[Objective] To explore the clinical features of IgG4-related urinary diseases so as to provide reference for the diagnosis and treatment of such diseases. [Methods] The clinical data of 4 cases of IgG4-related urinary system diseases diagnosed and treated in Xijing Hospital of Air Force Medical University during Aug.2019 and Dec.2023 were retrospectively collected.Here, we report on the diagnosis and treatment of these patients, analysing their symptoms, serology, imaging and pathology as well as their treatment and outcomes. [Results] The patients included 2 male and 2 female.The lesions were involved with the retroperitoneum and urinary system.Three patients had symptoms of lumbar pain.The imaging manifestations were complex, including retroperitoneal mass involving urinary system organs in 2 cases, tabdense shadow of the right kidney in 1 case, and simple cystic mass of kidney in 1 case.Serum IgG4 value was not detected before surgery.All patients underwent radical surgical treatment.Postoperative pathology showed fibrous tissue hyperplasia with a large number of plasma cells, lymphocytes, a few neutrophil infiltrates, and lymphoid follicles and obliterated vasculitis in some specimens.The number of IgG4⁺ plasma cells was more than 10 in all tissues under high power microscope.After surgery, 3 patients had symptoms improved, and serum IgG4 value was within the normal range; 1 patient (patem 3) had elevated IgG4 value during follow-up, received subsequent hormone therapy, and the serum IgG 4 level remained stable. [Conclusion] The symptoms of IgG4-related diseases involving the urinary system are non-specific, and the imaging findings are various, easily confused with other diseases.Early detection of serum IgG4 and biopsy pathology can help clinicians make correct diagnosis in the early stage.

Gualou Niubangtang is a classic formula for eliminating swelling and dispersing lumps， commonly used in the clinical treatment of breast diseases in traditional Chinese medicine （TCM）. This paper employed bibliometric methods to collect and organize 12 pieces of data from ancient texts related to Gualou Niubangtang， ultimately screening 10 valid references from 10 ancient Chinese medical books. Information regarding the prescription origin， main indications， formulation principles， drug composition， dosages， preparation methods， and decoction techniques was systematically verified. The results indicate that Gualou Niubangtang originates from the Orthodox Manual of External Medicine （Wai Ke Zheng Zong） by Chen Shigong in the Ming Dynasty. The formula consists of 12 Chinese medicines， including Citri Reticulatae Pericarpium， Arctii Fructus， Gardeniae Fructus， Lonicerae Japonicae Flos， Glycyrrhizae Radix et Rhizoma， Trichosanthis Semen， Scutellariae Radix， Trichosanthis Radix， Forsythiae Fructus， Gleditsiae Spina， Bupleuri Radix， and Citri Reticulatae Pericarpium Viridm. In terms of drug origins， the dominant radical for Trichosanthis Semen and Trichosanthis Radix is Trichosanthes kirilowii， and the historical dominant radical for Glycyrrhizae Radix et Rhizoma is Glycyrrhiza uralensis. The nine medicines， Citri Reticulatae Pericarpium， Arctii Fructus， Gardeniae Fructus， Lonicerae Japonicae Flos， Scutellariae Radix， Forsythiae Fructus， Gleditsiae Spina， Bupleuri Radix， and Citri Reticulatae Pericarpium Viridm， are consistent with the 2020 edition of the Chinese Pharmacopoeia. The preparation methods involve frying Arctii Fructus， removing the heart from Forsythiae Fructus， while the remaining 10 medicines are used raw. The efficacy includes clearing heat， removing toxins， reducing swelling， and dispersing lumps. Clinically， it is used to treat conditions such as breast carbuncles， breast gangrene， and knot-like swellings and pain. The dosage， converted to modern standards， includes 3.73 g of Trichosanthis Semen， 3.73 g of Trichosanthis Radix， 3.73 g of Arctii Fructus， 3.73 g of Scutellariae Radix， 3.73 g of Gardeniae Fructus， 3.73 g of Forsythiae Fructus， 3.73 g of Gleditsiae Spina， 3.73 g of Lonicerae Japonicae Flos， 3.73 g of Glycyrrhizae Radix et Rhizoma， 3.73 g of Citri Reticulatae Pericarpium， 1.85 g of Citri Reticulatae Pericarpium Viridm， and 1.85 g of Bupleuri Radix. The preparation is in the form of a decoction， with the 12 medicines added to 400 mL of water and decocted until 160 mL. The liquid is then mixed with 200 mL of yellow wine and taken before meals three times a day. Through the excavation and organization of ancient literature regarding Gualou Niubangtang， key information has been identified to provide a scientific basis for its clinical application and further development.

Objective To explore the effect of task-oriented training of intelligent mirror gloves combined with low-frequency repeti-tive transcranial magnetic stimulation(rTMS)on hand function recovery in stroke patients. Methods From October 1st,2022 to June 30th,2023,136 stroke patients in Northern Jiangsu People's Hospital were ran-domly divided into control group,mirror group,rTMS group and combination group,with 34 patients in each group.All the groups received routine rehabilitation treatment.In addition,the mirror group received task-orient-ed training of intelligent mirror gloves,rTMS group received low-frequency rTMS,and the combination group received task-oriented training combined with low-frequency rTMS,for four weeks.The Fugl-Meyer Assess-ment-Upper Extremities(FMA-UE)score,Wolf Motor Function Test(WMFT)score,and surface electromyo-graphic root mean square(RMS)of forearm extensor and flexor muscle groups on the affected/healthy side be-fore and after treatment were compared.And the differences of transcranial magnetic stimulation-motor-evoked potentials(MEP)between rTMS group and combination group before and after treatment were also compared. Results Four cases in the control group,seven in the mirror group,five in rTMS group and six in the combination group dropped off.The intra-group effect(F>996.656,P<0.001),inter-group effect(F>20.333,P<0.001)and inter-action effect(F>72.796,P<0.001)were significant in the scores of FMA-UE and WMFT,and the RMS ratio of forearm extensor and flexor muscle groups among four groups,in which the combination group was the best.After treatment,the amplitude of MEP increased in rTMS group and combination group(|t|>3.842,P<0.05),and was higher in the combination group than in rTMS group(t=-3.060,P<0.01). Conclusion The task-oriented training of intelligent mirror gloves combined with low-frequency rTMS could effectively promote the recovery of hand function in stroke patients.

Objective To establish a method to characterize the size and density of the female breast based on three-dimensional images of breast cone-beam computed tomography (CBCT), and describe the breast characteristics of women in a region of China, and to explore its value in dosimetric assessment for breast CBCT examinees. Methods We retrospectively surveyed the breast CBCT images of 203 women in a grade A tertiary hospital in a southwestern city of China from January 2021 to March 2023. The effective diameter of the breast at the chest-wall (D_eff), chest wall-to-nipple length (CNL), the effective diameter of the breast at half of CNL (D_h/2), breast volume (BV), glandular volume (GV), and volumetric breast density (VBD) were measured using the specific tools of the Koning Imaging Viewer system. The differences between groups were assessed using the Kruskal-Wallis H test. The correlation between variables was assessed using the Spearman’s correlation coefficient. Results The median values of D_eff, D_h/2, CNL, BV, GV, and VBD of the surveyed population were 11.9 cm, 8.3 cm, 6.5 cm, 327.7 cm³, 47.0 cm³, and 15.4%, respectively. GV and VBD had significant negative correlations with age. D_eff, D_h/2, CNL, and BV were significantly negatively correlated with VBD. Conclusion We established a quantitative method to analyze female breast characteristics based on three-dimensional breast CBCT images, and preliminarily characterized the female breast in a region of China, which can provide methodological support for the investigation of female breast characteristics in various regions of China in the future.

Objective:To identify key genes and their potential biological mechanisms in the progression of non-alcoholic fatty liver disease (NAFLD) using bioinformatics technology.Methods:Genes differentially expressed in simple non-alcoholic fatty liver disease (NAFL) and non-alcoholic steatohepatitis (NASH) were analyzed by integrating NAFLD-related sequencing datasets GSE135251 and GSE167523 from the Gene Expression Omnibus (GEO) datebase. Gene Ontology (GO) functional enrichment analysis, Kyoto Encyclopedia of Genes and Genomes (KEGG) and Reactome signaling pathway analysis were performed. Key genes were identified by STRING database and Cytoscape3.7.2 software, and the expression of key genes under different fibrosis grades and activity scores was observed. In addition, the expression of key genes in different cell clusters was observed based on the single-cell RNA-seq dataset of NAFLD mice.Results:Bioinformatics methods were used to obtain 97 common differential genes in NAFLD from two datasets. GO functional enrichment analysis was mainly performed in Extracellular Matrix (ECM) tissues. The main signaling pathway is ECM-receptor interaction. Five key genes were identified based on PPI network and Cytoscape software: COL1A1, THBS2, CXCL8, THY1 and LOXL1. The expression of key genes was significantly positively correlated with fibrosis grade and activity score, indicating that they were closely related to the progression of NAFLD. These key genes are highly expressed in hepatic stellate cells (HSCs) and natural killer/T cells (NK/T cells).Conclusion:In this study, bioinformatics technology was used to identify five key genes that may be involved in the NAFL-NASH transformation, suggesting that the ECM-receptor interaction signaling pathway may be a key molecular mechanism of NAFLD disease progression.

Objective:To observe any effect of combining motor imagery therapy (MIT) with repeated transcranial magnetic stimulation (rTMS) for improving upper limb motor functioning after a stroke.Methods:Ninety stroke survivors were randomly divided into a control group, an MIT group and a combination group, each of 30. All received conventional rehabilitation therapy, while the MIT group additionally received MIT and the combination group received the MIT along with 1Hz rTMS applied over the M1 region of the contralateral cortex. Before and after 4 weeks of treatment, everyone′s upper limb functioning was quantified using the Fugl-Meyer assessment scale (FMA) and the Hong Kong version of the hemiplegia upper limb function test (FTHUE-HK). Motor evoked potentials (MEPs), cortical latency (CL) and central motor conduction time (CMCT) were also recorded.Results:After the treatment the average FMA and FTHUE-HK scores of all three groups had improved significantly. The average CL and CMCT were significantly shortened. Compared with the control group, the average upper limb FMA score and FTHUE-HK scores of the treatment group were significantly higher. The combination group showed a significant improvement in its average MEP cortical latency and CMCT values.Conclusions:MIT therapy alone can improve the upper limb motor functioning of stroke survivors, but it is more effective in combination with rTMS.

Currently, commercial devices for electrical neural stimulations can only provide fixed stimulation paradigms with preset constant parameters, while the development of new stimulation paradigms with time-varying parameters has emerged as one of the important research directions for expanding clinical applications. To facilitate the performance of electrical stimulation paradigms with time-varying parameters in animal experiments, the present study developed a well-integrated stimulation system to output various pulse sequences by designing a LabVIEW software to control a general data acquisition card and an electrical stimulus isolator. The system was able to generate pulse sequences with inter-pulse-intervals (IPI) randomly varying in real time with specific distributions such as uniform distribution, normal distribution, gamma distribution and Poisson distribution. It was also able to generate pulse sequences with arbitrary time-varying IPIs. In addition, the pulse parameters, including pulse amplitude, pulse width, interphase delay of biphasic pulse and duration of pulse sequence, were adjustable. The results of performance tests of the stimulation system showed that the errors of the parameters of pulse sequences output by the system were all less than 1%. By utilizing the stimulation system, pulse sequences with IPI randomly varying in the range of 5~10 ms were generated and applied in rat hippocampal regions for animal experiments. The experimental results showed that, even with a same mean pulse frequency of ~130 Hz, for neuronal populations, the excitatory effect of stimulations with randomly varying IPIs was significantly greater than the effect of stimulations with fixed IPIs. In conclusion, the stimulation system designed here may provide a useful tool for the researches and the development of new paradigms of neural electrical stimulations.
Animals ; Electric Stimulation ; Neurons ; Rats

Objective To study the role of autophagy in proliferation,migration and tube formation of retinal vascular endothelial cells (RVECs) under the condition of hypoxia in vitro.Methods Mouse RVECs were isolated from 50 C57BL/6J mice primarily cultured using explant culture method,and the cells were identified by immunofluorescence of CD34.Well cultured RVECs were divided into normal control group,hypoxia control group and hypoxia+ 3-methyladenine (3-MA) group.The cells in the normal control group were cultured in the normal environment for 24 hours,and the cells in the hypoxia control group were cultured 1％ O2 environment for 24 hours,and the cells in the hypoxia+3-MA group were pretreated with 5 mmol/L 3-MA for 4 hours and then exposed to 1％ O2 environment for 24 hours.Microtubule-related protein 1 light chain 3 (LC3-Ⅱ/LC3-Ⅰ) and Beclin-1 protein contents in the cells were detected by Western blot analysis;the ultrastructure of autophagosome was examined under the transmission electron microscope.The proliferation,migration and tube formation of the cells were detected by Click-iTEdU kit,scratch assay and matrigel,respectively.Results Primarily culture cells grew well with the cobblestone-like appearance 5-7 days after culture and showed positive response for CD34.The autophagosome number was increased in the hypoxia control group compared with the hypoxia+3-MA group and normal control group.The LC3-Ⅱ/LC3-Ⅰ ratio was 0.243 ± 0.030,0.658 ± 0.032 and 0.405 ± 0.095;the relative expression of Beclin-1 protein in the cells was 0.260±0.040,0.650±0.071 and 0.461±0.089;the proliferation rate of the cells was (45.93± 6.39) ％,(22.74± 2.35) ％ and (24.12 ± 3.59) ％;the scratch healing rate of the cells was (36.02 ± 5.84) ％,(57.26±11.98) ％ and (18.16±9.73) ％;the number of tube formation was 29.20±6.10,41.40±4.04 and 22.00± 2.92 in the normal control group,hypoxia control group and hypoxia + 3-MA group,respectively,with significant differences among the groups (F =35.86,23.53,34.28,21.12,23.27;all at P＜0.01).Compared with the normal control group,the ratio of LC3-Ⅱ/LC3-Ⅰ and the expression of Beclin-1 protein,scratch healing rate and the number of tube formation were significantly increased,and the proliferation rate was significantly reduced in the hypoxia control group (all at P ＜ 0.05).Compared with the hypoxia control group,the ratio of LC3-Ⅱ/LC3-Ⅰ and the expression of Beclin-1 protein,scratch healing rate and the number of tube formation were significantly decreased in the hypoxia + 3-MA group.Conclusions Hypoxia environment activates autophagy of mouse RVECs,which enhances the migration and tube formation abilities of the cells.3-MA inhibits the angiogenesis abilities of mouse RVECs.

Objective To understand the situation of iodine deficiency disorders and iodine nutrition of children in Yunnan Province after the implementation of new standard of salt iodine,and provide the basic data for prevention and control of iodine deficiency disorders.Methods Using multistage sampling method,Yunnan provincial evaluations for iodine deficiency disorders elimination were carried out.According to the comparative analysis of 2010 (pre-adjustment) and 2015 (post-adjustment) evaluation results,the changes of the median of salt iodine,the coverage rate of iodized salt,the qualified rate of iodized salt,the rate of qualified iodized salt consumption,goiter rate of school children aged 8-10 and the median of urinary iodine were evaluated.Salt iodine was tested using the "Salt Industry General Test Method for Determination of Iodine" (GB/T 13025.7-1999);thyroid volume examination of children using B-scan ultrasonography,thyroid volume calculation and enlargement judgment using "Diagnostic Criteria for Endemic Goiter" (WS 276-2007);and urinary iodine detection using "Urinary Iodine Arsenic Cerium Catalytic Spectrophotometry" (WS/T 107-2006).Results The medians of salt iodine in 2010 and 2015 were 30.6 and 22.4 mg/kg,respectively,the difference was statistically significant (U =317 503.50,P ＜ 0.01).The coverage rates of iodized salt in 2010 and 2015 were 99.6％ (1 681/1 688) and 98.9％ (2 592/2 622),the qualified rates of iodized salt were 98.6％ (1 657/1 681) and 89.7％ (2 325/2 592),and the rates of qualified iodized salt consumption were 98.2％ (1 657/1 688) and 88.7％ (2 325/2 622),and the differences were statistically significant (x2 =6.42,125.11,130.18,P ＜ 0.01);the rates of children goiter in 2010 and 2015 were 0.8％ (25/3 272) and 1.4％(44/3 245),respectively;the medians of urinary iodine of children were 289.0 and 157.3 μg/L,respectively,the difference was statistically significant (U =1 121 669.50,P ＜ 0.01).Conclusion After decreasing of salt iodine level starting from 2012 in Yunnan Province,the children iodine nutrition condition is in a more proper level.

Objective:To investigate the accuracy of a threshold-based segmentation method based on cone beam breast CT(CBBCT) images in breast density measurement,and its value for breast-type classification and breast cancer screening.Methods:A retrospec-tive analysis of 195 patients who had undergone CBBCT examination at Tianjin Medical University Cancer Institute and Hospital be-tween May 2012 and August 2014 was performed.A total of 64 breasts were analyzed.On the basis of the classification criteria for breast density in BI-RADS,they were classified into four types and the majority report was reported.Breast density was measured by the threshold-based segmentation method based on CBBCT images and corrected manually to obtain the corrected breast density.A month later,the procedure was repeated.Intra-class correlation coefficients(ICCs)were used to compare the intra-observer and inter-observer consistencies of threshold-based segmentation and manually corrected breast density measurement results for non-dense and dense breasts.Results:For threshold-based segmentation measurements the intra-observer and inter-observer ICC values were 0.0.9624(95% CI:0.9388~0.9770)and 0.9666(95% CI:0.9500~0.9785).For manually corrected measurements,the intra-observer and inter-observer ICC values were 0.9750 (95% CI: 0.9592~0.9847) and 0.9775 (95% CI: 0.9661~0.9855). The ICC between the threshold-based segmentation method and manual correction was 0.9962 (95% CI: 0.9983~0.9977). The ICC values of threshold-based and manually corrected measurement in non-dense and dense breasts were 0.9497(95% CI:0.7072-0.9914)and 0.9983(95% CI:0.9971-0.9990),respectively.Conclusions:The threshold-based segmentation method based on CBBCT is a reliable and accurate com-puter-aided method of measuring breast density.It is expected to be applied in large-scale screening of breast cancer and to provide more information for predicting the risk of breast cancer.