Objective To evaluate the diagnostic efficacy of the Kaiser score for ultrasound(US)BI-RADS 4A lesions and the potential to avoid unnecessary biopsies.Methods Data of patients who underwent breast US and magnetic resonance imaging(MRI)between May 2019 and June 2023 were retrospectively collected,and all cases were confirmed by puncture biopsy or surgical pathology.The diagnostic efficacy of Kaiser score and MRI BI-RADS classification for US BI-RADS 4A lesions was calculated and compared using pathologic findings as the gold standard.Results A total of 119 lesions(74 benign and 45 malignant lesions)were found in the 119 patients.The diagnostic efficacy of the Kaiser score was significantly better than that of the MRI BI-RADS classification(AUC:0.88 vs.0.65,P＜0.000 1).The concordance of the Kaiser score results with the pathologic findings and the inter-observer concordance were better than that of the MRI BI-RADS classification.Unnecessary biopsies could be avoided in 87.8％(65/74)and 33.8％(25/74)of the cases when the Kaiser score and the MRI BI-RADS classification were applied for the diagnosis of US BI-RADS 4A lesions,respectively.Conclusion The Kaiser score can provide a diagnostic basis for risk stratification of US BI-RADS 4A lesions,and its diagnostic efficacy and inter-observer agreement are superior to those of MRI BI-RADS classification.

The aim of this study is to establish a rapid,efficient,and sensitive method for detecting the infectious laryngotracheitis virus(ILTV).The DNA of ILTV was extracted and used as a tem-plate to develop a recombinant enzyme-mediated isothermal amplification(RAA)fluorescence de-tection method for ILTV through optimization of conditions,sensitivity analysis,and repeatability assessment.Additionally,the nucleic acids of avian influenza virus(AIV),IBV,and Newcastle dis-ease virus(NDV)were detected to verify the specificity of this method.Finally,this method was applied to analyze 59 clinical samples collected from multiple large-scale chicken farms in Hebei Province,and the results were compared with those obtained from real-time fluorescence quantifi-cation(qPCR)and PCR methods according to national standards.The results showed that the RAA detection method established in this study had a reaction system of 25.0 μL buffer,2.1 μL primer,0.6 μL probe,5.0 μL magnesium acetate,and 5.0 μL template.The reaction temperature was 39 ℃ and the amplification time was within 20 minutes.The sensitivity of this method was 101 copies/μL,and the specificity detection was 100％.Testing of 59 clinical samples showed that 17 were detected positive by both RAA fluorescence and qPCR,and 12 were detected by PCR,and the detection rate of RAA(fluorescence)was consistent with real-time fluorescence quantification and qPCR,which was higher than that of the PCR assay.The research results indicate that the RAA fluorescence method has a short detection time,good specificity and sensitivity,and can be used for rapid detection of ILTV.

The aim of this study is to establish a rapid,efficient,and sensitive method for detecting the infectious laryngotracheitis virus(ILTV).The DNA of ILTV was extracted and used as a tem-plate to develop a recombinant enzyme-mediated isothermal amplification(RAA)fluorescence de-tection method for ILTV through optimization of conditions,sensitivity analysis,and repeatability assessment.Additionally,the nucleic acids of avian influenza virus(AIV),IBV,and Newcastle dis-ease virus(NDV)were detected to verify the specificity of this method.Finally,this method was applied to analyze 59 clinical samples collected from multiple large-scale chicken farms in Hebei Province,and the results were compared with those obtained from real-time fluorescence quantifi-cation(qPCR)and PCR methods according to national standards.The results showed that the RAA detection method established in this study had a reaction system of 25.0 μL buffer,2.1 μL primer,0.6 μL probe,5.0 μL magnesium acetate,and 5.0 μL template.The reaction temperature was 39 ℃ and the amplification time was within 20 minutes.The sensitivity of this method was 101 copies/μL,and the specificity detection was 100％.Testing of 59 clinical samples showed that 17 were detected positive by both RAA fluorescence and qPCR,and 12 were detected by PCR,and the detection rate of RAA(fluorescence)was consistent with real-time fluorescence quantification and qPCR,which was higher than that of the PCR assay.The research results indicate that the RAA fluorescence method has a short detection time,good specificity and sensitivity,and can be used for rapid detection of ILTV.

Objective To evaluate the diagnostic efficacy of the Kaiser score for ultrasound(US)BI-RADS 4A lesions and the potential to avoid unnecessary biopsies.Methods Data of patients who underwent breast US and magnetic resonance imaging(MRI)between May 2019 and June 2023 were retrospectively collected,and all cases were confirmed by puncture biopsy or surgical pathology.The diagnostic efficacy of Kaiser score and MRI BI-RADS classification for US BI-RADS 4A lesions was calculated and compared using pathologic findings as the gold standard.Results A total of 119 lesions(74 benign and 45 malignant lesions)were found in the 119 patients.The diagnostic efficacy of the Kaiser score was significantly better than that of the MRI BI-RADS classification(AUC:0.88 vs.0.65,P＜0.000 1).The concordance of the Kaiser score results with the pathologic findings and the inter-observer concordance were better than that of the MRI BI-RADS classification.Unnecessary biopsies could be avoided in 87.8％(65/74)and 33.8％(25/74)of the cases when the Kaiser score and the MRI BI-RADS classification were applied for the diagnosis of US BI-RADS 4A lesions,respectively.Conclusion The Kaiser score can provide a diagnostic basis for risk stratification of US BI-RADS 4A lesions,and its diagnostic efficacy and inter-observer agreement are superior to those of MRI BI-RADS classification.

Objective:The nanovesicles-hybridized selenized hyaluronic acid hydrogel(ICG-NV@SeHA)was constructed,and its mechanism of action in synergistically killing glioma GL261 cells in mice when combined with sonodynamic therapy(SDT)was systematically investigated.Methods:BMSC-derived nanovesicles(BMSC-NVs)were prepared via the extrusion method,followed by the incorporation of indocyanine green(ICG)to fabricate ICG-NV.Under the presence of EDC,hyaluronic acid(HA)was aminated using ethylenediamine(ED)to synthesize aminated HA(AHA),which was further conjugated with γ-selenobutyrolactone(SBL)via nucleophilic addition to form selenized HA(SeHA).AHA,ICG-NVs,and SBL solutions were mixed and oxidatively cross-linked to obtain ICG-NV@SeHA,followed by physical characterization.DiD-labeled ICG-NVs and ICG-NV@SeHA were co-cultured with GL261 cells for 12 h to observe cellular internalization.The biocompatibility of ICG-NVs and ICG-NV@SeHA with GL261 cells and mouse hippocampal neuronal HT22 cells was evaluated using the CCK-8 assay.GL261 cells were divided into four groups:PBS+ultrasound(US),ICG+US,ICG-NV+US,and ICG-NV@SeHA+US.Calcein-AM/PI staining and DCFH-DA fluorescent probes were employed to assess the synergistic SDT-induced cytotoxic effects on GL261 cells and intracellular reactive oxygen(ROS)generation,respectively.Cellular surface calreticulin(CRT)expression was analyzed via immunofluorescence,while enzyme-linked immunosorbent assay(ELISA)was used to measure the release of high mobility group box 1(HMGB1)and adenosine triphosphate(ATP).Results:BMSC-NVs were successfully prepared with an average particle size of approximately 154.3 nm.ICG was efficiently encapsulated into the nanovesicles with an encapsulation efficiency of 40.6%.HA was successfully aminated,achieving a grafting rate of 32.5%.Ultimately,the ICG-NV@SeHA hydrogel was successfully synthesized.Transmission electron microscopy(TEM)revealed a loose porous structure,and rheological analysis demonstrated that the storage modulus(G')exceeded the loss modulus(G''),consistent with hydrogel characteristics,along with shear-thinning behavior.Cellular experiments showed that ICG-NVs were effectively internalized by GL261 glioma cells.CCK-8 assays and Calcein-AM/PI fluorescence staining confirmed that both ICG-NVs and ICG-NV@SeHA exhibited excellent biocompatibility with no significant cytotoxicity toward GL261 and HT22 cells.However,the cell viability in the ICG-NV+US and ICG-NV@SeHA+US groups was significantly reduced compared to the ICG+US group(P<0.01 or P<0.001).DCFH-DA fluorescent probe assays revealed that the green fluorescence intensity in the ICG-NV+US and ICG-NV@SeHA+US groups was markedly higher than in the PBS,PBS+US,and ICG+US groups(P<0.000 1 or P<0.001),reflecting substantial intracellular ROS production.Additionally,cell surface CRT expression was significantly upregulated(P<0.000 1),and the release of HMGB1 and ATP in the supernatant increased(P<0.05 or P<0.01).Conclusion:The ICG-NV@SeHA hydrogel,which exhibits excellent mechanical properties and injectability,was successfully fabricated.Demonstrating favorable biocompatibility,this hydrogel,when combined with SDT,effectively kills glioma GL261 cells and induces immunogenic cell death(ICD).This strategy holds potential as a novel approach to prevent postoperative recurrence in glioma treatment.

Objective To systematically review the risk prediction models for intradialytic hypotension in maintenance hemodialysis patients,with a view to provide references for clinical practice.Methods PubMed,Embase,Web of Science,Cochrane Library,CINAHL,CNKI,VIP,Wanfang and CBM were searched from inception to May 29,2023.2 reviewers independently screened the literature,extracted information and assessed methodological quality using the Prediction Model Risk of Bias Assessment Tool.Results A total of 20 studies and 25 models were included with the sample size of 68～9 292 cases and the incidence of outcome events of 2.1～51％.Baseline systolic blood pressure,age,ultrafiltration rate,diabetes and dialysis duration were the top 5 predictors of repeated reporting of the models.20 models reported the area under the curve of ranging from 0.649 to 0.969,and 5 models reported calibration metrics.There were 9 internal validations and 4 combined internal and external validation models.The overall applicability of the 20 studies was good,but all had a high risk of bias,mainly in data analysis.Conclusion Research on risk prediction models for intradialytic hypotension in maintenance hemodialysis patients is still in the developmental stage.Future studies should improve the research design and reporting process,and validation studies of existing models should be carried out to further evaluate the effectiveness and feasibility in clinical practice.

Objective To evaluate which factors may affect magnetic resonance imaging(MRI)performance in the detection of pathologic complete response(pCR)after neoadjuvant chemotherapy(NAC).Methods This retrospective study involved 89 patients diagnosed with invasive breast carcinoma who received NAC at The Second Affiliated Hospital of Xi'an Jiaotong University from July 2019 to December 2021.Breast MRI was performed before and after NAC.Based on the pathological results obtained surgery after the completion NAC and using Miller-Payne classification as the evaluation standard,the patients were divided into two subgroups:pCR and non-pathological complete response(npCR).Chi-square test was used to compare the MRI characteristics of pre-NAC lesions between the two groups.ROC curve analysis was made to analyze the accuracy,sensitivity,specificity,positive predictive value,and negative predictive value of MRI after NAC;the diagnostic performance of MRI in predicting pCR in different tumor subtypes was analyzed.We made univariate and multivariate analyses of factors affecting radiographic complete response(rCR)and pCR concordance.Results MRI analysis after NAC showed rCR in 20 cases(22.5％)and pCR in 28 cases(31.5％).Considering rCR as a"positive"result of MRI analysis,MRI assessment was accurate in 79 cases,including 19 true positive cases and 60 true negative cases.MRI assessment was inaccurate in 10 cases,including 9 false negative cases and 1 false positive case.The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of MRI assessment of pCR were 67.86％,98.36％,88.76％,95.00％,and 86.96％.MRI had the lowest diagnostic efficiency in evaluating pCR of ERBB2+breast cancer after NAC.Single factor analysis showed that estrogen receptor(ER),clinical stage,background parenchymal enhancement,and maximum tumor diameter all affected the consistency of rCR and pCR(P＜0.05).Multivariate Logistic regression analysis showed that the independent influencing factor affecting the consistency of rCR and pCR was clinical stage.Conclusion MRI demonstrated good accuracy in predicting pCR after NAC in the breast cancer patients examined.Pre-treatment MRI characteristics and tumor subtypes may be related to the diagnostic accuracy of post-NAC MRI in breast cancer patients.

Objective This study aims to analyze the factors influencing benefit finding among cervical cancer patients and their spouses,as well as the interconnections between these factors.The goal is to provide a foundation for developing targeted clinical interventions.Methods Using the convenience sampling method,cervical cancer patients and spouses of 245 pairs who attended or were hospitalized in a tertiary-level hospital in Taiyuan City from October 2022 to July 2023 were selected as study subjects.Data were collected using a general information questionnaire,the Distress Disclosure Index,the Connor-Davidson Resilience Scale,and the Benefit Finding Scale.Univariate analysis,Pearson correlation analysis,and multiple linear regression were employed to scrutinize the data,leading to the establishment of Actor-Partner Interdependence Model.Results Benefit finding scores for cervical cancer patients and their spouses were(65.31±7.94)and(69.87±9.63),respectively.Multiple linear regression revealed that the educational level of patients and their spouses,whether or not they received chemotherapy or radiotherapy,self-disclosure and psychological resilience were the factors that affected patients'benefit finding.Spouse's education level,occupation,self-disclosure,psychological resilience and patients'self-disclosure and psychological resilience were the influencing factors of spouse's benefit finding.The Actor-Partner Interdependence Model analysis indicated that the self-disclosure and psychological resilience of cervical cancer patients positively predicted their own benefit finding and that of their spouses(path coefficients were 0.415,0.501,0.216,and 0.168,respectively,all P＜0.05).However,spouses'self-disclosure and psychological resilience could only positively predict their own benefit finding(path coefficients were 0.188 and 0.254,respectively,all P＜0.05).Conclusion Benefit finding among cervical cancer patients and their spouses is moderate and influenced by various factors.Both self-disclosure and psychological resilience of cervical cancer patients and their spouses have positive subjective effects on their own benefit finding.Healthcare professionals should encourage both parties to engage in healthy interactions about the disease,take steps to increase the level of psychological resilience of both,and ultimately tap into a higher level of benefit finding.

Objective:To explore the different categories of family resilience in cervical cancer patients and their influencing factors.Methods:From October 2022 to September 2023, 275 cervical cancer patients admitted to the First Hospital of Shanxi Medical University were selected as the study subject by convenience sampling. Cervical cancer patients were surveyed using the self-made General Information Questionnaire, Benefit Finding Scale (BFS), Connor-Davidson Resilience Scale (CD-RISC), and shortened Chinese Version of the Family Resilience Assessment Scale (FRAS-C). Latent profile analysis was used to investigate the family resilience of patients, and Logistic regression was used to analyze the influencing factors of family resilience in different categories.Results:A total of 275 questionnaires were distributed, and 253 valid questionnaires were collected, with a valid response rate of 92.0% (253/275). Family resilience of cervical cancer patients was divided into three categories of low resilience-negative coping group (18.6%, 47/253), moderate resilience-communication disorder group (59.3%, 150/253), and high resilience-inclusive understanding group (22.1%, 56/253). The per capita family monthly income, place of residence, primary caregivers, whether to undergo radiotherapy or chemotherapy, psychological resilience, and disease benefit finding were the influencing factors of family resilience in different categories of cervical cancer patients ( P<0.05) . Conclusions:The family resilience of cervical cancer patients can be divided into three latent categories. Medical and nursing staff should identify the characteristics of different categories of patients and provide targeted intervention measures to improve their family resilience.

In order to understand the difference and expression of genes in CEK cells before and af-ter baicalin interferes with IBV,further reveal and analyze the mechanism of baicalin interfering IBV replication in CEK cells in vitro.After IBV infected CEK cells for 2 h,9.75 mg/L baicalin liq-uid was added to interfere with CEK cells,which was recorded as the baicalin(H-IBV)group,and three replicate wells were set in the control group and the IBV(IBV)infection group.After 36 h culture,cell samples were collected and subject to transcriptome for sequencing.The results showed that there were 102 differentially expressed genes in H-IBV group compared with IBV in-fection group,among which 48 genes weresignificantly up-regulated and 54 genes were significantly down-regulated.Through functional annotation in GO and KEGG databases,it was found that dif-ferentially expressed genes were mainly annotated in biological processes such as cellular proces-ses,biological regulation,metabolism,and secondary pathways such as viral infectious diseases,signal transduction and interaction.Retinol metabolism pathway,phospholipid transfer to mem-brane,IL-27 mediated signaling pathway,MDA5/RIG-I and Toll-like receptor signaling pathway were significantly enriched in CEK cells,and the production of type Ⅰ interferon and interferon al-pha and the process of antiviral infection were also positively regulated.There were more differen-tial genes enriched in nucleic acid catalysis,immune system,and reaction,and interbiological reac-tion.Through the STRING network interaction map,it was found that most immune-related genes could form a 36-node interaction network centered on IRF7,TLR3 and STAT1.Therefore,com-pared with IBV group,the differentially expressed genes after baicalin treatment were mainly an-notated and enriched in the biological process,and the immune system and response were en-hanced,mainly through the positive regulation of IRF7 in the MDA5/RIG-I receptor signaling pathway and the inhibition of TLR3 signal transduction in the Toll-like receptor signaling path-way.Positive regulation of IL-27 mediated pathway and regulation of JAK-STAT signaling path-way were supplemented by activation of the expression of IRF7,TLR3,STAT1 and other related genes,and interaction with corresponding downstream proteins to promote the expression of IFN-α and regulatory cytokines,coupled with negative regulation of viral(defense)response and viral processes.Thus,baicalin interferes with IBV replication in CEK cells.