Background/Aims: The accuracy of endosonographers in diagnosing gastric subepithelial lesions (SELs) using endoscopic ultrasonography (EUS) is influenced by experience and subjectivity. Artificial intelligence (AI) has achieved remarkable development in this field. This study aimed to develop an AI-based EUS diagnostic model for the diagnosis of SELs, and evaluated its efficacy with external validation. Methods: We developed the EUS-AI model with ResNeSt50 using EUS images from two hospitals to predict the histopathology of the gastric SELs originating from muscularis propria. The diagnostic performance of the model was also validated using EUS images obtained from four other hospitals. Results: A total of 2,057 images from 367 patients (375 SELs) were chosen to build the models, and 914 images from 106 patients (108 SELs) were chosen for external validation. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the model for differentiating gastrointestinal stromal tumors (GISTs) and non-GISTs in the external validation sets by images were 82.01%, 68.22%, 86.77%, 59.86%, and 78.12%, respectively. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy in the external validation set by tumors were 83.75%, 71.43%, 89.33%, 60.61%, and 80.56%, respectively. The EUS-AI model showed better performance (especially specificity) than some endosonographers.The model helped improve the sensitivity, specificity, and accuracy of certain endosonographers. Conclusions We developed an EUS-AI model to classify gastric SELs originating from muscularis propria into GISTs and non-GISTs with good accuracy. The model may help improve the diagnostic performance of endosonographers. Further work is required to develop a multi-modal EUS-AI system.

Objective The aim of this study was to investigate the prevalence of erectile dysfunction (ED) and to assess the risk factors of ED in male post‐stroke patients .Methods One hundred and twenty six male post‐stroke patients were invited to par‐ticipate in this study .Patients were divided into ED group and non‐ED group according to the erectile function evaluated by Interna‐tional Index of Erectile Function‐5 (IIEF‐5) .The neurological impairment was measured using the National Institute of Health Stroke Scale (NIHSS) and the modified Rankin Scale (mRS) .Depressive symptoms was measured using the Hamilton Depression Scales (HAMD) .The global cognitive function was measured using the Mini mental Status Examination (MMSE) .The clinical and psychosocial factors were compared between the ED and non‐ED groups .Univariate and multivariate Logistic regression analyses were employed to assess the risk factors with ED .Results There were 38 patients (30 .2% ) with ED in all the 126 male post‐stroke patients .Univariate Logistic regression analyses revealed that hypertension ,diabetes ,ACEI ,and depression were significantly related to ED in male post‐stroke patients (P<0 .05) .Multivariate Logistic regression analyses revealed that ACEI and depression were independently associated with ED in male post‐stroke patients (P<0 .05) .Conclusion ED is common in Chinese male post‐stroke patients .ACEI and depression are the major determinants of ED .

Objective:To compare the content of total saponins in Paridis Rhizome from Wudang mountain area to explore the cor-relation between the quality of medicinal materials and the production areas and species. Methods: The content of total saponins in Paridis Rhizome was determined by an ultraviolet-visible spectrophotometer at 406nm with perchloric acid as the chromogenic reagent. Results:The saponins content in Paridis Rhizome from Wudang mountain area had obvious differences:the minimum was 1. 29%, and the maximum was up to 10. 22%. The content of total saponins had no obvious correlation with species, production area and altitude. Conclusion:The quality of Paridis Rhizome is unstable in Wudang mountain area, and that will affect the effectiveness and safety of the clinical medication. Only by promoting the standardized planting of Chinese medicine materials, the stable quality of Paridis Rhizo-me can be ensured.

Objective To evaluate the role of membrane-bound complement regulatory protein expression in spinal cord dorsal horn in the development of neuropathic pain (NP) in rats.Methods Forty-eight male Sprague-Dawley rats,weighing 200-250 g,in which intrathecal catheters were successfully implanted without complications,were randomly divided into 4 groups (n =12 each):sham operation group (group S),group NP,normal saline group (group NS) and minocycline group (group M).NP was induced by chronic constrictive injury of the sciatic nerve in NP,NS and M groups.Minocycline 50 μg was injected intrathecally once a day for 7 consecutive days starting from 1 day before ligation of the sciatic nerve in M group,while the equal volume of normal saline was given in stead of minocycline in NS group.Mechanical pain threshold and thermal pain threshold were measured at 1 day before ligation of the sciatic nerve (baseline,T0) and 1,3,7 days after ligation of the sciatic nerve (T1-3).Then the rats were sacrificed at T3 and the lumbar segment (L4,5) of spinal cord was removed for determination of the expression of CD46,CD55,CD59 protein and mRNA in the dorsal horn of spinal cord by Western-blot and RT-PCR,respectively.Results Compared with S group,mechanical pain threshold and thermal pain threshold were significantly decreased at T1-3 and the expression of CD46,CD55 and CD59 protein and RNA was down-regulated at T3 in NP,NS and M groups (P ＜ 0.05).Compared with groups NS and NP,mechanical pain threshold and thermal pain threshold were significantly increased at T2.3 and the expression of CD46,CD55 and CD59 protein and RNA was up-regulated at T3 in M group (P ＜ 0.05).Conclusion The down-regulated expression of membrane-bound complement regulatory proteins in spinal cord dorsal horn and abnormal activation of the complement are involved in the development of NP in rats.

OBJECTIVE: To explore the significance of MR and endoscopy in the postoperative management of skull base reconstruction with a vascular pedicle nasoseptal mucoperiosteal flap. METHOD: The immediate, and delayed postoperative MR imaging scans and endoscopic data of 8 patients who underwent endonasal endoscopic reconstruction of skull base dural defects with a vascular pedicle nasoseptal mucoperiosteal flap were retrospectively studied. Among the 8 patients, 7 cases have integrated immediate, delayed postoperative MR and synchronous endoscopic data which were harvest at the first week and at a 3- to 7-month interval respectively. One case was followed up by CT and endoscopy. The intracranial parenchymal changes, local situation of skull base defect site, the septal flap, healing of flap donor site and the transition of naso sinus mucosa were fully evaluated to explore the healing process and to improve the success rate of the reconstruction. RESULT: We can obtain the key postoperative information of intracranial and the skull base reconstruction site with MR and endoscopy. The MR can exclude the intracranial complications such as postoperative intracranial hematoma, cerebral edema, or pneumocephalus, and clearly show the location and extent of skull base defects, the position of the flap, the overlapping manner between the dural defect margin and the flap and the postoperative cerebrospinal fistula. In immediate and postoperative follow-up with MR, the septal flap had homogeneous enhanced image with a roughly "C" figure under the skull base, indicating stable blood supplement. The synchronous endoscopic examination also proved the survival of the septal flaps in 7 cases , the cerebrospinal fluid leakage in 1 case. One case flap necrosis. The septal flaps presented edema and congested in the immediate postoperative endoscopy, and returned to normal in the delayed examination. The non-vascular materials such as gelatin sponge and fat tissue had the different characteristics signal. Nasal mucosal edema and sinus ventilation continually recovered during the follow up and the exposed septal cartilage on the donor site resurfaced by mucosa in 2 months. CONCLUSION MR and endoscopy could provide the critical postoperative information about the vascular pedicle septal flap reconstruction. MR combined with endoscopy not only could rule out the complications, but also could gain the information such as the position, blood supply and healing of the flap, at the same time detected the cerebrospinal fluid leakage to provide accurate information for the secondary stage reconstruction. The information got from MR and endoscopy were important for the surgeon and the radiologist to recognize the flap and to evaluate for variations that may suggest potential flap failure.
Adult ; Cerebrospinal Fluid Rhinorrhea ; Endoscopy ; Humans ; Magnetic Resonance Spectroscopy ; Male ; Middle Aged ; Nasal Mucosa ; transplantation ; Nasal Septum ; Periosteum ; transplantation ; Postoperative Period ; Reconstructive Surgical Procedures ; methods ; Retrospective Studies ; Skull Base ; surgery ; Surgical Flaps ; blood supply

Infectious clone is a useful tool in exploring viral replication and pathogenesis. In order to prevent linear PCV2 cyclization, PCR mutagenesis was used to construct the first molecular clone (pSK-2PCV2) by ligating two copies of the complete PCV2 genome with the pBluescript SK (pSK) vector. In addition, pSK-PCV2 and ds-PCV2 were constructed. PK-15 cells were transfected with above three infectious clones. Indirect immunofluorescence assay (IFA) revealed that the virus antigen mainly localized in infected cell nucleolus and cytoplasm. PCV2 specific nucleotide fragment in cell culture was amplified by RT-PCR. Typical porcine circovirus particles with diameter about 17 nm were also observed by transmission electron microscope (TEM) in the infected cells. The rescued virus sequences from the cultures had 100% homology with the inserting PCV2 genome. The rescued virus shared similar properties with that of the parental virus. The study establishes a platform for further research on the virus molecular biology and pathogenicity.
Animals ; Cell Line ; Circoviridae Infections ; virology ; Circovirus ; genetics ; growth & development ; pathogenicity ; physiology ; Cloning, Molecular ; DNA, Viral ; genetics ; physiology ; Recombination, Genetic ; genetics ; Swine ; Transfection ; Virulence ; Virus Replication

Objective To study the imaging characteristics of the ligaments in craniocervical junction (CCJ), and to optimize the examination methods and scanning sequences of the ligaments in this region. Methods Two groups of 51 healthy volunteers in each were selected to undergo CT and MRI examination respectively. The CT and MRI features of the ligaments in CCJ were assessed. Two senior imaging doctors compared the results of showing the ligaments in CCJ by several MRI sequences, including T1 WI ,T2 WI, proton density weighted imaging (PDWI), T2 * WI and short time inversion recovery (STIR) ,and proton density fat saturate (PDFSAT). Standard normal rank transformation was done according to the primary data,and then analysis of variance of repeated measurement was applied. Results CT and MRI could both demonstrate the ligaments (except the anterior atlantooccipital membrane only seen on MRI) and their adjoins in CCJ, while MRI had more advantages than CT. The display ratio of the anterior atlantooccipital membrane was 100% (51/51) by MRI. The display ratio of the apical ligament was 29.4%(15/51) by CT and 43.1% (22/51) by MRI. The posterior atlantooccipital membrane-dura complex,tectorial ligament-dura complex, transverse ligament, and alar ligament could be demonstrated clearly by CT and MRI, the display ratio was 100% respectively (51/51). The results of PDWi scored by two doctors were both 5.0, there were no significant differences between them (F = 0.000, P > 0.05), which were significantly higher than T, WI (M = 3.0), T2Wi (M = 3.0), T2 * WI (M = 1.0), STIR (M = 1.0), and PDFSAT(M = 3.0)(P < 0.01). Conclusion MRI was superior to CT in demonstrating the ligaments in CCJ. PDWI was the optimal MRI sequence. Imaging research of normal ligamentous structures in CCJ could provide valuable diagnostic and therapeutic information for evaluating the ligamentous diseases.

OBJECTIVE: To screen the anti-tumor fraction of ethanol extracts from Thymus quinquecostatus Celak and investigate its anti-tumor effect on human leukemia cell line. METHODS: Ethyl acetate, n-butanol and acetone fractions were separated from the ethanol extracts of wild Thymus quinquecostatus Celak. Growth inhibiting effects of these extracts on human leukemia cell lines K562 and HL-60 were determined by live cell counting and cell growth curve analysis. The possible anti-tumor mechanism was studied by morphological analysis with norcantharidin as a positive control. RESULTS: Ethyl acetate fraction could significantly inhibit the proliferations of K562 and HL-60 cells, and the inhibiting effect depended on the concentration of ethyl acetate fraction. Ethyl acetate fraction could induce apoptosis of K562 and HL-60 cells. The n-butanol and acetone fractions had no significant inhibiting effect on K562 and HL-60 cells. CONCLUSION: Ethyl acetate fraction is the major anti-tumor fraction in ethanol extracts from Thymus quinquecostatus Celak.

OBJECTIVE: To study the anti-tumor and immunological effect of extracts from Thymus quinquecostatus Celak on mice transplanted S180 tumor cells. METHODS: Different doses of volatile oil and alcohol extracted substances from Thymus quinquecostatus Celak were given to mice bearing S180 tumor for 9 days. Tumor inhibition rates and coefficients of spleen and thymus were determined. RESULTS: Tumor inhibition rates of the groups with alcohol extracts (40 g crude drug.kg(-1).d(-1) and 20 g crude drug.kg(-1).d(-1)) were 51.5% (P<0.01) and 36.4% (P<0.05) respectively, and those of the groups with volatile oil (40 g crude drug.kg(-1).d(-1) and 20 g crude drug.kg(-1).d(-1))were both 39.4% (P<0.05). CONCLUSION: The extracts from Thymus quinquecostatus Celak have anti-tumor activities. The coefficient of spleen in group with alcohol extracts (40 g crude drug.kg(-1).d(-1))was close to normal value, and its coefficient of thymus was between that of the negative control group and the group with cyclophosphamide (0.02 g.kg(-1).d(-1)). The anti-tumor activity of the alcohol extracts was significantly higher than that of the control group and the tumor inhibition rate was depending on drug concentration. Depending on index of immunity,the extracts from Thymus quinquecostatus Celak may have some influences on immunity.