To compare the therapeutic effects of short-term spinal cord stimulation (stSCS) and long-term spinal cord stimulation (ltSCS) on patients with prolonged disorders of consciousness(pDoC).

Objective The MMV-Net,a deep learning framework based on mammogram multiple views,was constructed to evaluate the classification performance of the model for benign and malignant masses.Methods A retrospective analysis was conduc-ted on a dataset of 1 585 breast X-ray images from Harbin Medical University Cancer Hospital from 2018 to 2020,including 806 be-nign cases and 779 malignant cases.The dataset was divided into the training set(n=1268)and the test set(n=317)according to an 8∶2 ratios,and the training set was stratified according to the 5-fold cross validation.The integrated DDSM dataset and INBreast dataset were used as external test sets(n=1645)to evaluate the model performance.Each case in the input layer contained 4 views.The MMV-Net model was constructed by removing the last two layers of the ResNet22 network structure and adding an average poo-ling layer as the feature extraction layer,as well as fully connection layer and softmax activation function as the decision layers.Bayes-ian hyperparameter optimization was used.The performance of MMV-Net,MFA Net,and ensemble inception V4 models in AUC val-ues,accuracy,precision,recall and F1 scores were compared.Results The AUC values of MMV-Net model for distinguishing benign and malignant masses on the test set were 0.913,0.882 for MFA-Net,and 0.865 for inception V4.The accuracy and precision evalu-ation metrics of the MMV-Net model were also higher than the other two models.Conclusion The deep learning MMV-Net model based on multiple views of mammogram is helpful for the classification of benign and malignant breast masses.

Objective:To investigate the impact of small extracellular vesicles(sEVs) derived from perirenal adipose cells on the biological behavior of renal tubular epithelial cells under diabetic conditions and the underlying molecular mechanisms.Methods:Primary perirenal adipose cells were extracted from db/m and db/db mice for in vitro culture. The culture supernatant was collected and sEVs(NDM-sEVs PRAT-Adipo, DM-sEVs PRAT-Adipo) were extracted by ultracentrifugation. The sEVs were incubated with human renal tubular epithelial cell line(HK-2) to observe changes in their proliferation, apoptosis, autophagy, and epithelial-mesenchymal transition(EMT) levels. The protein composition of sEVs was analyzed using mass spectrometry to explore the molecular mechanisms. Results:CCK8 results showed that the proliferation level of HK-2 cells after DM-sEVs PRAT-Adipo intervention did not change significantly compared with the two control groups(Ctrl group and NDM-sEVs PRAT-Adipo intervention group). Western Blot(WB) results indicated that there were no significant changes in apoptosis levels(Bcl-2, Cleaved-caspase 3, Caspase 3) and autophagy levels(p62, LC3BⅠ, LC3BⅡ) in the DM-sEVs PRAT-Adipo intervention group compared with the two control groups. WB and immunofluorescence results demonstrated that DM-sEVs PRAT-Adipo intervention upregulated the expression levels of mesenchymal cell marker proteins(Vimentin, α-SMA, Snail2) and downregulated the expression level of epithelial cell marker protein ZO-1 in HK-2 cells compared with the two control groups. Mass spectrometry analysis of sEVs revealed that the differential proteins between DM-sEVs PRAT-Adipo and NDM-sEVs PRAT-Adipo were enriched in EMT-related pathways. Among them, the enrichment of thrombospondin(THBS1) in DM-sEVs PRAT-Adipo might be involved in the regulation of EMT in HK-2 cells. Conclusion:Under diabetic conditions, sEVs secreted by PRAT-derived adipocytes promote the upregulation of EMT in renal tubular epithelial cells, a process that may be mediated by the enrichment of THBS1 in sEVs.

Objective To investigate the CT characteristics of hepatitis B cirrhosis, and to predict the risk of bleeding by establishing a predictive model for upper gastrointestinal bleeding in liver cirrhosis. Methods A retrospective analysis was performed for the clinical data of 101 patients with hepatitis B cirrhosis who were admitted to Tianjin First Central Hospital from January 2015 to June 2021, and these patients were divided into upper gastrointestinal bleeding group and non- bleeding group. The two groups were compared in terms of laboratory findings and CT values in plain scan, arterial phase, portal vein phase, and venous phase measured by contrast-enhanced CT, and the changes in CT values (ΔCT) across different phases were calculated. The t -test or the Mann-Whitney U rank sum test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups. Logistic regression analysis was used to predict the related risk factors; The discrimination of the model was evaluated by calculating the area under the working characteristic curve of the subjects, and the model calibration criteria were determined by Hosmer-lemeshow. Based on the results of multivariate logistic regression analysis, Rstudio4.1.2 R package was used to establish a predictive model, and draws the corresponding ROC curve, calibration curve and clinical decision curve. Results There were significant differences in serum TBil, WBC and PLT levels between the non-bleeding group and the bleeding group (all P < 0.05). There were significant differences in liver-plain, spleen-P-plain and spleen-P-A ΔCT(all P < 0.05). The univariate logistic analysis showed that there were significant differences in leukocytes (odds ratio [ OR ]=0.770, 95% confidence interval [ CI ]: 0.624-0.952, P =0.016), platelets ( OR =0.979, 95% CI : 0.965-0.994, P =0.006), liver plain scan ( OR =1.142, 95% CI : 1.058-1.233, P =0.001), ΔCT value of the spleen from portal vein phase to plain scan ( OR =0.979, 95% CI : 0.959-1.000, P =0.050), and ΔCT value of the spleen from portal vein phase to arterial phase ( OR =0.979, 95% CI : 0.944-0.994, P =0.015) between the hepatitis B cirrhosis patients with upper gastrointestinal bleeding and those without bleeding. The multivariate logistic analysis showed that platelets ( OR =0.968, 95% CI : 0.944-0.993, P =0.011), liver plain phase ( OR =1.148, 95% CI : 1.047-1.259, P =0.003), and ΔCT value of the spleen from portal vein phase to arterial phase ( OR =0.951, 95% CI : 0.908-0.995, P =0.030) were independent risk factors for upper gastrointestinal bleeding. A predictive model for upper gastrointestinal bleeding in hepatitis B cirrhosis was established based on the results of the multivariate logistic analysis, and a calibration curve was plotted. This model had an area under the receiver operating characteristic curve of 0.801 at the cut-off value of 0.433, with a sensitivity of 81.4% and a specificity of 77.6%. The calibration curve of the model fitted well with the ideal curve. Conclusion There are special ΔCT changes in hepatitis B cirrhosis, and the predictive model based on ΔCT has a good predictive ability for upper gastrointestinal bleeding in patients with hepatitis B cirrhosis.

Objective:To evaluate the systemic involvement, outcome and other disease characteristics of children with systemic lupus erythematosus (cSLE), and to explore the prognostic factors.Methods:cSLE treated in Beijing Children′s Hospital, Capital Medical University from January 1, 2016 to December 31, 2017 were enrolled in this study.Medical records including clinical manifestations and evaluation of affected systems, autoantibodies, treatment adjustment, and follow-up were collected and analyzed retrospectively.SPSS 21.0 was used for statistical analysis and mapping.The prognostic factors were studied by the Cox proportional risk regression model.Results:A total of 210 children were included, including 37 males and 173 females, with a male to female ratio of 1.0∶4.7.The average age of onset was (121.39±30.44) months.There were 167 (79.5%) patients with skin and mucous membrane damage, 137(65.2%) patients with blood system damage, 129(61.4%) patients with digestive system damage, 123(58.6%) patients with kidney damage, 119(56.7%) patients with skeletal and musculoskeletal system damage, 71(33.8%) patients with nervous system damage, 68(32.4%) patients with heart damage, and 60(28.6%) patients with respiratory system damage.The 90.95%(191/210) of the children enrolled presented moderate or high disease activity at the first visit.The effective rate was 76.92% (150/195) after 1-month follow-up and 96.95% (159/164) after 1-year follow-up.A high level of compliment C 3 was a protective factor for disease remission.The glucocorticoid level was declined to 5 mg or less in 42 children, and the median time was 40.5 (36.0, 42.0) months.Young onset age and no renal damage were protective factors for glucocorticoid reduction. Conclusions:cSLE tends to occur in female children with multiple involved systems and severe conditions.After reasonable treatment and follow-up, the disease can be alleviated or improved in one year.A high level of complement C 3 at the beginning of disease is conducive to rapid remission of the disease, and the young age of onset and no renal damage is conducive to rapid glucocorticoid reduction.

Objective:To investigate the relationship between serum Betatrophin levels and metabolic parameters in patients with polycystic ovary syndrome (PCOS) .Methods:98 patients with PCOS (PCOS group) treated in Zhengzhou People’s Hospital from Dec. 2017 to Sep. 2019 were selected. They were divided into non-obese group ( n=45) and obese group ( n=53) according to BMI value; They were divided into non-IR group ( n= 21) and IR group ( n=77) according to HOMA-IR value; They were divided into non-hyperandrogen group ( n=24) and hyperandrogen group ( n=74) according to TT level; Another 90 healthy women were taken as the control group. The baseline data, lipid metabolism indexes, hormone indexes, glucose metabolism indexes and Betatrophin levels of the two groups were recorded. Pearson test and logisitc regression model were used to analyze the influencing factors related to the increase of serum Betatrophin level in patients with PCOS. Results:Compared with the control group, PCOS group had higher level of BMI, body fat, WHR, VLDL, LDL, TG, TC, FAI, TT, LH, DHEA-S, 17-OHP, FSH, FBG, FINS, and HOMA-IR, while the HDL level was significantly lower. The difference was significant ( P<0.01). Serum Betatrophin level in obese group was significantly higher than that in the control group (163.99±126.97 vs 110.99±102.97), and the difference was statistically significant ( t=3.21, P<0.001) ; serum Betatrophin level in IR group was higher than that in the control group (160.26±136.80 vs 133.17±112.06), and the serum Betatrophin level in IR group was higher than that in the control group (173.51±147.85 vs 144.26±124.56), but the difference was not statistically significant ( P>0.05). Serum Betatrophin levels in PCOS group were positively correlated with BMI, WHR, TG, FAI, FBG, FINS ( P<0.05), and negatively correlated with HDL ( P<0.05). Logistic analysis showed that BMI, WHR and TG were independent factors affecting the increase of serum Betatrophin level. Conclusion:Serum Betatrophin levels of PCOS patients are significantly increased, and BMI, WHR, TG, HDL, FAI, FBG, FINS may play an important role in the occurrence and development of PCOS and obesity, insulin resistance, blood lipids and androgen metabolism disorders.

Objective:To investigate the influence of the prevalence and co-prevalence of risk factors for metabolic syndrome on the scores of different levels of metabolic syndrome in people receiving physical examination in Urumqi.Methods:Using the 2017 Xinjiang Health Examination Database, a total of 175 927 people from 7 districts and 1 county in Urumqi were selected as subjects. Face-to-face survey and body measurements were used to collect cardiovascular risk factors and metabolic syndrome scores. Metabolic syndrome scores were used. For the 0-5 points at 6 levels, χ2, χ2 trend test, correlation analysis of ordered variable Kendall’s tau-b, and logistic regression analysis of ordered results were used to analyze the influence of prevalence and co-prevalence of behavioral risk factors on the MS scores. Results:The percentages of 6 metabolic syndrome scores in the sample population were 23.82 %, 27.87 %, 22.41 %, 16.03 %, 8.02 %, and 1.85 %, respectively. The scores of metabolic syndrome were different in different age groups, ethnic groups, groups with different drinking rates, and groups with different dietary types, with the differences all significant ( P<0.05).The MS score in men increased with the increase of oil/salt rate and excessive drinking rate ( P<0.01). The score in women increased with the increase of the current smoking rate, oil/salt rate, and increased with the decrease of physical activity ( P≤0.01). There was no significant difference in the distribution of regular drinking rates between different score groups ( P>0.05). The scores of metabolic syndrome increased with the increase of risk factors ( P<0.05). Ordered results logistic analysis found that in the men with ≥3 risk factors and the metabolic syndrome score was 1.15 (1.06-1.26) times higher than that in the men without risk factor, as well as in women with 2 risk factors and≥3 risk factors. The metabolic syndrome scores were 1.38 (1.22-1.55), 2.02 (1.53-2.66) times higher than those in the women without risk factors. Conclusions:The physical examination group in Urumqi, the more the metabolic syndrome disease behavior risk factors clustered, the higher the metabolic syndrome score was. Therefore, comprehensive intervention measures should be taken to control the different forms of metabolic syndrome to prevent the occurrence and progress of the disease.

Objective The aim of this study was to investigate FFDM differential diagnosis between breast mastitis,benign hyperplasia and breast cancer. Methods Fifty-nine cases of non-puerperal breast mastitis,sixty-eight cases of benign hyperpla-sia and two hundred and forty cases with non-mass type breast cancer were analyzed retrospectively,which were verified by surgery and pathology by contrast with FFDM signs,pathological types,grouped and statistics processed. The observation indexes of lamellar shadow included shape,density and edge. The observation indexes of linear shadow included direction,form and diameter. Results The FFDM signs in three groups of breast diseases were statistically significant(P<0. 05):the form of linear shadow,accompanied by calcifications,the shape of lamellar shadow,the direction of linear shadow,the distribution of lesion,the sharp angle of shadow edge. χ2 segmentation show that there were significant differences between three groups(P<0. 0125):the shape of lamellar shadow,the direc-tion of linear shadow. Conclusion There have some values for the diagnosis of breast cancer by rigid form and radial distribution of linear shadow,rigid shape and segmental distribution of lamellar shadow,the polymorphic calcifications and the sharp angle sign.

Objective To analyze the causes of misdiagnosis and mistreatment of Dravet syndrome. Methods Patients with Dravet syndrome diagnosed according to clinical features and SCN1A gene mutation detection were recruited within recent 3 years. The patients were grouped into correct diagnosis-treatment group and misdiagnosis-mistreatment group according to whether the patients had ever been misdiagnosed and mistreated by sodium channel blockers. The clinical features were compared between two groups. Results Thirty-five cases with Dravet syndrome were collected and the rate of misdiagnosis reached 40%, Nine cases were misdiagnosed as symptomatic focal epilepsy, 4 as Lennox-Gastaut syndrome and 1 as Doose syndrome. The average age of onset in misdiagnosis-mistreatment group was (5.50 ± 3.56) months,and the age of confirmed diagnosis was (83.57 ± 105.62) months. The percentage of abnormal EEG, onset seizure with partial seizure, the seizure frequency within the first year from onset, onset with afebrile seizure, patients with status epilepticus or cluster seizures was higher in misdiagnosis-mistreatment group but it showed no significant statistical significance when compared with that of correct diagnosis-treatment group. The percentage of patients with mental retardation and focal neurological signs was significantly higher in misdiagnosis-mistreatment group (P=0.005 and 0.002, respectively). Conclusions Dravet syndrome is frequently misdiagnosed as symptomatic focal epilepsy. The appearance of focal neurological signs and mental retardation before confirmed diagnosis are important factors for misdiagnosis. Gene mutation screening will be helpful for differential diagnosis of Dravet syndrome.