A system for achieving two-dimensional(2D)visualization and three-dimensional(3D)reconstruction of lung images using CT data is designed.After DICOM image processing,and lung nodule segmentation and labeling,the multi-view and multi-resolution 3D display of lung parenchyma and nodules is realized using techniques such as resampling of CT sequences,3D reconstruction based on surface rendering,and morphological processing.Finally,the interactive interface is designed for implementing the functions of image enhancement,2D visualization,nodule delineation,3D reconstructions of lung parenchyma and nodules,rotation,zooming and switching the viewpoint.Experimental results show that the system provides clear and accurate 2D image visualization and lesion delineation,while reconstructing nodules in the generated 3D images completely and smoothly.Compared with the existing similar medical processing software,the developed system substantially improves the reconstruction and visualization efficiencies,enabling doctors to observe 3D images more quickly and accurately,and assisting in disease diagnosis and surgical planning.

Objective:To study the feasibility of magnetic resonance imaging(MRI)technique with amide proton transfer(APT)in predicting the prognosis of cerebral stroke.Methods:A total of 71 patients with acute cerebral stroke who admitted to the Nanjing First Hospital,Nanjing Medical University from September 2022 to May 2023 were selected.All of them underwent the test of National Institute of Health Stroke Scale(NIHSS),and received the MRI examination with chemical exchange saturation transfer(CEST).According to the modified Rankin scale(mRS)values of 1-month follow-up,they were divided into favorable recovery group(mRS<2,44 cases)and poor group(mRS≥2,27 cases).The asymmetric magnetization transfer ratio(MTRasym)image(APT)was obtained by analyzing data with special software.And then,the difference(△APTw)of APT values between ischemic zone and contralateral normal tissue was further calculated.The △APTw values of two groups were compared and analyzed,and the Pearson correlation analysis was adopted to analyze the correlation among △APTw,NIHSS and mRS.The receiver operating characteristics(ROC)curve was drawn,and the area under curve(AUC)of ROC curve was calculated.Results:There were significant positive correlations among △APTw,NIHSS and mRS scores(R2=0.659,0.522,P<0.001),and the differences of △APTW,NIHSS and mRS scores between the favorable recovery group and poor group were significant(t=5.73,6.36,13.92,P<0.05),respectively.The AUC value was 0.886,and the sensitivity and specificity of prediction were respectively 77.8%and 95.5%.The positive and negative predictive values were respectively 91.3%and 87.5%.Conclusion:APT imaging technique has feasibility in predicting the prognosis of acute cerebral ischemic stroke.

Objective:To develop an Arteriovenous Fistula Physical Examination Knowledge, Attitude, and Practice Scale for Hemodialysis Nurses and test its reliability and validity.Methods:Based on the theory of knowledge, attitude, and practice, a preliminary scale draft was formed through a literature review, three rounds of Delphi expert consultation, and a pre-survey. Using convenience sampling, 311 hemodialysis nurses were selected for a survey from December 2022 to February 2023 for item analysis, exploratory factor analysis and reliability testing. Another survey was conducted on 260 hemodialysis nurses from February to June 2023 for confirmatory factor analysis, convergent validity, and discriminant validity testing.Results:The Arteriovenous Fistula Physical Examination Knowledge, Attitude, and Practice Scale for Hemodialysis Nurses included three subscales and five dimensions, with a total of 33 items. The content validity index at the item level was 0.867 to 1.000, and the content validity index at the scale level was 0.992. After exploratory factor analysis, two, one, and two common factors were extracted from the knowledge, attitude, and practice subscales, with cumulative variance contribution rates of 70.114%, 75.192%, and 67.467%, respectively.Confirmatory:factor analysis showed that the model fitted well. The Cronbach's α coefficients of the three subscales were 0.929 to 0.943, the half reliability coefficients were 0.861 to 0.903, and the retest reliability coefficients were 0.824 to 0.874. Conclusions The Arteriovenous Fistula Physical Examination Knowledge, Attitude, and Practice Scale for Hemodialysis Nurses has good reliability and validity and can be used to evaluate the physical examination ability of hemodialysis nurses for arteriovenous fistula.

Objective:To investigate the correlation between different degrees of white matter hyperintensities (WMHs) and outcome after intravenous thrombolysis (IVT) in patients with acute ischemic stroke.Methods:Patients with AIS received intravenous thrombolytic therapy with standard dose of alteplase in the First Hospital of Putian City from January 2019 to June 2022 were retrospectively included. The Fazekas scale was used to score the WMHs shown on MRI, and the patients were divided into without or mild WMH group and moderate-to-severe WMH group. The clinical baseline data and the clinical outcome after 3 months of the two groups were compared. The poor outcome was defined as the modified Rankin scale score >2. Multivariate logistic regression analysis was used to determine the influence of the severity of WMHs on the outcome after intravenous thrombolysis. Results:A total of 103 patients with AIS were included. Their age was 64.85±10.89 years old, and 66 (64.1%) were men. There were 60 patients (58.3%) in the without or mild WMH group, and 43 (41.7%) in the moderate-to-severe WMH group. There were significant differences in age, body mass index, systolic blood pressure, baseline National Institutes of Health Stroke Scale (NIHSS) scores, as well as the proportion of patients with hypertension, smoking, hemorrhagic transformation and poor functional outcome at 3 months after onset in different degrees of WMH groups (all P<0.05). There were 73 patients (70.9%) in the good outcome group and 30 (29.1%) in the poor outcome group. There were significant differences in age, body mass index, baseline NIHSS score, WMH score, as well as the proportion of patients with hypertension, large atherosclerotic stroke and symptomatic intracranial hemorrhage between the two groups ( P<0.05). Multivariate logistic regression analysis showed that after adjusting for confounding factors, moderate-to-severe WMHs were the independent risk factors for the poor outcome at 3 months after intravenous thrombolysis (odds ratio 3.810, 95% confidence interval 1.298-1.124; P=0.015). Conclusion:Moderate-to-severe WMHs are associated with the poor outcome in patients with AIS at 3 months after intravenous thrombolysis.

Objective:To investigate the necessity and feasibility of the virtual simulation teaching experiment software of the bronchoscopy intelligent navigation-based fiducial marker implantation technology in the clinical application of radiotherapy.Methods:This study developed a 3D virtual operation and interactive system using the Unity3D engine, tools including 3Dmax and Maya, and the SQL database. The scenes in the system were produced using the currently popular next-generation production process. Targeting the priorities and difficulties in the implantation of fiducial markers, the system developed in this study allowed for simulated demonstration and training based on 12 steps and 10 knowledge points. Internal tests and remote evaluation tests were adopted in this system to obtain the test result of each subject. Then, the application value of the system was analyzed based on the test result.Results:As of May 1, 2022, the system had received 2 409 views and 425 test participants, with an test completion rate of 100% and an experiment pass rate of 96.5%. Moreover, this system won unanimous praise from 167 users, primarily including the students majoring in multilevel medical imaging technology and medical imaging science from the Fujian Medical University, as well as the radiotherapy-related staff of this university.Conclusions:The virtual simulation teaching experiment software of the bronchoscopy intelligent navigation-based fiducial marker implantation technology can be applied to the teaching of students and the training of related professionals.

Objective:To investigate the correlation of peripheral blood 25-hydroxyvitamin D3 [25 (OH) D3] level with T cell subsets in multiple myeloma (MM).Methods:The clinical data of 11 newly diagnosed MM patients hospitalized in Heze Municipal Hospital and the First People's Hospital of Jining from June 2019 to June 2021 were retrospectively analyzed, and 8 healthy people were selected as the healthy control group. The patients achieved disease remission after 4 courses of BD (bortezomib + dexamethasone) regimen. High performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) was used to measure the peripheral blood 25-(OH) D3 level in MM patients at initial diagnosis and after 4 courses of treatment, as well as people in the healthy control group. The proportion of peripheral blood helper T cell (Th) 1, Th2, Th17, and regulatory T cells (Treg cells) in CD3 + CD8 + T cells was measured by using flow cytometry. IgA, IgG, IgM, lactic dehydrogenase (LDH), β 2-microglobulin (β 2-MG) levels were analyzed by using fully automatic biochemical analyser. Cytoanalyze was used to detect the hemoglobin level in the peripheral blood. The differences of all indicators in MM patients at initial diagnosis, remission after treatment and the healthy control group were compared. Pearson method was used to analyze the correlation of the peripheral blood 25-(OH) D3 level with T cell subsets and other biochemical indicators in MM patients at initial diagnosis and remission after treatment. Results:Compared with the healthy control group, the peripheral blood 25-(OH) D3 level, Th1-to-Th2 ratio (Th1/Th2), the proportion of Treg cells were all decreased (all P < 0.01), and Th17-to-Treg cells ratio (Th17/Treg) was increased ( P = 0.002). The proportion of Th17 and Th17/Treg in MM patients achieving remission after treatment was higher than that in the healthy control group (all P < 0.05); the proportion of Treg cells in MM patients achieving remission after treatment was lower than that in the healthy control group ( P = 0.010); 25-(OH) D3 level in MM patients achieving remission after treatment was lower than that in the healthy control group, while the difference was not statistically significant ( P = 0.060). The peripheral blood IgM in MM patients at initial diagnosis and those achieving remission after treatment was lower than that in the healthy control group (all P < 0.01); the levels of LDH and β 2-MG in MM patients at initial diagnosis and those achieving remission after treatment was higher than that in the healthy control group (all P < 0.05). The peripheral blood 25-(OH) D3 level in MM patients at initial diagnosis was positively correlated with the proportion of Th1, Th1/Th2 ( r values 0.89, 0.60, all P < 0.05), and negatively correlated with the proportion of Th17 and Th17/Treg ( r values -0.61, -0.75, all P < 0.05). After treatment, there was no correlation of the proportion of Th1, Th2, Th17, Treg, Th1/Th2, Th17/Treg with peripheral blood 25- (OH) D3 level for patients achieving remission ( r values were -0.36, -0.45, -0.10, 0.10, 0.19, 0.03, all P > 0.05). IgM, LDH, β 2-MG was negatively correlated with 25- (OH) D3 level in the peripheral blood of MM patients at initial diagnosis ( r values were -0.76, -0.71, -0.62, all P < 0.05); while there was no correlation of 25-(OH) D3 level with IgA, IgG, IgM, LDH, β 2-MG, hemoglobin for patients achieving remission after treatment ( r values were -0.36, 0.19, -0.09, 0.47, 0.47, -0.11, all P > 0.05). Conclusions:MM patients show the decreased peripheral blood 25-(OH) D3 level, the increased Th17 and the decreased Treg cells; 25-(OH) D3 level is related to the imbalance of Th1/Th2/Th17/Treg, which suggests that 25-(OH) D3 may be related to the development, progression, prognosis and abnormal immune responses in the body of MM.

Salt stress may cause primary osmotic stress and ion toxicity, as well as secondary oxidative stress and nutritional stress in plants, which hampers the agricultural production. Salt stress-responsive transcription factors can mitigate the damage of salt stress to plants through regulating the expression of downstream target genes. Based on the soil salinization and its damage to plants, and the central regulatory role of transcription factors in the plant salt stress-responsive signal transduction network, this review summarized the salt stress-responsive signal transduction pathways that the transcription factors are involved, and the application of salt stress-responsive transcription factors to enhance the salt tolerance of plants. We also reviewed the transcription factors-regulated complex downstream gene network which is formed by forming homo- or heterodimers between transcription factors and by forming complexes with regulatory proteins. This paper provides a theoretical basis for understanding the role of salt stress-responsive transcription factors in the salt stress regulatory network, which may facilitate the molecular breeding for improved stress resistance.
Gene Expression Regulation, Plant ; Osmotic Pressure ; Plant Proteins/metabolism* ; Plants, Genetically Modified ; Salt Stress ; Salt Tolerance ; Stress, Physiological ; Transcription Factors/metabolism*

Objective:To investigate the clinical efficacy and related adverse reactions of ixazomib-based chemotherapy regimens in the treatment of relapsed/refractory multiple myeloma (RRMM).Methods:Twenty-one patients with RRMM who received ≥2 courses of ixazomib-based chemotherapy regimens in Heze Municipal Hospital and Zoucheng People's Hospital of Shandong Province from October 2018 to February 2020 were collected. Among them, 15 patients had previously received the bortezomib-based regimens, 10 patients had received the lenalidomide-based regimens, and 6 patients had received the treatment regimens containing the above two drugs. The patients were treated by a two-drug or three-drug regimen: 4 mg ixazomib was taken orally on day 1, 8 and 15 in combination with other drugs (dexamethasone, cyclophosphamide or lenalidomide). The therapeutic efficacy and safety were evaluated after the 2nd and the 4th treatment cycles.Results:The overall response rate (ORR) of 21 patients with RRMM after 2 treatment cycles was 38.09% (8/21), including 6 cases of partial remission (PR) and 2 cases of very good partial remission (VGPR). After 4 cycles, ORR was 57.14% (12/21), including 7 cases of PR, 4 cases of VGPR, and 1 case of complete remission (CR). The incidence of grade 3-4 adverse reactions of the ixazomib-based chemotherapy regimens was 23.81% (5/21). Hematological adverse reactions included neutropenia, thrombocytopenia and anemia, and other common adverse reactions included the digestive tract reactions, fatigue, hypokalemia, etc., and the peripheral nerve adverse reactions were all grade 2 or below grade 2.Conclusion:The ixazomib-based chemotherapy regimens are effective and safe in treating RRMM.

Objective:To observe the clinical efficacy and adverse reactions of bortezomib once-weekly therapy for newly diagnosed multiple myeloma (MM).Methods:The clinical data of 50 patients with newly diagnosed MM who received bortezomib combined with chemotherapy in Heze Municipal Hospital of Shandong Province from June 2016 to June 2019 were retrospectively analyzed. The patients were divided into once-weekly medication regimen (the observation group, 21 cases) and twice-weekly medication regimen (the control group, 29 cases). The efficacy and adverse reactions of both groups were compared.Results:The total effective rate of the former 2 treatment courses in the observation group was lower than that in the control group, and the difference was statistically significant [23.8% (5/21) vs. 55.2% (16/29), χ 2 = 4.918, P = 0.027]. After treatment of 4 and 6 courses, there were no statistically significant differences in the total effective rate between the observation group and the control group [66.7% (14/21) vs. 72.4% (21/29); 81.0% (17/21) vs. 86.2% (25/29), all P > 0.05]. The incidence of peripheral neuropathy in the observation group was lower than that in the control group, and the difference was statistically significant [14.3% (3/21) vs. 41.4% (12/29), χ 2 = 4.416, P = 0.036]. There was no statistically significant difference in the incidence of other adverse reactions of both groups (both P < 0.05). Conclusions:The therapeutic effect of once-weekly medication regimen is similar to that of twice-weekly medication regimen for the treatment of newly diagnosed MM. The incidence of peripheral neuropathy in the once-weekly therapy is low and the patients can have better tolerance.

Objective To analyze special histopathological characteristics of melanocytic nevi and their associations with age,gender,anatomical locations and pathological subtypes.Methods Clinical and histopathological data were collected from 1 011 patients with melanocytic nevi,who visited Beijing Hospital from January 2005 to January 2019,and analyzed retrospectively.Statistical analysis was carried out by using chi-square test for comparing enumeration data,and t test for comparing measurement data.Results Among the 1 011 patients with melanocytic nevi,the age at the clinic visit was 40.90 + 19.19years,and there were 289 males and 722 females.Lesional (biopsy) sites included the trunk (402 cases,39.8％),face and neck (268 cases,26.5％),extremities (138 cases,13.6％),hands and feet (133 cases,13.2％),scalp (53 cases,5.2％) and vulva (17 cases,1.7％).Pathological subtypes included intradermal nevus (580 cases,57.4％),compound nevus (333 cases,32.9％) and junctional nevus (98 cases,9.7％).Among special histopathological characteristics,neuralization and adipose cell hyperplasia were observed in 172 (17.0％) and 155 (15.3％) cases respectively,and the prevalence of neuralization and adipose cell hyperplasia was significantly higher in female patients than in male patients,higher in elderly patients than in young patients,and higher on the scalp than on the other sites (all P ＜ 0.05);vascular proliferation was observed in 313 (31.0％) cases,and more commonly occurred on the scalp than on the other sites (P＜0.05);nevus cells distributed along the hair follicles/sebaceous glands were observed in 502 (49.7％)cases,and more commonly seen on the face and neck than on the other sites (P ＜ 0.05);nevus cell lysis occurred in 203 (20.1％) cases,and fissures were observed in 384 (38.0％).All the above histopathological characteristics were more frequently observed in the intradermal nevus subtype than in the compound nevus subtype (all P＜0.05).Nevus cells distributed along the blood vessels were observed in 20 (2.0％) cases,and more commonly seen on the extremities than on the trunk,hands and feet (P ＜ 0.05),as well as in the compound nevus subtype than in the intradermal nevus subtype (P ＜ 0.05).Conclusions There are many special histopathological characteristics in melanocytic nevi,such as neuralization,adipose cell hyperplasia,vascular proliferation,and nevus cells distributed along the hair follicles/sebaceous glands,which are associated with patients' age,gender,lesional locations and histopathological subtypes.