Objective To construct a machine learning model for predicting benign and malignant pulmonary nodules based on CT features.Methods A total of 129 patients with single solid nodules on CT from January 2021 to January 2023 in Hai'an People's Hospital were selected.All of them underwent chest CT scan,and the quantitative parameters,morphological features and radiomics features were recorded.The differentiation of benign and malignant pulmonary nodules was carried out according to relevant diagnostic criteria.The cases were divided into the training set and the internal test set.The constructed models included radiomics labels,morphological model,CT model and combined model.Results There were 98 cases in the training set(27 malignance and 71 benign)and 31 cases in the internal test set(7 malignance and 24 benign).Univariate analysis showed that there were significant differences in age,lesion diameter,mean density,burr sign,pleural depression sign,vacuole sign and air bronchial sign between malignant group and benign group(P<0.05).Compared with benign group,malignant group had higher proportions of burr sign,pleural depression sign,vacuole sign,air bronchial sign,and larger lesion diameter and mean density(P<0.05).LinkDocAI intelligent diagnosis system for pulmonary nodules was used to outline regions of interest and from which 1 000 radiomics features were extracted.The feature selection was performed in 98 cases,and 20 features were screened out after standardized treatment and correlation testing,excluding missing features,low importance feature values and highly correlated features.Through LASSO regression and 10-fold cross validation,λ1se was selected as the optimal λ to construct radiomics labels,and the two most meaningful features(LBP_Glszm_ZoneEntropy and Gradient_Shape_MinorAxis)were enrolled.CT model was considered as the optimal model in this study,and it had an area under receiver operating characteristic curve of 0.912 and 0.889 in the training set and the internal testing set,respectively.Conclusion The machine learning model to predict benign and malignant lung nodules based on CT features has good predictive efficiency,and it can realize the differential diagnosis of benign and malignant pulmonary nodules.

Objective: To investigate the expression of uteroglobin-related protein 1(UGRP1) in thyroid cells induced by interleukin-1β(IL-1β) and its correlation with Fas/FasL mediated apoptosis. Methods: Control group, IL-1β group and IL-1β+anti-FasL antibody group were established, rat thyroid cells(FRTL-5 cells) were culturedin vitro. The expression levels of UGRP1 and Fas mRNA of each group were detected by real-time PCR and the apoptosis rate of each group was detected by flow cytometry. Results: Compared with control group, the mRNA expression levels of UGRP1 and Fas in IL-1β group and IL-1β+anti-FasL antibody group increased, and the difference was statistically significant(P<0.05). Compared with control group, the early apoptosis rate of thyroid cells in IL-1β group increased(7.49%±1.91%vs28.46%±3.17%), and the difference was statistically significant(P<0.001). Compared with IL-1β group, the early apoptosis rate of thyroid cells in IL-1β+anti-FasL antibody group decreased(28.46%±3.17%vs19.20%±1.75%), and the difference was statistically significant(P<0.05). Compared with IL-1β group, the expression levels of UGRP1 mRNA(2.22±0.31vs2.66±0.28) and Fas mRNA(2.75±0.18vs3.03±0.16) in IL-1β+anti-FasL antibody group were not significantly different(P>0.05). Conclusion IL-1β induces the high expression of UGRP1 and Fas and apoptosis of thyroid cells, the high expression of UGRP1 is not associated with Fas/FasL mediated apoptosis.

The adjacent anatomy of the pelvis is complicated, with digestive, urinary, reproductive and other organs as well as important blood vessels and nerves. Therefore, accurate resection of pelvic tumors and precise reconstruction of defects after resection are extremely difficult. The development of medical 3D printing technology provides new ideas for precise resection and personalized reconstruction of pelvic tumors. The “triune” application of 3D printing personalized lesion model, osteotomy guide plate and reconstruction prosthesis in pelvic tumor limb salvage reconstruction treatment has achieved good clinical results. However, the current lack of normative guidance standards such as preparation and application of 3D printing personalized lesion model, osteotomy guide plate and reconstruction prosthesis restricts its promotion and application. The formulation of this consensus provides normative guidance for 3D printing personalized pelvic tumor limb salvage reconstruction treatment.

With the population aging,the number of elderly with Alzheimer's disease or other types of dementia is increasing,which seriously threatens the health and quality of life in elderly.The early screening and detection of dementia among high-risk population and appropriate interventional measures would delay the disease course,and maintain patients' self-care abilities and dignity.Computerized neuropsychological assessment devices are economic and efficient,and suitable for screening in large population.This article reviews the theory,characteristics and application of internet-based neuropsychological assessment for age-related cognitive impairment,as well as the prospect in the future studies.

Objective To analyze the application of intraoperative neurophysiological monitoring combined with neuronavigation multi-modal fusion technology in the brainstem glioma resection. Methods One hundred twenty patients with brainstem glioma were divided into observation group and control group. The control group was treated by traditional operation, while the observation group was treated by intraoperative nerve electrophysiological monitoring combined with neuronavigation multimodal fusion technology. The general condition, clinical efficacy, KPS score, complications and survival rate of the two groups were compared. Results The effect was significantly better in the observation group(76.66%)than in control group(53.33%)( x2=11.962,P=0.001).KPS scores were significantly higher in the observation group (27.91 ±1.98) than in the control group (12.11 ±2.13)(t=32.669, P<0.001). Conclusions Intraoperative nerve electrophysiological monitoring plus neuronavigation multimodality fusion technology can improve clinical efficacy and quality of life in patients with brainstem glioma.

Objective To analyze the relationship between tumor top,tumor neck,tumor rupture point of intraoperative aneurysm rupture (IAR) and the prognosis in patients with anterior circulation aneurysms (ACA) by craniotomy clipping.Methods Clinical materials of 123 patients with ACA (135 aneurysms) by craniotomy clipping were analyzed retrospectively,including 40 patients had IAR (41 aneurysms) during operation.The general informations of IAR patients were analyzed.Prognostic factors of IAR were analyzed by single and multiple factor analysis.Results The sex,age,history of hypertension,aneurysm diameter,the use of temporary blockage and blocking time,intraoperative blood loss showed no significant influences on the prognosis of patients with IAR (P ＞0.05),while preoperative Hunt-Hess classification and intraoperative rupture were the influencing factors for the prognosis of IAR patients (P ＜ 0.01).The preoperative Hunt-Hess classification and intraoperative rupture were the independent risk factors for the prognosis of IAR patients (P ＜0.01).Conclusion In craniotomy clipping,the different aneurysm rupture points can significantly affect the prognosis of patients with ACA,and aneurysm neck rupture is a main factor for poor prognosis of patients.

Objective To analyze the relationship between tumor top,tumor neck,tumor rupture point of intraoperative aneurysm rupture (IAR) and the prognosis in patients with anterior circulation aneurysms (ACA) by craniotomy clipping.Methods Clinical materials of 123 patients with ACA (135 aneurysms) by craniotomy clipping were analyzed retrospectively,including 40 patients had IAR (41 aneurysms) during operation.The general informations of IAR patients were analyzed.Prognostic factors of IAR were analyzed by single and multiple factor analysis.Results The sex,age,history of hypertension,aneurysm diameter,the use of temporary blockage and blocking time,intraoperative blood loss showed no significant influences on the prognosis of patients with IAR (P ＞0.05),while preoperative Hunt-Hess classification and intraoperative rupture were the influencing factors for the prognosis of IAR patients (P ＜ 0.01).The preoperative Hunt-Hess classification and intraoperative rupture were the independent risk factors for the prognosis of IAR patients (P ＜0.01).Conclusion In craniotomy clipping,the different aneurysm rupture points can significantly affect the prognosis of patients with ACA,and aneurysm neck rupture is a main factor for poor prognosis of patients.

Objective To investigate the results of defect reconstruction using anterolateral thigh free flap in medial and lateral approaches.Methods We reviewed the soft tissue defect reconstruction in 200 patients from February 2010 to June 2014 with anterolateral thigh flap in medial or lateral approach,to compare the operative time and donor site morbidity.Results The mean time of flap raising in medial group was (45 ± 4.5) minutes,while in lateral group was (65 ± 3.5) minutes.In medial group,fascial lata was closed directly in 39 cases (39％),while fascial lata was closed directly in all the cases (100％) in lateral group.All the 200 flaps survived uneventfully.All the donor sites healed smoothly.No infection occurred.An 8 to 32 months follow-up revealed a high satisfactory rate from the patients.No sensory deficit or functional impairment was noted in the donor sites.Conclusions Both in medial and lateral approach can achieve safely harvesting free anterolateral thigh flap.

Objective To explore the effect of hypoxic preconditioning (HPC) on endoplasmic reticulum stress after traumatic brain injury in rats.Methods Forty-eight Sprague Dawley rats were randomly divided into HPC group (HPC modeling) and non-HPC group (without HPC modeling),with 24 rats in each group.And then,each of the group was further divided into four sub-groups (n=6):three sub-groups after traumatic brain injury (TBI) for one,3 and 7 days (TBI modeling,and drawing and observation after various TBI treatment times),and a control sub-group (without any treatment).HPC models were induced in the low-pressure oxygen chamber for 3 h daily continuing for 3 d.TBI models were established by modified Freeny's freely falling equipment.Modified neurological severity scale (mNSS) scores of the rats were recorded after brain injury.C/EBP homologous protein (CHOP) mRNA and protein expressions were detected by quantitative real-time PCR (qRT-PCR) and Western blotting.TUNEL was used to evaluate the apoptotic rate and the correlation between CHOP levels and apoptotic rate was analyzed.Results The rnNSS scores,relative CHOP mRNA and protein expressions,and apoptotic rate in the one,3 and 7 days subgroups after TBI were significantly higher than those in the control group (P＜0.05);and these levels peaked at 3 d;the mNSS scores,relative CHOP mRNA and protein expressions,and apoptotic rate in HPC group were significantly lower than those in the non-HCP group (P＜0.05);and the correlation analysis showed the CHOP expressions were positively correlated with apoptotic rate in the in HPC group and non-HCP group (r=0.957,P=0.000;r=0.966,P=0.000).Conclusion HPC can down-regulate the expression of pro-apoptotic protein CHOP which participates in endoplasmic reticulum stress pathway,reduce neuronal apoptosis and improve neurological function.

The purpose of this study is to discuss the feasibility of establishing capsaicin pain model and the possibility to evaluate different degrees of pain by the heart rate variability (HRV). It also aims to investigate the changes of autonomic nervous activity of volunteers during the process of pain caused by capsaicin. A total of 30 volunteers were selected, who were physically and mentally healthy, into the study. To assess the effects of capsaicin on the healthy volunteers, we recorded the Visual Analogue Scale (VAS) scores after the capsaicin stimulus. Additionally, the electrocardiogram signals and HRV analysis index before and after stimulating were also recorded, respectively. More specifically, the HRV analysis indexes included the time domain index, the frequency domain index, and the nonlinear analysis index. The results demonstrated that the activity of the autonomic nerves was enhanced in the process of capsaicin stimulus, especially for the sympathetic nerve, which exhibited a significantly differences in HRV. In conclusion, the degree of pain can be reflected by the HRV. It is feasible to establish a capsaicin pain model. And in further experiments, HRV analysis could be used as a reference index for quantitative evaluation of pain.
Autonomic Nervous System ; physiopathology ; Capsaicin ; Electrocardiography ; Feasibility Studies ; Healthy Volunteers ; Heart Rate ; Humans ; Pain ; physiopathology ; Pain Measurement ; methods