Purpose To explore the value of deep learning ultrasound radiomics nomogram in assessing the biological characteristics of invasive metastases in invasive breast cancer.Materials and Methods A retrospective collection of ultrasound imaging data from 180 pathologically confirmed invasive breast cancer between January 2021 to December 2022 in Maoming People's Hospital was conducted,with pathological reports indicating the status of lymph node metastasis(LNM),lymphovascular space invasion(LVSI)or perineural invasion(PNI),according to the LNM/LVSI/PNI status,the three indexes were divided into the training cohort and the verification cohort by 8∶2.Based on Pyradiomics and ResNet50 deep learning extractor,1 316 radiomic features and 2 048 deep learning features were extracted,respectively.The random forest machine learning algorithm was employed to develop evaluation models,and the model scores were calculated.The deep learning radiomics nomograms were developed based on the radiomic and deep learning model scores.The receiver operating characteristic curve was used to assess the performance of the models.The Delong test was applied to analyze the performance differences between different models.Results In the evaluation of LNM,LVSI and PNI status,the area under the curve of all the nomogram in the cohorts demonstrated moderate or above assessment performance(≥0.73),with accuracies all greater than 0.70.Specifically,in the LNM evaluation,the area under the curve of the training cohort was 0.97,the accuracy was 0.93,the sensitivity was 0.88 and the specificity was 0.96.Through the Delong test,the assessment performance of the nomograms was superior to the radiomics models(LNM,Z=2.04,P=0.04;LVSI,Z=2.80,P=0.01;PNI,Z=3.52,P<0.01),and was superior to or similar to the deep learning models(LNM,Z=4.52,P<0.01;LVSI,Z=1.86,P=0.06;PNI,Z=0.31,P=0.76)in the training cohort.Conclusion The deep learning radiomics nomogram can effectively evaluate the biological characteristics of invasion and metastasis in invasive breast cancer.The nomogram improves the assessment performance by integrating the radiomic and deep learning feature information.

Objective To examine the effect of aerobic exercise training on plasma metabolites in pre-diabetes mellitus(PDM)subjects.Methods Twenty-five PDM subjects were selected,and each 10 age-and sex-matched with normoglycemia and new-onset T2DM subjects were enrolled.PDM subjects underwent aerobic exercise(n=13)or health education (n=12) for 12 weeks.The aerobic exercise was con ducted 3 times/week,50 min/time at 40％-60％ of oxygen uptake reserve.Liquid chromatography-mass spectrometry(LC-MS)was used to analyze the spectrum of plasma metabolites.Principal component analysis was employed to study the differences in plasma metabolite profiles between subjects with different glycemic level and between PDM subjects before and after aerobic exercise.Results After training,the body fat percentage,2-hour plasma glucose,and low density lipoprotein cholesterol of PDM subjects reduced significantly(by 4.6％,16.22％ and 9.27％ on average).Comparison of plasma metabolizers in PDM subjects before and after exercise revealed 31 differential metabolites,with 25 metabolites such as phosphatidylcholine,lysophosphatidylcholines,sphingomyelin and betaine increasing,and 6 metabolites,such as oleic acid and cytosine decreasing.Conclusion Aerobic exercise has a marked effect on the plasma metabolites in PDM subjects.Phosphatidylcholine,lysophosphatidylcholines,sphingomyelin and oleic acid may be the potential biomarkers of aerobic exercise improving the glycolipid metabolism in PDM subjects.These findings can help us better understand the mechanism of aerobic exercise preventing T2DM diabetes.

Objective To investigate the efficacy of leflunomide combined with prednisone in the induction therapy of proliferative lupus nephritis (LN).Methods A prospective,multicenter,randomized controlled clinical trial was conducted in patients with biopsy-proved proliferative lupus nephritis recruited from 15 renal centers from 2013 to 2015.Patients were randomized to two groups.Oral leflunomide or intravenous cyclophosphamide was given to patients in each group.Both groups received a tapering course of oral prednisone therapy.All patients were followed up for 24 weeks.The blood biochemistry,urine index,clinical curative effect and adverse reaction were recorded and analyzed statistically.Results A total of 100 patients were enrolled in this clinical trial,including 48 patients in leflunomide group and 52 patients in cyclophosphamide group.After 24 weeks,the overall response rate was 79％ (95％ CI 67％-90％) in the leflunomide group and 69％ (95％ CI 56％-82％) in the cyclophosphamide group.23％ (95％CI 11％-35％) of patients in leflunomide group showed complete remission compared with 27％ (95％CI 24％-30％) in cyclophosphamide group (P=0.35).The levels of 24-hr urine protein excretion,SLEDAI and anti-dsDNA antibody titers were decreased in patients treated with leflunomide group after 24-weeks treatment.And the levels of serum albumin and complement 3 after treatment were significantly higher compared with these before treatment.There was also no significant difference in changes of 24-hr urine protein excretion,SLEDAI score,anti-dsDNA antibody titers,serum albumin and complement C3 levels after treatment between two groups.Incidence of adverse events did not differ between the leflunomide and cyclophosphamide group.Conclusions Leflunomide combined with prednisone showed same efficacy compared with cyclophosphamide as induction therapy for lupus nephritis.Leflunomide might be an useful medicine in the induction therapy of lupus nephritis.

Objective To researching the effect of gestational diabetes mellitus (GDM) prevention and control management by WeChat consultation on the Internet platform. Methods There were 586 pregnant women who performed prenatal care regularly and accepted glucose tolerance test for GDM at 24 to 28 weeks in our hospital during 2015 and 2016 as research objects. Determination of the observation group:in 2016, the 308 people who match the condition of the study during annual prenatal examination in line, in addition to routine guidance outside the clinic and joined the division to establish a dedicated WeChat group for a comprehensive health management consulting. Determination of the control group:in 2015, the 278 people who match the condition of the study during annual prenatal examination in line were treated as control groups. The two groups of observation indexes included the fasting blood glucose and two-hour postprandial blood glucose control in GDM pregnant women, the weight growth rate of the whole pregnancy, cesarean section rate, birth rate of newborns, neonatal referral rate and so on. Results The rate of fasting blood glucose and two-hour postprandial blood glucose control in the observation group was significantly better than that in the control group (t=2.01-3.11, all P<0.05). According to the pre-pregnancy physical index, the weight growth of the observation group was significantly better than the control group (t=2.12-3.76, all P<0.05).The cesarean section rate, birth rate and neonatal referral rate were 21.10％(65/308), 4.87％(15/308), 7.14％(22/308)in the observation group , and 28.78％(80/278), 10.07％(28/278), 12.23％(34/278)in the control group, there were significant differences (U = 2.10-2.42, all P<0.05). Conclusions Gestational diabetes prevention and control management in the Internet platform for WeChat consultation application effect is remarkable, which can effectively improve the maternal and child outcomes. In the protection of maternal and child health is of great significance.

Both single and long-term aerobic exercise may play a role for insulin resistance (IR), however, there is no agreement for in-terval exercise. Simple resistance training is controversial, and the significance of resistance-aerobic exercise for IR is also mixed.

Objective To summary the experience of surgical types selection of chronic suppurative otitis media tympano‐plasty and evaluate its clinical curative effect .Methods Chronic suppurative otitis media patient records were collected ,surgical types selection based on hearing ,otoscope and mastoid CT selection .Finally 161 chronic suppurative otitis media patients (164 ears) whoes medical records and follow‐up of contents were complete were collected ,in which type Ⅰ tympanoplasty group with 40 ears , intact bridge radical mastoidectomy+ type Ⅰ tympanoplasty group with 30 ears ,and open radical mastoidectomy+type Ⅱ tympan‐oplasty group with 94 ears .The therapeutic effects of the three surgical methods for the treatment of chronic suppurative otitis media were evaluated from hearing ,quality of life as well as satisfactory score after surgery .Results The mean values of the air conductive hearing thresholds after operation in the three tympanoplasty groups were decreased than those before operation (all P<0 .05) ,while the mean values of the bone conductive hearing thresholds after operation showed no obvious changes (all P>0 .05) .There were no statistically significant improvements in the air conductive hearing thresholds in the three tympanoplasty groups (P>0 .05) .The improvements in patient′s subjective hearing of the there surgical methods were 82 .5% ,70 .0% and 83 .0%respectively ,there was no statistically significant (P>0 .05) .The improvements in the overall quality of life of the three surgical methods were 80 .0% ,80 .0% and 79 .8% respectively ,showed no statistically significant differences (P>0 .05);the reduction rate of patient′s worry about illness were 90 .0% ,93 .3% and 95 .7% ,showed no statistically significant differences (P>0 .05);the bas‐ic satisfaction rates in the postoperative satisfaction ratings of the three surgical methods were 100 .0% ,100 .0% and 97 .9% ,and there were no statistically significant differences (P>0 .05) .Conclusion For tympanoplasty in chronic suppurative otitis media pa‐tients ,surgical types selection based on hearing ,otoscope ,mastoid CT selection and intraoperative findings .From the evaluation of postoperative patients with hearing and quality of life ,three surgical methods of chronic suppurative otitis media Tympanoplasty a‐chieve satisfactory results .

Objective To analyze the quality of life among adults with chronic suppurative otitis media,and to research the chan-ges of the life quality between preoperative and postoperative.Methods We modified the chronic ear survey(CES)through inter-view adults with chronic suppurative otitis media.The modified scale (Chronic Suppurative Otitis Media Outcome Survey)was ad-ministered to 110 patients in a prospective manner,and then was validated according to established criteria for reliability and validi-ty.Then we assessed the outcomes of surgeries for chronic suppurative otitis media.Results The chronic suppurative otitis media outcome survey includes 17 entries,and was divide into four dimensions.Excellent test-retest reliability was obtained for the survey score (R=0.967).Cronbach′s α correlation coefficient were calculated as 0.864 for the total survey.Criterion validity showed a high correlation between scores on chronic suppurative otitis media outcome survey and scores on CES (R=0.977,P <0.01).U-sing principal components extraction with orthogonal rotation,it was performed on the composite data set,and this yielded a four-factor solution that explained 70.394% of the variance.The average score of patients before surgery was 51.660±10.762,post-op-erative scores was 75.893 ± 7.734.The total score wasn′t significantly changed after the surgery,and the average value was 24.23±7.67 (t=24.653,P <0.01).Conclusion The chronic suppurative otitis media outcome survey is a reliable and valid meas-ure of quality of life for adults with chronic suppurative otitis media,and it is more suitable than the CES in outcomes studies and clinical trials.

Objective To investigate the relationship between the serum uric acid (SUA) levels and the short-term clinical outcome in patients with spontaneous intracerebral hemorrhage.Methods Consecutive patients with spontaneous intracerebral hemorrhage admitted within 24 hours after onset were prospectively included.SUA levels was measured on the next morning after admission.Modified Rankin Scale (mRS) was used to ascertain clinical outcome at 30 days.The patients were divided into a good outcome group (mRS＜2) and poor outcome group (mRS≥3).Results A total of 92 patients with spontaneous intracerebral hemorrhage were included,and 46 of them (50％) were men,the mean age was 63 ± 12 years.At 30 days after onset,22 patients (23.9％) had a good outcome and 70 patients (76.1％) had a poor outcome.Univariate analysis showed that the Glasgow Come Scale (GCS) score in the good outcome group was significantly higher than that in the poor outcome group (13.85 ± 2.80 vs.11.21 ± 2.51; t=4.186,P=0.000),while hematoma volume (25.65 ±5.33 cm3 vs.34.60± 8.97 cm3,t=4.430,P=0.000) and SUA levels (324.90± 86.02 μmol/L vs.458.63 ±72.77 μmol/L; t =7.193,P =0.000) were significantly lower than those in the poor outcome group.Multivariate logistic regression analysis showed that the lower GCS score (odds ratio [OR]1.810,95％ confidence interval [CI]1.382-2.382; P =0.001),larger hematoma volume (OR 1.156,95％ CI 1.045-1.280; P=0.005) and higher SUA levels (OR 2.127,95％ CI 1.055-4.287; P=0.035) were the independent predictive factors for the short-term clinical outcome in patients with spontaneous intracerebral hemorrhage.Conclusions The increased SUA levels may predict the poor short-term clinical outcome in patients with spontaneous intracerebral hemorrhage.

In kidney, the role of cell proliferation, differentiation, apoptosis, inflammatory mediators and cytokines expression is closely related with cell signaling pathways, including tyrosine kinase pathway, transforming growth factor-beta/Smad pathway, Rho/Rho-associated coiled-coil forming protein kinase pathway, phosphoinositol pathway, cyclic nucleotide pathway, nuclear factor kappaB pathway and so on. Some Chinese herbs and their extracts, such as rhubarb and triptolide, as well as some Chinese herbal prescriptions, such as astragalus-angelica mixture and Chailing decoction, not only could ameliorate proliferation, differentiation and apoptosis of renal cell by regulating cell signaling pathways, but also could control target gene transcription, expression and its biological effects through inhibiting the phosphorylation of key signaling molecules.
Animals ; Apoptosis ; drug effects ; Cell Differentiation ; drug effects ; Cell Proliferation ; drug effects ; Drugs, Chinese Herbal ; pharmacology ; Humans ; Kidney ; cytology ; drug effects ; metabolism ; Signal Transduction ; drug effects

Objective To analyze and compare the incidence of cerebral vasospasm (CVS) in patients with aneurismal subarachnoid hemorrhage(aSAH) in China and in Europe.Methods A literature search was performed for all the papers investigating the incidence,diagnosis, treatment or prognosis of CVS after aSAH using the MEDLINE and China Knowledge Resource Integrated Database (CNKI) from January 1, 1990 to December 31, 2010.The incidences of angiographic CVS, symptomatic CVS and CVS-related infarcts were recorded.The incidences of CVS between Chinese and white men in Europe were compared. Results A total of 237 articles were searched via CNKI and reference reviews, and 9 of the studies met the inclusion criteria. A total of 172 articles were searched via MEDLINE and reference reviews, and 18 of the studies met the inclusion criteria. The risk of occurring symptomatic CVS in patients with aSAH in Chinese was significantly higher than that in white men in Europe (relative risk,2. 063, 95％ confidence interval 1.816-2. 343, P ＜0. 001). Conclusions The incidence of CVS in patients with aSAH in Chinese was significantly higher than that in white men in Europe,indicating the pathogenesis of CVS may have genetic basis.