AIM:To establish a model of recurrent hypoglycemia(RH)in mice with type 1 diabetes mellitus(T1DM)and to investigate the expression and effects of glucagon-like peptide-1(GLP-1)in the intestines of the model mice.METHODS:The T1DM model was established by induction with streptozotocin.Starting from the 15th day of T1DM,the mice in RH group were injected intraperitoneally with short-acting insulin,experiencing 1 episode of hyperin-sulinemic hypoglycemia every 3 days over 5 episodes,to establish the RH model in T1DM mice.Body weight,blood glu-cose,and activity status of the mice were recorded.Enzyme-linked immunosorbent assay(ELISA)was used to measure plasma adrenaline,glucagon(GCG),GLP-1,and somatostatin(SST)levels after the fifth episode of hypoglycemia for 60 min.Immunofluorescence staining was utilized to detect the expression of intestinal GLP-1 and hormone secretions from pancreatic α and δ cells in each group.Western blot was employed to detect protein expressions of GLP-1,GLP-1 receptor(GLP-1R),and prohormone convertase 1/3(PC1/3)in the intestine.RESULTS:Blood glucose and body weight met the standards for T1DM mice.During the 5 episodes of hypoglycemia,blood glucose levels in the RH group dropped to(3.3±0.5)mmol/L for more than 60 min during each episode of hypoglycemia,along with levels of plasma adrenaline and gluca-gon and the behavioral changes of RH mice during hypoglycemia,which met the modeling criteria of RH and impaired hy-poglycemic counterregulation in diabetic mice.ELISA detection showed that the plasma adrenaline and GCG levels were lower in RH group than those in T1DM group(P<0.01),while the plasma active GLP-1 and SST levels in mice were sig-nificantly higher in RH group(P<0.01).Immunofluorescence analysis showed that intestinal GLP-1 expression and pan-creatic SST secretion increased in RH group(P<0.01),while GCG secretion decreased(P<0.01).Western blot analysis showed that the levels of intestinal active GLP-1 and GLP-1R in RH group were significantly higher than those in T1DM group(P<0.01).CONCLUSION:Recurrent hypoglycemia in T1DM mice leads to increased intestinal GLP-1 expres-sion and secretion,which is closely related to the formation or aggravation of impaired hypoglycemic counterregulation.

Objective To evaluate the performance of a clinical-radiomics model for differentiating focal organizing pneumonia(FOP)and lung adenocarcinoma(LUAD).Methods We retrospectively analyzed the data of 60 patients with FOP confirmed by postoperative pathology at the First Medical Center of the Chinese PLA General Hospital from January,2019 to December,2022,who were matched with 120 LUAD patients using propensity score matching in a 1∶2 ratio.The independent risk factors for FOP were identified by logistic regression analysis of the patients'clinical data.The cohort was divided into a training set(144 patients)and a test set(36 patients)by random sampling.Python 3.7 was used for extracting 1835 features from CT image data of the patients.The radiographic features and clinical data were used to construct the model,whose performance was validated using ROC curves in both the training and test sets.The diagnostic efficacy of the model for FOP and LUAD was evaluated and a diagnostic nomogram was constructed.Results Statistical analysis revealed that an history of was an independent risk factor for FOP(P=0.016),which was correlated with none of the hematological findings(P>0.05).Feature extraction and dimensionality reduction in radiomics yielded 30 significant labels for distinguishing the two diseases.The top 3 most discriminative radiomics labels were GraylevelNonUniformity,SizeZoneNonUniformity and shape-Sphericity.The clinical-radiomics model achieved an AUC of 0.909(95%CI:0.855-0.963)in the training set and 0.901(95%CI:0.803-0.999)in the test set.The model showed a sensitivity of 85.4%,a specificity of 83.5%,and an accuracy of 84.0%in the training set,as compared with 94.7%,70.6%,and 83.3%in the test set,respectively.Conclusion The clinical-radiomics nomogram model shows a good performance for differential diagnosis of FOP and LUAD and may help to minimize misdiagnosis-related overtreatment and improve the patients'outcomes.

Objective To explore the optimal postoperative adjuvant regimens for patients with stage IB lung adenocarcinoma.Methods We respectively analyzed the data of 653 patients undergoing surgery for stage IB lung adenocarcinoma in our hospital from January,2013 to December,2021.The 5-year disease-free survival(DFS)and overall survival(OS)rates were compared among the patients receiving postoperative adjuvant therapy with epidermal growth factor-tyrosine kinase inhibitors(EGFR-TKIs group,n=111),chemotherapy(CT group,n=108)and clinical observation(CO group,n=434).Results In TKIs,CT,and CO groups,the 5-year DFS rates were 92.8%,80.7%,and 81.7%,respectively,significantly higher in TKIs group than in CO group(P<0.01).The 3-year OS rates of the 3 groups were 96.8%,97.1%,and 91.7%,respectively.Subgroup analysis showed that in TKIs,CT,and CO groups,the 5-year DFS rates of patients with with T3-4 cmN0M0 were 92.6%,84.0%,and 81.4%,respectively,significantly higher in TKIs group than in CO group(P<0.05);the 5-year DFS rates of T2ViscPlN0M0 patients were 95.1%,71.4%,and 83.5%,respectively.Multivariate COX regression analysis showed that age(P<0.05;HR=0.631,95%CI:0.401-0.993),solid nodules(P<0.01;HR=7.620,95%CI:3.037-19.121),micropapillary or solid component(P<0.05;HR=1.776,95%CI:1.010-3.122),lymphovascular invasion(P<0.05;HR=2.981,95%CI:1.198-7.419),and adjuvant therapy(P<0.01)were independent predictors of DFS.The most common adverse effects included rashes,paronychia,and diarrhea for TKIs and hematological suppression and gastrointestinal reactions for chemotherapy,and TKIs were associated with a higher incidence of grade 3 or above adverse effects(44.4%vs 9.0%).Conclusion Adjuvant therapy with TKIs helps improve DFS in patients with stage IB(T3-4cmN0M0)lung adenocarcinoma but not in patients with T2ViscPlN0M0.Adjuvant chemotherapy does not improve DFS or OS in patients with stage IB lung adenocarcinoma.

Objective To evaluate the performance of a clinical-radiomics model for differentiating focal organizing pneumonia(FOP)and lung adenocarcinoma(LUAD).Methods We retrospectively analyzed the data of 60 patients with FOP confirmed by postoperative pathology at the First Medical Center of the Chinese PLA General Hospital from January,2019 to December,2022,who were matched with 120 LUAD patients using propensity score matching in a 1∶2 ratio.The independent risk factors for FOP were identified by logistic regression analysis of the patients'clinical data.The cohort was divided into a training set(144 patients)and a test set(36 patients)by random sampling.Python 3.7 was used for extracting 1835 features from CT image data of the patients.The radiographic features and clinical data were used to construct the model,whose performance was validated using ROC curves in both the training and test sets.The diagnostic efficacy of the model for FOP and LUAD was evaluated and a diagnostic nomogram was constructed.Results Statistical analysis revealed that an history of was an independent risk factor for FOP(P=0.016),which was correlated with none of the hematological findings(P>0.05).Feature extraction and dimensionality reduction in radiomics yielded 30 significant labels for distinguishing the two diseases.The top 3 most discriminative radiomics labels were GraylevelNonUniformity,SizeZoneNonUniformity and shape-Sphericity.The clinical-radiomics model achieved an AUC of 0.909(95%CI:0.855-0.963)in the training set and 0.901(95%CI:0.803-0.999)in the test set.The model showed a sensitivity of 85.4%,a specificity of 83.5%,and an accuracy of 84.0%in the training set,as compared with 94.7%,70.6%,and 83.3%in the test set,respectively.Conclusion The clinical-radiomics nomogram model shows a good performance for differential diagnosis of FOP and LUAD and may help to minimize misdiagnosis-related overtreatment and improve the patients'outcomes.

Objective To explore the optimal postoperative adjuvant regimens for patients with stage IB lung adenocarcinoma.Methods We respectively analyzed the data of 653 patients undergoing surgery for stage IB lung adenocarcinoma in our hospital from January,2013 to December,2021.The 5-year disease-free survival(DFS)and overall survival(OS)rates were compared among the patients receiving postoperative adjuvant therapy with epidermal growth factor-tyrosine kinase inhibitors(EGFR-TKIs group,n=111),chemotherapy(CT group,n=108)and clinical observation(CO group,n=434).Results In TKIs,CT,and CO groups,the 5-year DFS rates were 92.8%,80.7%,and 81.7%,respectively,significantly higher in TKIs group than in CO group(P<0.01).The 3-year OS rates of the 3 groups were 96.8%,97.1%,and 91.7%,respectively.Subgroup analysis showed that in TKIs,CT,and CO groups,the 5-year DFS rates of patients with with T3-4 cmN0M0 were 92.6%,84.0%,and 81.4%,respectively,significantly higher in TKIs group than in CO group(P<0.05);the 5-year DFS rates of T2ViscPlN0M0 patients were 95.1%,71.4%,and 83.5%,respectively.Multivariate COX regression analysis showed that age(P<0.05;HR=0.631,95%CI:0.401-0.993),solid nodules(P<0.01;HR=7.620,95%CI:3.037-19.121),micropapillary or solid component(P<0.05;HR=1.776,95%CI:1.010-3.122),lymphovascular invasion(P<0.05;HR=2.981,95%CI:1.198-7.419),and adjuvant therapy(P<0.01)were independent predictors of DFS.The most common adverse effects included rashes,paronychia,and diarrhea for TKIs and hematological suppression and gastrointestinal reactions for chemotherapy,and TKIs were associated with a higher incidence of grade 3 or above adverse effects(44.4%vs 9.0%).Conclusion Adjuvant therapy with TKIs helps improve DFS in patients with stage IB(T3-4cmN0M0)lung adenocarcinoma but not in patients with T2ViscPlN0M0.Adjuvant chemotherapy does not improve DFS or OS in patients with stage IB lung adenocarcinoma.

OBJECTIVE: To analyze the clinicopathological characteristics and risk factors of 4L lymph node metastasis in left non-small cell lung cancer. METHODS: We retrospectively analyzed the data of 134 patients undergoing surgical resection of left non-small cell lung cancer and 4L lymph node dissection, including 60 patients with squamous cell carcinoma (SCC) and 74 with lung adenocarcinoma (ADC). The clinicopathological characteristics of the patients were analyzed, and logistic regression analysis was used to identify the predictors of station 4L metastasis. RESULTS: Of these patients, 16.4% (22/134) presented with station 4L metastasis. The patients with SCC and ADC showed significant differences in age, gender, smoking history, neoadjuvant chemotherapy, tumor size, tumor location and type, visceral pleural invasion, Ki-67 index, 4L metastasis and pathological TNM stage (stage Ⅱ). The rate of station 4L metastasis was significantly lower in SCC group than in ADC group. Univariate analysis revealed that pathological types (SCC or ADC), visceral pleural invasion, lymphovascular invasion, tumor markerabnormality, and station 5 to 10 metastasis were all high-risk factors for station 4L metastasis. Multivariate analysis suggested that the pathological type (OR=0.120, CONCLUSIONS In patients with left non-small cell lung cancer, station 4L metastasis is not rare and is more likely to occur in patients with lung adenocarcinoma. Dissection of the 4L lymph nodes should be performed in cases with low risk of damages of the adjacent tissues and high risk of station 4L metastasis.
Carcinoma, Non-Small-Cell Lung/pathology* ; Humans ; Lung Neoplasms/pathology* ; Lymph Node Excision ; Lymph Nodes/pathology* ; Lymphatic Metastasis ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Risk Factors

Objective To investigate the effect of A53T α-synuclein on the expression of type 2 vesicular monoamine transporter (VMAT2) in neuronblastoma SH-SY5Y cells stably expressing A53T α-synuclein.Methods A53T α-synuclein eukaryotic plasmid was constructed by transfection of the SH-SY5Y cells using LipofectamineTM 2000, and a stable transfected monoclonal cell line was selected by G418.Western blotting and DCFH-DA staining were used to detect the effect of A53T α-synuclein overexpression on the expression of VMAT2 protein and level of reactive oxygen species (ROS).Results Western blotting showed that compared with the control group, the expression of VMAT2 protein was significantly decreased, and DCFH-DA staining showed that DCF signal was significantly increased (507.3 ±7.1) than that in the cell line stably expressing A53T α-synuclein (410.7 ±10.5) (P <0.05).Conclusions A53T α-synuclein can increase the intracellular ROS level by inhibiting the expression of VMAT2, thereby playing an important role in the pathogenesis of Parkinson′s disease.

Objective To study the effects of radical surgical treatment for early esophageal cancer, and to investigate the prevention and cure of their complications,cancer recurrence and metastasis.Methods Treatments of 240 patients with early esophageal cancer of Chinese PLA General Hospital from January 2005 to January 2009 were retrospectively analyzed.The patients were treated by left thoracotomy,thoracic or cervical mechanical anastomosis surgical methods of treatment.Their postoperative adverse reactions,complications and 1 -,3-,5-year survival rates were observed and analyzed.Results The surgical resection rate was 1 00.00%. Complications included postoperative pulmonary infection (1 2 patients,5.00%), cardiac arrhythmias (1 patient,0.42%),delayed gastric emptying (2 patients,0.83%),pleural hemorrhage (1 patient, 0.42%),recurrent laryngeal nerve injury (2 patients,0.83%)and anastomotic fistula (1 patient,0.42%). One-year,3-year and 5-year survival rates after surgery were 1 00.00% (240 /240),97.9% (235 /240)and 95.8% (230 /240)respectively.The main causes of postoperative death were tumor recurrence and metastasis. Conclusion Timely surgery for early esophageal cancer can bring in good effect and long-term outcome,with little complication,which can obtain a good forward curative effect.

OBJECTIVETo probe the clinical application and value of dual source CT quantification volume imaging to forecast lung cancer patients' postoperative pulmonary function changing.

METHODSBetween June 2012 and June 2013, there were 233 patients (121 male patients and 112 female patients, with a mean age of (53 ± 16) years) who accepted the thoracoscope lobectomy or unilateral holo-lungs pneumonectomy accepted pulmonary function test before and after 3 months of the surgery. CT scan was conducted at both inspiration phase and expiration phase before the surgery and the lung volume of the single lobe, the pixel exponential distribution histogram, and the average lung density were measured after CT scan. The discrepancy and correlation between the preoperative lung volume accepted by CT and preoperative, postoperative pulmonary function index were compared.

RESULTSThe CT volume scan showed that average lung density of the superior part at decubitus position is -(870 ± 22) HU, the inferior part was -(767 ± 16) HU (t = 3.13, P < 0.01). The volume ratio of the right upper lobe, right middle lobe, right lower lobe, left upper lobe, left lower lobe were 20.5%, 10.3%, 23.1%, 24.6%, 21.5%, whole-right lung was 53.9% and whole-left was 46.1%. There were high correlation between CT volume index and preoperative routine pulmonary function index such as total lung capacity, forced vital capacity (FVC), forced expiratory volume in the first second (FEV(1)), residual volume, and FEV(1)/FVC. The highest correlation coefficient were 0.92, 0.76, 0.70, 0.85, 0.56 (t = 3.14, 3.05, 2.86, 3.09, 2.68; all P < 0.01). The highest correlation coefficient for the postoperative pulmonary function index were 0.87, 0.68, 0.75, 0.81, -0.64 (t = 3.10, 2.85, 3.05, 3.02, 2.79; all P < 0.01).

CONCLUSIONSIt is feasible to use dual source CT quantification volume imaging to predict lung cancer patients' postoperative pulmonary function alteration, which can provide precise predictive value of these patients. CT quantification volume imaging technology has important clinical application value.

Adult ; Aged ; Female ; Forced Expiratory Volume ; physiology ; Humans ; Lung ; physiology ; Lung Neoplasms ; physiopathology ; surgery ; Male ; Middle Aged ; Pneumonectomy ; Postoperative Period ; Prospective Studies ; Respiratory Function Tests ; Tidal Volume ; physiology ; Tomography, X-Ray Computed ; methods ; Vital Capacity ; physiology

Objective To develop a method of studying fiber projecting in the spinal cord duiring chicken embryo development.Methods At embryonic incubation 3 day (E3), pCAGGS-green fluorescent protein (GFP) plasmid was injected into the spinal cord using in vivo electroporation.Three days after transfection (E6), GFP-positive embryos were collected under a stereo fluorescence microscope .Subsequently , the spinal cord was separated from the embryos and cut from the roof plate as an open book .After fixed with 4%paraformaldehyde ( PFA) for one hour , the opened spinal cords were used for immunohistochemistry with N-cadherin antibody and with DAPI for nuclei .Finally, the nerve fiber projecting was photographed and analyzed under a fluorescence microscope . Results Based on the opened spinal cord and immunostaining in the cryosection , we observed that the nerve fibers projected across the midline of the floor plate and reached to the sulcus terminalis along the white matter of the contra side .The immunoreaction against N-cadherin indicated that overexpression of GFP has no significant effect on chicken embryonic development .Conclusion A new method to study fiber projecting in the developing chicken spinal cord is established successfully in this study .