Objective:To evaluate the clinical efficacy of ultrasound-guided radiofrequency ablation therapy for patients with papillary thyroid microcarcinoma (PTMC).Methods:A retrospective analysis was conducted on the clinical data of 80 PTMC patients admitted to Zhongshan Hospital of Traditional Chinese Medicine(Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine) from January 2018 to September 2020. All cases were divided into two groups according to different treatment methods, with 40 cases in each group. The control group received PTMC radical surgery, while the observation group received ultrasound guided radiofrequency ablation. The situation of new tumors and cervical lymph node metastasis in both groups was observed through follow-up, the relative indexes of operation and safety of the two groups were compared.Results:There was no significant difference in the incidence of situation of new tumors and cervical lymph node metastasis between the two groups ( P>0.05). The operation time, intraoperative blood loss and hospital stay in the observation group were less than those in the control group: (20.23 ± 5.07) min vs. (54.51 ± 12.13) min, (1.68 ± 0.28) ml vs.(13.68 ± 2.31) ml, (1.82 ± 0.32) d vs. (5.43 ± 0.57) d, there were statistical differences ( P<0.05). The incidence of complications in the observation group was lower than that in the control group: 5.00%(2/40) vs. 25.00%(10/40), there was statistical difference ( P<0.05). Conclusions:Ultrasound guided radiofrequency ablation for the treatment of PTMC is safe and effective, minimally invasive in beauty, and can effectively reduce the incidence of complications.

Alzheimer's disease (AD) is an irreversible neurodegenerative disorder that damages patients' memory and cognitive abilities. Therefore, the diagnosis of AD holds significant importance. The interactions between regions of interest (ROIs) in the brain often involve multiple areas collaborating in a nonlinear manner. Leveraging these nonlinear higher-order interaction features to their fullest potential contributes to enhancing the accuracy of AD diagnosis. To address this, a framework combining nonlinear higher-order feature extraction and three-dimensional (3D) hypergraph neural networks is proposed for computer-assisted diagnosis of AD. First, a support vector machine regression model based on the radial basis function kernel was trained on ROI data to obtain a base estimator. Then, a recursive feature elimination algorithm based on the base estimator was applied to extract nonlinear higher-order features from functional magnetic resonance imaging (fMRI) data. These features were subsequently constructed into a hypergraph, leveraging the complex interactions captured in the data. Finally, a four-dimensional (4D) spatiotemporal hypergraph convolutional neural network model was constructed based on the fMRI data for classification. Experimental results on the Alzheimer's Disease Neuroimaging Initiative (ADNI) database demonstrated that the proposed framework outperformed the Hyper Graph Convolutional Network (HyperGCN) framework by 8% and traditional two-dimensional (2D) linear feature extraction methods by 12% in the AD/normal control (NC) classification task. In conclusion, this framework demonstrates an improvement in AD classification compared to mainstream deep learning methods, providing valuable evidence for computer-assisted diagnosis of AD.
Humans ; Alzheimer Disease/diagnostic imaging* ; Neural Networks, Computer ; Magnetic Resonance Imaging/methods* ; Neuroimaging/methods* ; Diagnosis, Computer-Assisted ; Brain ; Cognitive Dysfunction

Schizophrenia is a serious mental disease. The diagnosis of schizophrenia so far relies heavily on subjective evidence, including self-reported experiences by patients, manifestations described by relatives, and abnormal behaviors assessed by psychiatrists. The diagnosis, monitoring of the disease progression and therapy efficacy assessment are challenging due to the lack of established laboratory biomarkers. Based on the current literature, clinical consensus, guidelines, and expert recommendations, this review highlighted evidence-based potential laboratory biomarkers for the diagnosis of schizophrenia, including genetic biomarkers, neurotransmitters, neurodevelopmental-related proteins, and intestinal flora, and discussed the potential future directions for the application of these biomarkers in this field, aiming to provide an objective basis for the use of these biomarkers in the early and accurate diagnosis, treatment, and prognosis and rehabilitation assessment of schizophrenia.

Objective:To construct an early predictive model for the death of patients after extracorporeal membrane oxygenation (ECMO) based on the baseline information of patients and laboratory indicators.Methods:The clinical data of 139 patients who underwent ECMO in Affiliated Jinhua Hospital, Zhejiang University School of Medicine from January 2015 to December 2021 were collected, including age, gender, primary disease, ECMO model, other clinical characteristics, and laboratory indicators 2 hours after establishment of ECMO. The patients were divided into training cohort ( n = 111) and validation cohort ( n = 28) according to a ratio of 4∶1. The least absolute shrinkage and selection operator (Lasso) regression and multivariate Logistic regression were used to select predictive factors, and a nomogram was used to establish the predictive model. The calibration and discrimination of the model were assessed using the receiver operator characteristic curve (ROC curve), the calibration curve and Kaplan-Meier analysis. Results:Four predictive variables including anion gap (AG), lactic acid (Lac), arterial partial pressure of oxygen (PaO 2), and serum amylase (AMY) 2 hours after ECMO were selected from 34 laboratory indicators by Lasso regression. These variables and three other clinically important factors [primary diseases, ECMO model, and acute kidney injury (AKI)] were analyzed using multivariate Logistic regression (forward: LR method), Finally, four strong predictive factors (Lac-2 h, PaO 2-2 h, AMY-2 h, and primary diseases) for mortality were used to construct a nomogram [the area under ROC curve (AUC) was 0.85, 95% confidence interval (95% CI) was 0.78-0.92]. The optimal cut-off value of the ROC curve was 0.398 based on the maximum principle of the Youden index, corresponding to 80.2% accuracy, 89.1% sensitivity, and 68.1% specificity. The validation cohort with an in-hospital mortality of 64.3% was used to verify the performance of the model by ROC curve and Kaplan-Meier analysis. According to the optimal cut-off value of the ROC curve (0.398), the validation cohort was divided into low- and high-risk groups. Based on this model, the survival probability of the low-risk group was significantly higher than that of the high-risk group ( P = 0.018), indicating this model had good discriminative ability in the validation cohort. Based on this model, the AUC of the validation cohort was 0.76, 95% CI was 0.58-0.94, and the accuracy rate was 71.43%, which indicated this model showed good calibration consistency. Conclusions:The predictive model incorporating Lac-2 h, PaO 2-2 h, AMY-2 h, and primary diseases may be significant for predicting the in-hospital mortality of patients undergoing ECMO.

Allergic rhinitis (AR) is a global health problem that causes major illnesses and disabilities worldwide. Epidemiologic studies have demonstrated that the prevalence of AR has increased progressively over the last few decades in more developed countries and currently affects up to 40% of the population worldwide. Likewise, a rising trend of AR has also been observed over the last 2–3 decades in developing countries including China, with the prevalence of AR varying widely in these countries. A survey of self-reported AR over a 6-year period in the general Chinese adult population reported that the standardized prevalence of adult AR increased from 11.1% in 2005 to 17.6% in 2011. An increasing number of original articles and imporclinical trials on the epidemiology, pathophysiologic mechanisms, diagnosis, management and comorbidities of AR in Chinese subjects have been published in international peer-reviewed journals over the past 2 decades, and substantially added to our understanding of this disease as a global problem. Although guidelines for the diagnosis and treatment of AR in Chinese subjects have also been published, they have not been translated into English and therefore not generally accessible for reference to non-Chinese speaking international medical communities. Moreover, methods for the diagnosis and treatment of AR in China have not been standardized entirely and some patients are still treated according to regional preferences. Thus, the present guidelines have been developed by the Chinese Society of Allergy to be accessible to both national and international medical communities involved in the management of AR patients. These guidelines have been prepared in line with existing international guidelines to provide evidence-based recommendations for the diagnosis and management of AR in China.
Adult ; Asian Continental Ancestry Group* ; China ; Comorbidity ; Developed Countries ; Developing Countries ; Diagnosis* ; Epidemiologic Studies ; Epidemiology ; Global Health ; Humans ; Hypersensitivity* ; Prevalence ; Rhinitis, Allergic*

Objective To study the spatial and temporal mode of infectious TB transmission in Guangxi Zhuang Autonomous Region (Guangxi).Methods Data related to infectious TB case (Include smear and/or culture positive patients) in Guangxi were collected from the National Notifiable Disease Reported System (NNDRS) from 2010 to 2015.Spatial-temporal analysis and prediction were performed by SaTScan 7.0.2,GeoDa 1.8.12,R program v 3.3.1 and SPSS 19.0 software,using the time series model,Moran' s I global and local spatial autocorrelation (Empirical Bayes adjustment).Kulldorff ' s space-time scan statistics displayed by R software was used to identify the temporal and spatial trend of TB.Results The total number of infectious TB cases,collected from NNDRS was 76 151,and showing a decreasing trend on annual incidence (value of Chi-square for Linear trend=3 464.53,P-value=0.000).The forecast value of TB cases in 2016 was 7 764 (4 971-10 557),with peak in March,analyzed through the Winters' multiplicative model.The Moran' s I global Statistics was greater than 0 (0.257-0.390).TB cluster seemed to have been existed for several years.The most significant hot spots seemed to be mainly located in the central and western parts of Guangxi,shown by local spatial autocorrelation statistics and the result from space-time scanning.Counties or districts that located in the east parts of Guangxi presented the low-low relation (significant cold spots).The situation of infectious TB seemed migratory.Conclusions Our data showed an annual decreasing trend of incidence on infectious TB with temporal concentration in spring and summer.Main clusters (hot spots) were found to be located in the central and western parts of Guangxi.Hopefully,our findings can provide clues to uncover the real mode of TB transmission at the molecular-biological level.

BACKGROUND: Tissue-engineered spinal cord has brought new treatment ideas for spinal cord repair.OBJECTIVE: To construct the tissue-engineered spinal cord by chitosan alginate scaffold and adipose-derived mesenchymal stem cells (ADMSCs), and to investigate its repairing effects on acute spinal cord injury in rats.METHODS: The spinal cord hemisection model was established in 48 Sprague-Dawley rats and then, rat models were randomly divided into four groups: model group, scaffold group, ADMSCs group and tissue-engineered spinal cord group,followed by direct suturing of the dura mater, implantation of chitosan alginate scaffold, implantation of ADMSCs, and implantation of tissue-engineered spinal cord, respectively. The limb motor function of rats was evaluated based on the Basso-Beattie-Bresnahan score at 1, 3, 7 weeks after transplantation. Immunofluorescence staining and hematoxylin-eosin staining of the spinal cord specimens were performed at 7 weeks after transplantation.RESULTS AND CONCLUSION: (1) Motor function of the hind limb: At 3 and 7 weeks after transplantation, the Basso-Beattie-Bresnahan score was highest in the tissue-engineered spinal cord followed, followed by the ADMSCs and scaffold groups, and lowest in the model group (P < 0.05). (2) Immunofluorescence and hematoxylin-eosin staining: in the model group, the spinal cord injury area was infiltrated with a large number of fibroblasts and inflammatory cells. In the scaffold group, there was no scar formation; neuron-specific enolase-positive cells, glial fibrillary acidic protein-positive cells and a few neurofilament protein 200-positive cells were found in the junctional area. In the ADMSCs group, the spinal cord injury area was filled with scar tissue, and a large number of glial fibrillary acidic protein-positive cells were found. In the tissue-engineered spinal cord group, there was no scar tissue, and there were a large number of neuron-specific enolase-positive cells, a small amount of CM-Dil-labeled ADMSCs and more glial fibrillary acidic protein-positive cells. Neurofilament protein 200 positive cells were connected to each other at the junction. These findings indicate that the tissue-engineered spinal cord constructed by chitosan alginate scaffold and ADMSCs can promote spinal cord repair after acute spinal cord injury.

Objective To analyze the data of TB/HIV dual infection screening and treatment monitoring in Guangxi during 2010-2015 and to evaluate the prevention and treatment status quo and development trend.Methods The annual monitoring report forms of TB/HIV dual infection during 2010-2015 were collected for deriving the special data of AIDS in corresponding years.Then the data were conducted the comparison and trend analysis.Results The acceptance rates of HIV detection among Guangxi TB patients and the acceptance rate of TB related screening detection in patients with HIV infection/AIDS showed the increasing trend year by year (P＜0.05);the positive detection rate of two-way showed the decreasing trend year by year (P＜0.05).The patients with TB/HIV dual infection were mainly concentrated in the central area of Guangxi.The annual monitoring report table data in annual monitoring TB/HIV dual infection prevention and treatment work trended to be consistent with the twoway registration and screening data in the special report system,but the errors still existed;the rate of receiving anti-TB and anti-viral combined therapy in the patients with TB/HIV dual infection was lower,which was fluctuated from 20％ to 60％;the treatment success rate was still elevated year by year,but which was affected by death,lose and other outcomes.Conclusion The TB/HIV dual epidemic situation has already obtained a certain effect along with comprehensively promoting the dual infection prevention and control work in Guangxi area.

Objective To analyze the peculiarity of infants steroid-resistant nephrotic syndrome (SRNS) and to assess the efficacy,side-effect and relapse of various of Tacrolimus prescribed in infants SRNS.Methods A total of 76 case of infant SRNS from August 2012 to August 2015 in Guangzhou Weman and Children's Medical Center grouped into oral Tacrolimus (TAC group),Methyprenisolone pulse therapy (MP group) and Methyprenisolong combined Cyclophosphamide(CTX) pulse therapy(MP + CTX group),were observed for 1 year,and the urine protein excretion,renal function (CCr),blood glucose (B G),urine retinal-binding-protein (URBP),lymphocyte count etc.were recorded and the situation of infection and relapse regularly were monitored regularly.The data were retrospectively analyzed by the statistical method.Results All SRNS children underwent kidney biopsy,and 36 cases of minimal change disease,32 cases of mesangial proliferative glomerulonephritis and 8 cases of focal segmental glome-rulosclerosis were contained in the patients.The pathological constituent ratios were not obviously different among these 3 groups.By 6-month follow-up,the complete remission ratio of TAC group was 63.64％,the total remission ratio was 95.45％,which were remarkably higher than those of MP group (26.09％,60.87％) and MP + CTX group (41.94％,74.19％);the urine protein excretion of TAC group [(7.8 ± 8.6) mg/(kg · d)] was distinctly lower than that of pretreatment and lower than that of MP group [(144.2 ± 118.3) mg/(kg · d)],and lower than that of MP + CTX group [(91.3 ± 87.4) mg/(kg · d)],and the difference was significant (F =22.69,P ＜ 0.05).The remission time of TAC group was about 2 months,that of other two groups was about 3 months.By 1-year follow-up,the lymphocyte counts including total T-cell (CD3 +),the helper T-cell (CD4 +) and the inhibited T-cell (CD8 +) of TAC group decreased obviously(all P ＜ 0.01),which were extremely lower than those of the M P group and MP + CTX group,and there were significant differences (all P ＜ 0.05).By 1-year follow-up,the person-time of infection existed superior to the other 2 groups,TAC group was compared with MP plus group,the rank sum was 348.5 (U =-3.69,P ＜ 0.01);compared with MP + CTX plus group,the rank sum was 369.5 (U =-4.18,P ＜ 0.01).During the observation the URBP of TAC group was distinctly higher than that of the MP group and the MP + CTX group [(13.77 ± 19.19) mg/L vs.(2.50 ± 1.77) mg/L,(2.06 ±3.63) mg/L],and the differences were significant(t =3.16,2.99,all P ＜0.05);the TAC group with BG and CCr maintained stably.Conclusions Tacrolimus shows its own advantages of more reliable effect and less side-effect in the infants with SRNS over MP therapy and MP combined CTX therapy,but it could not lessen the recurrence of the disease,and its long-term prognosis is still not very clear.

PURPOSE: MicroRNAs (miRs) were recently recognized to be important for immune cell differentiation and immune regulation. However, whether miRs were involved in allergen-specific immunotherapy (SIT) remains largely unknown. This study sought to examine changes in miR-146a and T regulatory cells in children with persistent allergic rhinitis (AR) after 3 months of subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT). METHODS: Twenty-four HDM-sensitized children with persistent AR were enrolled and treated with SCIT (n=13) or SLIT (n=11) for 3 months. Relative miR-146a and Foxp3 mRNA expression, the TRAF6 protein level, and the ratio of post-treatment to baseline IL-10+CD4+ T cells between the SCIT and SLIT groups were examined in the peripheral blood mononuclear cells (PBMCs) of AR patients using quantitative reverse transcription polymerase chain reaction (qRT-PCR), flow cytometry, and Western blot analysis, respectively. Serum levels of IL-5 and IL-10 were determined using ELISA. RESULTS: After 3 months of SIT, both the TNSS and INSS scores were significantly decreased compared to the baseline value (P<0.01). The relative expression of miR-146a and Foxp3 mRNA was significantly increased after both SCIT and SLIT (P<0.01). The ratio of post-treatment to baseline IL-10+CD4+ T cells and the serum IL-10 level were significantly increased in both the SCIT and SLIT groups (P<0.01), whereas the TRAF6 protein level and serum IL-5 level were significantly decreased (P<0.01). No significant differences in these biomarkers were observed between the SCIT and SLIT groups. CONCLUSIONS: Our findings suggest that miR-146a and its related biomarkers may be comparably modulated after both SCIT and SLIT, highlighting miR-146a as a potential therapeutic target for the improved management of AR.
Biomarkers ; Blotting, Western ; Cell Differentiation ; Child* ; Enzyme-Linked Immunosorbent Assay ; Flow Cytometry ; Humans ; Immunotherapy* ; Interleukin-10 ; Interleukin-5 ; MicroRNAs ; Polymerase Chain Reaction ; Reverse Transcription ; Rhinitis* ; RNA, Messenger ; Sublingual Immunotherapy ; T-Lymphocytes ; TNF Receptor-Associated Factor 6