites in the IGF-2 DMR region of female offspring in the model group were lower than those in the control group ( t=-3.21, -3.00, -3.34, all P<0.05), located at chr1215831028, chr1215831055 and chr1215831205, respectively. The methylation level of IGF-2 DMR fragment was lower than that of the control group ( t=-3.453, P=0.048). The relative expression levels of DNMT3A mRNA ( t=5.102, P=0.002), DNMT3A ( t=10.213, P<0.001) and DNMT3B ( t=4.169, P=0.014) in female offspring of the model group were lower than those in the control group. Conclusion:Chronic stress during pregnancy causes depression and despair in female offspring mice, and the mechanism may be related to the decrease of methylation level of imprinted gene IGF-2 DMR caused by the decrease of methyltransferase expression.

BACKGROUND: At present, more and more studies predict invasive adenocarcinoma (IAC) through three-dimensional features of pulmonary nodules, but few studies have confirmed that three-dimensional features have more advantages in diagnosing IAC than traditional two-dimensional features of pulmonary nodules. This study analyzed the differences of chest computed tomography (CT) features between IAC and minimally invasive adenocarcinoma (MIA) from three-dimensional and two-dimensional levels, and compared the ability of diagnosing IAC. The non-invasive adenocarcinoma group includes precursor glandular lesions (PGL) and minimally invasive adenocarcinoma (MIA). METHODS: The clinical data of 1,045 patients with ground glass opacity (GGO) from January to December 2019 were collected. Then the correlation between preoperative CT image characteristics and pathological results were analyzed retrospectively. The independent influencing factors for the identification of IAC were screened out according to two-dimensional and three-dimensional classification by multivariate Logistic regression and the cut-off point for the identification of IAC was found out through the receiver operating characteristic (ROC) curve. At last, the ability of diagnosing IAC was evaluated by Yoden index. RESULTS: The diameter of nodule, the diameter of solid component, the diameter of mediastinal window nodule in two-dimensional factors, and the volume of nodule, the volume of solid part and the average CT value in three-dimensional factors were independent risk factors for the diagnosis of IAC. These factors were arranged by Yoden index: solid partial volume (0.601)>nodule volume (0.536)>solid component diameter (0.525)>nodule diameter (0.518)>mediastinal window nodule diameter (0.488)>proportion of solid component volume (0.471)>1-tumor disappearance ratio (TDR) (0.468)>consolidation tumor ratio (CTR) (0.394)>average CT value (0.380). CONCLUSIONS The CT features of three-dimensional are better than two-dimensional in the diagnosis of IAC, and the size of solid components is better than the overall size of nodules.
Humans ; Lung Neoplasms/pathology* ; Retrospective Studies ; Neoplasm Invasiveness ; Multiple Pulmonary Nodules/diagnostic imaging* ; Adenocarcinoma/pathology*

Objective:To explore the mechanism of EYA1 (eyes absent 1) inhibiting the malignant progression of gastric cancer SGC7901 cells through regulating PTEN/PI3K/AKT signaling pathway. Methods: Twenty-nine pairs of gastric cancer tissues and para-cancerous tissues collected at the General Surgery center, Southwest Hospital Affiliated to Military Medical University during June 2016 and June 2018 were used in this study. Wb and RT-PCR assays were used to test the mRNA and protein expressions of EYA1 in gastric cancer tissues and the paired para-cancerous tissues; Transfection with plasmid or siRNAs were used to up-regulate or down-regulate EYA1 or PTEN expression in gastric cancer SGC-7901 cells; MTT, Flow Cytometry, Wound Healing and Transwell assays were carried out to detect cell proliferation, apoptosis, metastasis and invasion abilities, respectively. Results: EYA1 expression was decreased in gastric cancer tissues as compared with the para-cancerous tissues at both mRNA and protein levels (P<0.01); EYA1 over-expression significantly enhanced the proliferation, metastasis and invasion of SGC-7901 cells (all P<0.05), and inhibited cell apoptosis (P<0.05); moreover, its over-expressionsignificantly increased the expression of PTEN, and inhibited the activation of PI3K/AKT pathway (all P< 0.05 or P<0.01). However, the above effects mediated by EYA1 up-regulation were significantly impaired after the knockout of PTEN (all P<0.05 or P<0.01). Conclusion: EYA1 can inhibit the malignant progression of gastric cancer SGC-7901 cells through promoting the expression of PTEN and activating PI3K/AKT pathway.

Objective To study the clinical efficacy and effects on CRP levels of ambroxol in treatment of pulmonary infections.Methods 68 patients with pulmonary infection were selected and divided into the observation group(n =34)and control group by using the random number table method(n =34).The observation group was treated with ammonia bromine atomization inhalation treatment,while the control group was treated with alpha chymo-trypsin atomization inhalation therapy.The clinical effect and duration of symptoms and signs disappeared of the two groups were compared,and serum CRP level changes in the two groups before and after treatment were also compared. Results After treatment,the clinical total effective rate was 91.2% of the observation group.And the total effective rate was 70.6% in control group,the comparison between the two groups had statistically significant difference (χ2 =4.316,P <0.05).Compared with the control group,the observation group patients symptoms disappear time(3.1 ± 0.5)d,pulmonary symptoms disappear time(4.1 ±1.7)d,body temperature returned to normal time(4.1 ±1.6)d and hospital stay(8.4 ±2.8)d were significantly shortened,the differences were statistically significant (t =2.879, 2.918,3.025,3.972,all P <0.05 ).The serum CRP levels in patients of the observation group was (22.45 ± 9.27)mg/L,which of the control group was (33.45 ±14.67 )mg/L,both were significantly lower than before treatment,the difference was statistically significant (t =6.314,5.126,all P <0.05).The lower degree of serum CRP level in the observation group was obviously better than tha in the control group,the difference was statistically significant (t =6.263,P <0.05).Conclusion The ambroxol can achieve significant clinical effect on treatment of pulmonary infections,which can significantly shorten the patientˊs symptoms and lung signs disappear time and length of hospital stay,etc.It can reduce the serum CRP level,and is worth popularization and application in clinic.

Objective: To investigate the effect of the acid inhibitor-Lansoprazole on the distribution of Helicobacter pylori (H.pylori) in stomach. Methods: Biopsy specimens were taken from the duodenal ulcer patients who underwent gastroscopy before and after the treatment of Lansoprazole. The biopsy specimens were taken from the lesser curvature of the antrum and the greater curvature of the corpus respectively. H&E and Warthin-Starry staining were used for detecting the changing of active gastritis and the positive rate of H.pylori. Results: (1)The positive rates of H.pylori before treatment, 4 weeks after treatment and 3 months after treatment, in the lesser curvature of the antrum were 93.02%, 58.14%, and 86.05%, respectively. The positive rate and density of H.pylori 4 weeks after treatment were greatly decreased compared with those before treatment (P