Guided by molecular networking, nine novel curvularin derivatives (1-9) and 16 known analogs (10-25) were isolated from the hydrothermal vent sediment fungus Penicillium sp. HL-50. Notably, compounds 5-7 represented a hybrid of curvularin and purine. The structures and absolute configurations of compounds 1-9 were elucidated via nuclear magnetic resonance (NMR) spectroscopy, X-ray diffraction, electronic circular dichroism (ECD) calculations, ¹³C NMR calculation, modified Mosher's method, and chemical derivatization. Investigation of anti-inflammatory activities revealed that compounds 7-9, 11, 12, 14, 15, and 18 exhibited significant suppressive effects against lipopolysaccharide (LPS)-induced nitric oxide (NO) production in murine macrophage RAW264.7 cells, with IC₅₀ values ranging from 0.44 to 4.40 μmol·L^-1. Furthermore, these bioactive compounds were found to suppress the expression of inflammation-related proteins, including inducible NO synthase (iNOS), cyclooxygenase-2 (COX-2), NLR family pyrin domain-containing protein 3 (NLRP3), and nuclear factor kappa-B (NF-κB). Additional studies demonstrated that the novel compound 7 possessed potent anti-inflammatory activity by inhibiting the transcription of inflammation-related genes, downregulating the expression of inflammation-related proteins, and inhibiting the release of inflammatory cytokines, indicating its potential application in the treatment of inflammatory diseases.
Penicillium/chemistry* ; Mice ; Animals ; Anti-Inflammatory Agents/isolation & purification* ; RAW 264.7 Cells ; Nitric Oxide/metabolism* ; Hydrothermal Vents/microbiology* ; Macrophages/immunology* ; Molecular Structure ; Nitric Oxide Synthase Type II/immunology* ; Cyclooxygenase 2/immunology* ; Geologic Sediments/microbiology* ; NF-kappa B/immunology* ; NLR Family, Pyrin Domain-Containing 3 Protein/immunology*

Ideological and political education within the curriculum of higher institutions of traditional Chinese medicine （TCM） not only bears the important responsibility of promoting China's outstanding traditional culture but also serves as a vital domain for upholding integrity and innovation in medical education. These institutions must profoundly comprehend the contemporary significance of curriculum-based ideological and political education， clarify its core role in talent cultivation， leverage the distinctive advantages of TCM culture， and promote the organic integration of ideological education and professional training. By reviewing the current situation and development trends of ideological and political education in the curriculum of higher TCM institutions， this paper has analyzed the challenges in teaching design， teachers' ideological and political literacy and competence， and the integration of ideological content with specialized courses， and has proposed implementation strategies such as using TCM culture as a guiding force， strengthening teachers' teaching capacity in ideological and political education， developing distinctive educational resources， and improving evaluation and incentive mechanisms. These strategies aim to effectively enhance the impact of ideological and political education in the new era， fostering well-rounded TCM talents with both moral integrity and professional competence.

OBJECTIVE: To investigate the application of three-dimensional (3D) reconstruction technology in preoperative planning for anterolateral thigh flap transplantation. METHODS: A retrospective analysis was performed on the clinical data of 11 patients with skin and soft tissue defects treated with free anterolateral thigh flap transplantation between January 2022 and January 2024, who met the selection criteria. There were 8 males and 3 females, aged 34-70 years (mean, 50.8 years). Causes of injury included traffic accidents (4 cases), machine trauma (3 cases), heavy object crush injury (3 cases), and tumor (1 case). The time from injury to flap repair ranged from 7 to 35 days (mean, 23 days). Preoperatively, the patients' CT angiography images were imported into Mimics21.0 software. Through the software's segmentation, editing, and reconstruction functions, 3D visualization and measurement of the vascular pedicle, perforators, wound size, and morphology were performed to plan the flap harvest area, contour, vascular pedicle length, and anastomosis site, guiding the implementation of flap transplantation. RESULTS: The length of the vascular pedicle needed by the recipient site was (9.1±0.9) cm, and the maximum length of vascular pedicle in the donor area was (10.6±0.6) cm, with a significant difference ( t=4.230, P<0.001). The operation time ranged from 220 to 600 minutes (mean, 361.9 minutes). One patient had poor wound healing at the recipient site, which healed after dressing changes. All 11 flaps survived well without necrosis. All patients were followed up 6-19 months (mean, 11 months). Four flaps showed bulkiness and underwent secondary debulking; the remaining flaps had good contour and soft texture. The donor sites healed well, with no sensory disturbance around the incision or complications such as walking impairment. CONCLUSION Preoperative planning using CT angiography data and 3D reconstruction software can effectively determine the flap area, contour, required vascular pedicle length, anastomosis site, and whether vascular grafting is needed, thereby guiding the successful execution of anterolateral thigh flap transplantation.
Humans ; Middle Aged ; Male ; Female ; Adult ; Thigh/diagnostic imaging* ; Aged ; Plastic Surgery Procedures/methods* ; Retrospective Studies ; Imaging, Three-Dimensional/methods* ; Soft Tissue Injuries/surgery* ; Surgical Flaps ; Computed Tomography Angiography ; Free Tissue Flaps/blood supply* ; Preoperative Care

Objective Exploring the performance of a sensitivity recognition model for neoadjuvant therapy based on ensemble learning algorithms for predicting neoadjuvant therapy sensitive patients.Methods In this study,255 rectal cancer patients who underwent standard neoadjuvant therapy and surgery at the Affiliated Cancer Hospital of Harbin Medical University were collected,of which 139 patients were sensitive to neoadjuvant therapy and 116 patients were not.The recursive feature elimination method was used to screen deep learning features and imaging histology features to construct an integrated learning model.The generalization performance of the model was verified using the leave-out method,and the sensitivity,specificity,positive predictive value,negative predictive value,accuracy,G-mean,F-measure,Mathews correlation coefficient(MCC),and area under the receiver operating charactpristic curve(AUC)were used to evaluate and compare the model performance.Results The performance of the integrated model on the external validation set was:an AUC value of 0.916(95％CI:0.899 to 0.935),a sensitivity of 1.000,a specificity of 0.833,a positive predictive value of 0.875,a negative predictive value of 1.000,an accuracy of 0.923,a G-mean of 0.913,an F-measure of 0.933,a MCC was 0.854.Conclusion The integration model of depth features and imaging omics features is superior to the individual depth feature model and imaging omics feature model,and has good practicality and reliability in identifying sensitive patients with neoadjuvant therapy,which can be used as a reference for clinical practice.

Objective We improved the segmentation model TransUNet based on deep learning methods to construct a multitask model that can both segment regions of interest and predict classification,which made it possible to identify sensitive populations of patients undergoing neoadjuvant therapy for rectal cancer.Methods The multitask model added classification structure on the basis of TransUNet,including the fully connected layer(input of 512,output of 256),the ReLU activation function,and the fully connected layer(input of 256,output of 3),to achieve the prediction of triple classification outcomes(stable disease(SD),partial response(PD),and complete response(CR)).The 3D MRI of 71 rectal cancer patients before neoadjuvant chemotherapy admitted to the Harbin Medical University Cancer Hospital from 2015 to 2017 were extracted into 2D images as data for the study.Dice coefficient and Hausdorff distance were used to evaluate thesegmentation performance,and accuracy,micro-precision,micro-recall,and micro-F1 score were used for classification performance.Results The model was trained for 100 epochs,and the average Dice coefficient and average Hausdorff distance for the segmentation task on the test set were 0.851 and 10.806,respectively.For the classification task,the accuracy,micro-precision,micro-recall,and micro-F1 score on the test set were all 0.651 from the slicing perspective,and all four metrics were 0.857 from the patient perspective.Conclusion Our model works well in the segmentation task.Although the model performs poorly on the classification task at the slice level,the performance was acceptable at the patient level taking into account the tripartite classification results.The multitask model has the potential to be used in the clinic for assisted diagnosis.

Objective We improved the segmentation model TransUNet based on deep learning methods to construct a multitask model that can both segment regions of interest and predict classification,which made it possible to identify sensitive populations of patients undergoing neoadjuvant therapy for rectal cancer.Methods The multitask model added classification structure on the basis of TransUNet,including the fully connected layer(input of 512,output of 256),the ReLU activation function,and the fully connected layer(input of 256,output of 3),to achieve the prediction of triple classification outcomes(stable disease(SD),partial response(PD),and complete response(CR)).The 3D MRI of 71 rectal cancer patients before neoadjuvant chemotherapy admitted to the Harbin Medical University Cancer Hospital from 2015 to 2017 were extracted into 2D images as data for the study.Dice coefficient and Hausdorff distance were used to evaluate thesegmentation performance,and accuracy,micro-precision,micro-recall,and micro-F1 score were used for classification performance.Results The model was trained for 100 epochs,and the average Dice coefficient and average Hausdorff distance for the segmentation task on the test set were 0.851 and 10.806,respectively.For the classification task,the accuracy,micro-precision,micro-recall,and micro-F1 score on the test set were all 0.651 from the slicing perspective,and all four metrics were 0.857 from the patient perspective.Conclusion Our model works well in the segmentation task.Although the model performs poorly on the classification task at the slice level,the performance was acceptable at the patient level taking into account the tripartite classification results.The multitask model has the potential to be used in the clinic for assisted diagnosis.

Objective Exploring the performance of a sensitivity recognition model for neoadjuvant therapy based on ensemble learning algorithms for predicting neoadjuvant therapy sensitive patients.Methods In this study,255 rectal cancer patients who underwent standard neoadjuvant therapy and surgery at the Affiliated Cancer Hospital of Harbin Medical University were collected,of which 139 patients were sensitive to neoadjuvant therapy and 116 patients were not.The recursive feature elimination method was used to screen deep learning features and imaging histology features to construct an integrated learning model.The generalization performance of the model was verified using the leave-out method,and the sensitivity,specificity,positive predictive value,negative predictive value,accuracy,G-mean,F-measure,Mathews correlation coefficient(MCC),and area under the receiver operating charactpristic curve(AUC)were used to evaluate and compare the model performance.Results The performance of the integrated model on the external validation set was:an AUC value of 0.916(95％CI:0.899 to 0.935),a sensitivity of 1.000,a specificity of 0.833,a positive predictive value of 0.875,a negative predictive value of 1.000,an accuracy of 0.923,a G-mean of 0.913,an F-measure of 0.933,a MCC was 0.854.Conclusion The integration model of depth features and imaging omics features is superior to the individual depth feature model and imaging omics feature model,and has good practicality and reliability in identifying sensitive patients with neoadjuvant therapy,which can be used as a reference for clinical practice.

BACKGROUND:Arthroplasty is the primary treatment for displaced femoral neck fractures in the elderly,and the choice of total hip arthroplasty versus hemiarthroplasty is currently the subject of considerable debate. OBJECTIVE:To compare the mid-and long-term survival status of total hip arthroplasty versus hemiarthroplasty under a direct anterior approach for displaced femoral neck fractures in the elderly based on the propensity score matching method. METHODS:One hundred and forty-seven elderly patients(≥65 years of age)with displaced femoral neck fractures were admitted from January 2016 to January 2021,of whom 88 had total hip arthroplasty(total hip arthroplasty group)and 59 had artificial femoral head replacement(hemiarthroplasty group).For the patients'preoperative comorbidities,the age-corrected Charlson Comorbidity Scale was used to quantify the scores and calculate patient frailty.The propensity score matching method was used to match the two groups 1:1 and to compare the operation time,bleeding,postoperative hospitalization time,hospitalization cost,nutritional index,postoperative complications,and mortality between the two groups after matching.Postoperative survival time was determined by Kaplan-Meier Survival analysis. RESULTS AND CONCLUSION:(1)After propensity score matching,a total of 42 matched pairs were successful in both groups,and the preoperative data of patients in both groups were balanced and comparable after matching(P>0.05).(2)Compared with the hemiarthroplasty group,operation time(79.71 minutes vs.59.07 minutes,P<0.001),bleeding volume(839.64 mL vs.597.83 mL,P=0.001),and hospitalization cost(56 508.15 yuan vs.41 702.85 yuan,P<0.001)were significantly higher in the total hip arthroplasty group.However,the mortality rate was lower in the total hip arthroplasty group than in the hemiarthroplasty group(36%vs.57%,HR=0.44,95%CI:0.23-0.87,P=0.018),and the mean survival time was longer in the total hip arthroplasty group than in the hemiarthroplasty group(59.4 months vs.43.7 months,P=0.024).(3)There were no statistically significant differences in postoperative hospitalization time,preoperative and postoperative nutritional indicators,and overall postoperative complication rate between the two groups(P>0.05).However,in terms of postoperative pain,the incidence of pain was significantly higher in the hemiarthroplasty group than that in the total hip arthroplasty group(24%vs.7%,P=0.035).(4)Overall,total hip arthroplasty has a better prognosis for survival,while hemiarthroplasty is more appropriate for patients with poor physical fitness.At the same time,postoperative pain may largely affect the quality and survival time of patients after hip arthroplasty.

BACKGROUND:Transposition of the long head of biceps tendon is a commonly surgical method for massive rotator cuff tears.Currently,there are a few reports on the clinical efficacy of the transposition of the long head of biceps tendon and there is no consensus on the influencing factors for retearing. OBJECTIVE:To observe the outcome of arthroscopic long head of the biceps tendon in the treatment of massive rotator cuff tear. METHODS:The clinical data of 28 patients with massive rotator cuff tears,aged(61.79±10.50)years,admitted at Jiangsu Province Hospital of Chinese Medicine from March 2019 to May 2022 were retrospectively analyzed.All patients underwent arthroscopic long head of the biceps tendon.Patients were assessed for visual analog scale scores,University of California at Los Angeles scores,American Shoulder and Elbow Surgeons scores,Constant-Murley scores,and shoulder range of motion before and 1 year after operation.MRI of the shoulder joint was performed for observing the integrity of the repaired structure at 1 year after operation.Twenty-three patients(5 of 28 lost to follow-up)were categorized into the intact tendon group(n=18)and the tendon retear group(n=5)according to the Sugaya typing at 1 year after operation;the patients were divided into the normal group(n=8),the degeneration group(n=9),and the partial tear group(n=6)according to the intraoperative quality of the long head of the biceps tendon.Differences in the above indexes were compared between groups. RESULTS AND CONCLUSION:When followed up at 1 year after surgery,the range of motion,visual analog scale scores,University of California at Los Angeles scores,American Shoulder and Elbow Surgeons scores,Constant-Murley scores of the shoulder were significantly improved compared with preoperative data(P＜0.05).There was a significant difference in Goutellier grading between intact tendon and tendon retear groups(P＜0.05),while no significant difference was observed in the other influencing factors(P＞0.05).There were no significant differences in visual analog scale scores,University of California at Los Angeles scores,American Shoulder and Elbow Surgeons scores,Constant-Murley scores,and shoulder range of motion at 1 year after operation among the normal,degeneration,and partial tear groups(P＞0.05).MRI findings indicated that the sutured tendon healed well in 18 patients,with a healing rate of 78%.Arthroscopic long head of the biceps tendon for augmented repair can provide a reliable repair for massive rotator cuff tear that is refractory,significantly alleviate the pain of the shoulder joint,and restore the function of the shoulder joint.

Objective:To investigate the risk factors and their warning effectiveness for meniscus tear secondary to delayed anterior cruciate ligament (ACL) reconstruction.Methods:A retrospective cohort study was conducted to analyze the clinical data of 114 patients (114 knees) with ACL injury, who were admitted to Affiliated Hospital of Nanjing University of Chinese Medicine from December 2018 to December 2023, including 78 males and 36 females, aged 11-50 years [29(21, 35)years]. The patients were divided into tear group ( n=46) and non-tear group ( n=68) according to whether combined with meniscus tear or not during the surgery. Gender, age, duration of disease, smoking history, Body Mass Index (BMI), cause of injury, mechanism of injury, side of the injury, Beighton score, difference of KT-2000 examination, Tegner activity scale of the knee joint, anterior tibial translation sign, medial posterior tibial slope angle, lateral posterior tibial slope angle, and pivot shift grading of the patients in the two groups were recorded. Correlations between the above-mentioned indicators and occurrence of meniscus tear secondary to delayed ACL reconstruction were assessed. In the meantime, the independent risk factors were determined by univariate and multivariate binary logistic regression analysis. Receiver operating characteristic (ROC) curve and area under curve (AUC) were used to evaluate the warning effectiveness of each risk factor for meniscal tear secondary to delayed ACL reconstruction. Results:Univariate analysis showed correlation of duration of disease, BMI, Tegner activity scale of the knee joint, medial posterior tibial slope angle, lateral posterior tibial slope angle and high-grade pivot shift with occurrence of meniscus tear secondary to delayed ACL reconstruction ( P<0.01). The results of multivariate binary logistic regression analysis showed that the duration of disease ≥14.5 weeks ( OR=1.20, 95% CI 1.05, 1.38, P<0.01), BMI≥26.9 kg/m 2 ( OR=1.36, 95% CI 1.03, 1.81, P<0.05), Tegner activity scale of the knee joint ≥4 points ( OR=2.29, 95% CI 1.18, 4.46, P<0.05), medial posterior tibial slope angle ≥11.2° ( OR=2.27, 95% CI 1.06, 4.89, P<0.05) and high-grade pivot shift ( OR=0.03, 95% CI 0.01, 0.03, P<0.05) were significantly correlated with occurrence of meniscus tear secondary to delayed ACL reconstruction. Results of ROC curve analysis showed that the medial posterior tibial slope angle (AUC=0.86, 95% CI 0.80, 0.93) and duration of disease (AUC=0.85, 95% CI 0.77, 0.92) had good warning value, BMI (AUC=0.78, 95% CI 0.69, 0.87) and Tegner activity scale of the knee joint (AUC=0.73, 95% CI 0.64, 0.83) had ordinary warning value, and the warning value of high-grade pivot shift (AUC=0.60, 95% CI 0.49, 0.71) was the lowest. The combination of the risk factors revealed superior warning effectiveness for meniscus tear second to delayed ACL reconstruction (AUC=0.97, 95% CI 0.96, 1.00). Conclusions:The duration of disease ≥14.5 weeks, BMI ≥26.9 kg/m 2, Tegner score ≥4 points, medial posterior tibial slope angle ≥11.2°and high-grade pivot shift are independent risk factors for meniscus tear secondary to delayed ACL reconstruction. The medial posterior tibial slope angle and duration of disease have good warning value, BMI and Tegner scores have ordinary warning value and high-grade pivot shift has the lowest warning value. The combination of the above risk factors has better warning effectiveness for meniscus tear secondary to delayed ACL reconstruction.