Objective:To investigate the diagnostic value and imaging characteristics of MRI combined with 18F-fluorodeoxyglucose (FDG) positron-emission tomography (PET)/CT in focal cortical dysplasia (FCD) complicated with refractory epilepsy. Methods:A retrospective analysis was performed on 42 patients with FCD complicated with refractory epilepsy who were admitted to the Affiliated Hospital of Jining Medical University from January 2017 to December 2022. All patients underwent preoperative MRI and 18F-FDG PET/CT, and PET/MRI fusion was performed on the images. Chi-square test and Kappa consistency test were used to compare the localization diagnostic efficacy of PET/CT, MRI and PET/MRI fusion for epileptic foci. The patients were categorized based on gender, lesion location, pathological type, seizure type, and efficacy. Independent sample t-test and analysis of variance were used to compare maximum standardized uptake (SUVmax) values and asymmetry index (AI) of the patients between different groups. Results:Among the 42 patients, the positive rates of MRI, PET/CT, PET/MRI fusion examinations were 85.7%(36/42), 95.2%(40/42), 100.0%(42/42), the lateral localization rates were 71.4%(30/42), 92.9%(39/42), 95.2%(40/42), and the localization rates were 57.1%(24/42), 81.0%(34/42), 88.1%(37/42), respectively. There were significant differences in the lateral localization rates and localization rates of epileptogenic foci between MRI and PET/CT (χ 2=6.574, P=0.010; χ 2=5.570, P=0.018). There were significant differences in the positive rates of lesions, the lateral localization rates and the localization rates of epileptogenic foci between MRI and PET/MRI fusion (χ 2=6.385, P=0.012; χ 2=8.571, P=0.003; χ 2=10.118, P=0.001). There were no significant differences in the positive rates of lesions between MRI and PET/CT, and in the positive rates of lesions, the lateral localization rates and localization rates of epileptogenic foci between PET/CT and PET/MRI fusion (χ 2=2.184, P=0.139; χ 2=2.024, P=0.155; χ 2=0.210, P=0.647; χ 2=0.819, P=0.365). The Kappa consistency test of PET/CT and PET/MRI fusion imaging was performed for the location of epileptogenic foci, and the Kappa=0.721 was obtained, indicating that they were consistent in the location of epileptogenic foci. The SUVmax values of patients with temporal lobe epilepsy were lower, and the AI values were higher than that of patients with extra temporal lobe epilepsy (7.4±1.3 vs 9.6±1.6, 15.5±2.6 vs 12.9±2.4; t=5.154, 6.083; P=0.001, 0.001). The SUVmax values of patients with good efficacy (according to the Engel efficacy grading system, grades Ⅰ-Ⅱ indicating good efficacy) were higher, and the AI values were lower than that of patients with poor efficacy (according to the Engel efficacy grading system, grades Ⅲ-Ⅳ indicating poor efficacy; 9.5±1.9 vs 7.9±2.1, 13.5±3.3 vs 14.8±3.0; t=2.789, 3.722; P=0.042, 0.029). There were no significant differences in SUVmax and AI values among different genders, pathological types and seizure types (all P>0.05). Conclusions:The imaging characteristics of patients with different types of FCD complicated with refractory epilepsy are different. PET/MRI fusion is better than MRI in the diagnosis of FCD complicated with refractory epilepsy, and is consistent with PET/CT in the location of epileptogenic foci.

Objective:To investigate the effect of behavioral lifestyle on the CT values of urinary tract stones, as well as the relationship between behavioral lifestyle and the therapeutic effect of extracorporeal shock wave lithotripsy (ESWL).Methods:A total of 265 patients with urinary tract stones who underwent ESWL treatment at Affiliated Hospital of Jining Medical University from January 2019 to June 2023 were selected. According to the CT values of the stones, the subjects were divided into high CT value group (CT value > 1 000 HU, n=106) and low CT value group (CT value ≤ 1 000 HU, n=159). A retrospective survey was conducted to assess the patients' behavioral lifestyles, and general data, CT values, number of lithotripsy sessions, lithotripsy time, lithotripsy efficiency, and incidence of complications were compared between the two groups. SPSS 22.0 software was used for statistical analysis. The χ2 test and t-test were used for group comparisons, and Pearson correlation analysis was used to examine the relationship between stone CT values and different behavioral lifestyles. Results:The high CT value group had lower average daily water intake((1 242±347)mL vs (1 784±376)mL), average daily fresh fruit intake((135±43)g vs (196±51)g), and average daily exercise time((18±12)min vs (32±14)min) compared with the low CT value group( t=-11.850, -9.926, -8.434, all P<0.01). In contrast, the high CT value group had higher average daily salt intake((8.3±2.2)g vs (6.5±1.7)g) and average daily animal protein intake ((72±18)g vs (54±16)g) compared with the low CT value group ( t=7.495, 8.531, both P<0.01). The high CT value group required more lithotripsy sessions and longer lithotripsy time than the low CT value group ( t=6.192, 7.507, both P<0.05), while lithotripsy efficiency was lower than the low CT value group ( χ2=33.181, P<0.01). The incidence of complications was higher in the high CT value group compared to the low CT value group ( χ2=3.915, P=0.048), with statistically significant differences. Conclusion:Appropriate water intake, diet, and exercise habits are beneficial in reducing stone CT values, improving the efficacy of ESWL treatment, and decreasing the incidence of complications.

Objective:To explore the diagnostic value of 18F-FDG PET/CT imaging in etiology of patients with hemophagocytic lymphohistiocytosis (HLH). Methods:Retrospective analysis was performed on 49 patients newly diagnosed as HLH (32 males, 17 females; age 19-61 years) who received 18F-FDG PET/CT imaging in Affiliated Hospital of Jining Medical University from January 2017 to January 2023. PET/CT images and clinical parameters were observed and recorded. Based on the pathological examination and clinical follow-up results, diagnostic efficacies for HLH etiology of PET/CT, PET and CT imaging were calculated. χ2 test, independent-sample t test and Mann-Whitney U test were used to compare the differences between hematologic tumors associated HLH and non-hematologic tumor associated HLH. Multivariate logistic regression was used to analyze the predictors of secondary HLH in hematologic tumors. ROC curve analysis was used to calculate AUCs and optimal threshold of lymph node SUV max and soluble CD25 (sCD25) to predict secondary HLH in patients with hematologic tumors. Results:The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of PET/CT, PET and CT in the etiological diagnosis of HLH were 85.7%(30/35), 8/10, 84.4%(38/45), 93.8%(30/32), 8/13; 77.1%(27/35), 6/10, 73.3%(33/45), 87.1%(27/31), 6/14; 62.9%(22/35), 5/10, 60.0%(27/45), 81.5%(22/27), 5/18, respectively. There were differences in lymph node distribution and boundary, liver and spleen and bone lesions, SUV max of lymph node and liver and spleen and bone, gender, age, WBC, neutrophil (ANC), PLT, lactate dehydrogenase (LDH), total bilirubin (TBIL), C-reactive protein (CRP) and sCD25 between different etiology groups ( χ2 values: 3.91-9.66, t values: 3.75-7.90, z values: 3.82-4.01, all P<0.05). SUV max of lymph nodes and sCD25 were predictive factors for secondary HLH of hematological tumors (odds ratio ( OR): 1.28 (95% CI: 1.09-1.72), 1.56 (95% CI: 1.17-2.49), P values: 0.004, 0.013). The optimal thresholds were 12.6 and 40 028 ng/L, with the AUC of 0.87 and 0.76, with the sensitivity and specificity of 88.6%(31/35) and 8/10, 65.7%(23/35) and 7/10, respectively. The combined AUC was 0.83 and the sensitivity and specificity were 74.3% (26/35) and 9/10. Conclusions:18F-FDG PET/CT imaging is of high value for the diagnosis of the cause of HLH. SUV max of lymph node and sCD25 are predictive factors for secondary HLH of hematologic tumors.

Objective:To investigate the diagnostic accuracy of serological indicators and evaluate the diagnostic value of a new established combined serological model on identifying the minimal hepatic encephalopathy (MHE) in patients with compensated cirrhosis.Methods:This prospective multicenter study enrolled 263 compensated cirrhotic patients from 23 hospitals in 15 provinces, autonomous regions and municipalities of China between October 2021 and August 2022. Clinical data and laboratory test results were collected, and the model for end-stage liver disease (MELD) score was calculated. Ammonia level was corrected to the upper limit of normal (AMM-ULN) by the baseline blood ammonia measurements/upper limit of the normal reference value. MHE was diagnosed by combined abnormal number connection test-A and abnormal digit symbol test as suggested by Guidelines on the management of hepatic encephalopathy in cirrhosis. The patients were randomly divided (7∶3) into training set ( n=185) and validation set ( n=78) based on caret package of R language. Logistic regression was used to establish a combined model of MHE diagnosis. The diagnostic performance was evaluated by the area under the curve (AUC) of receiver operating characteristic curve, Hosmer-Lemeshow test and calibration curve. The internal verification was carried out by the Bootstrap method ( n=200). AUC comparisons were achieved using the Delong test. Results:In the training set, prevalence of MHE was 37.8% (70/185). There were statistically significant differences in AMM-ULN, albumin, platelet, alkaline phosphatase, international normalized ratio, MELD score and education between non-MHE group and MHE group (all P<0.05). Multivariate Logistic regression analysis showed that AMM-ULN [odds ratio ( OR)=1.78, 95% confidence interval ( CI) 1.05-3.14, P=0.038] and MELD score ( OR=1.11, 95% CI 1.04-1.20, P=0.002) were independent risk factors for MHE, and the AUC for predicting MHE were 0.663, 0.625, respectively. Compared with the use of blood AMM-ULN and MELD score alone, the AUC of the combined model of AMM-ULN, MELD score and education exhibited better predictive performance in determining the presence of MHE was 0.755, the specificity and sensitivity was 85.2% and 55.7%, respectively. Hosmer-Lemeshow test and calibration curve showed that the model had good calibration ( P=0.733). The AUC for internal validation of the combined model for diagnosing MHE was 0.752. In the validation set, the AUC of the combined model for diagnosing MHE was 0.794, and Hosmer-Lemeshow test showed good calibration ( P=0.841). Conclusion:Use of the combined model including AMM-ULN, MELD score and education could improve the predictive efficiency of MHE among patients with compensated cirrhosis.

Objective:To investigate the mechanism of crossed cerebellar diaschisis(CCD) induced by supratentorial tumors and the characteristics of 18F-FDG PET/CT imaging. Methods:Eighty-six patients with supratentorial tumors who underwent 18F-FDG PET/CT whole-body imaging from January 2017 to June 2021 were retrospectively analyzed.Placement, number, size, SUVmax, CT values, relationship with basal ganglia, edema, and cerebellar asymmetry index (AI) were observed and recorded.The imaging differences between patients with CCD and patients without CCD were compared, and the correlations between SUVmax, maximum diameter and cerebellar AI were analyzed.SPSS 21.0 software was used for statistical analysis.Chi-square test, independent sample t-test and Pearson correlation analysis were used for data statistics. Results:Among the 86 patients, 14 were patients with CCD and 72 were patients without CCD.The incidence of CCD was 16.3%.There were statistically significant differences in whether the primary lesions involved the basal ganglia region between patients with CCD and patients without CCD ( χ2=7.637, P=0.006). The cerebellar AI ((0.27±0.09), (0.05±0.02), t=6.847, P=0.003)and maximum diameter of primary lesions((3.98±1.09)cm, (2.36±1.61)cm, t=2.011, P=0.040) in patients with CCD were both larger than those in patients without CCD.There was a significant positive correlation between cerebellar AI and the maximum diameter of primary lesions in patients with CCD ( r=0.375 P=0.028). Conclusion:18F-FDG PET/CT imaging can assist in the diagnosis of crossed cerebellar diaschisis.The primary lesion of supratentorial tumor involving the basal ganglia is more likely to cause crossed cerebellar diaschisis, and the size of the primary lesion is correlated with cerebellar AI.

Hd-Zip, a unique transcription factor in plant kingdom, influences the growth, development, and secondary metabolism of plants. Hd-zip Ⅳ is thought to play an important role in trichome development of Schizonepeta tenuifolia. This study aims to explore the functions of StHD1 and StHD8 in Hd-zip Ⅳ subfamily in peltate glandular trichome development. To be specific, the expression patterns of the two genes and interaction between the proteins encoded by them were analyzed based on transcriptome sequencing and two-hybrid screening. The subcellular localization was performed and functions of the genes were verified in tobacco and S. tenuifolia. The results showed that StHD1 and StHD8 had high similarity to HD-Zip Ⅳ proteins of other plants and they all had the characteristic conserved domains of HD-Zip Ⅳ subfamily. They were located in the nucleus. The two genes mainly expressed in young tissues and spikes, and StHD1 and StHD8 proteins interacted with each other. The density and length of glandular trichomes increased significantly in tobacco plants with the overexpression of StHD1 and StHD8. Inhibiting the expression of StHD1 and StHD8 by VIGS(virus-induced gene silencing) in S. tenuifolia resulted in the reduction in the density of peltate glandular trichomes, the expression of key genes related to mono-terpene synthesis, and the relative content of limonene and pulegone, the main components of monoterpene. These results suggested that StHD1 and StHD8 of S. tenuifolia formed a complex to regulate glandular trichomes and affect the biosynthesis of monoterpenes.
Trichomes/metabolism* ; Lamiaceae/genetics* ; Tobacco/genetics* ; Monoterpenes/metabolism* ; Cloning, Molecular ; Plant Proteins/metabolism* ; Gene Expression Regulation, Plant

To know the current status of family health and negative psychology of primary and secondary school students, and to explore the correlation between them during the prevention and control of COVID-19. From January 15 to 30, in 2022, a total of 19 343 urban and rural primary and secondary school students in X city were selected. The short form of the family health scale, center for epidemiologica survey-depression scale and student burnout inventory for junior middle school students were used to conduct a cross-sectional survey. The Pearson correlation was used to analyze the relationship between the family health and negative psychology. The family health of primary and secondary school students is at the medium level or above, and more than half of students may/must be depressed. There are significant differences in study burnout in different learning stages and epidemic management in different places of residence. It is recommended that family members and schools staff should give more psychological and social support to primary and secondary school students to reduce the negative impact of COVID-19 on them.

Objective:This study aimed to observe whether the treatment-free remission (TFR) of second-generation tyrosine kinase inhibitors (TKI) in chronic myeloid leukemia (CML) is better than imatinib (IM) .Methods:The clinical data of 274 CML patients who discontinued treatment and with complete clinical data were retrospectively studied from June 2013 to March 2021. Using both univariate and multivariate Cox proportional hazards regression models, risk factors influencing TFR outcomes after drug withdrawal in CML patients were assessed.Results:A total of 274 patients were enrolled, 140 patients were women (51.1%) , with a median age of 48 (9-84) years at the time of TKI discontinuation. Prior to TKI discontinuation, 172 (62.8%) patients were treated with IM, and 102 (37.2%) had received second-generation TKI treatment, including 73 patients who had shifted from IM to a second-generation TKI and 29 patients who used second-generation TKI as the first-line treatment. The rationale for converting to a second-generation TKI are as follows: 37 patients aimed deep molecular response (DMR) to achieve TFR, seven patients changed due to IM intolerance, and 29 patients changed because of failure to achieve the optimal treatment response. The use of the last type of TKI included 96 patients (94.1%) with nilotinib, three patients (2.9%) with dasatinib, and two patients (2%) with flumatinib, including one patient who changed to IM due to second-generation TKI intolerance. No statistical differences were found in the median age at diagnosis and TKI discontinuation, sex, Sokal score, IFN treatment before TKI, median time of TKI treatment to achieve DMR, and the reasons for TKI discontinuation between the second TKI and IM ( P>0.05) .The median cumulative treatment time of TKI (71.5 months vs 88 months, P<0.001) , the last TKI median treatment time (60 months vs 88 months, P<0.001) , and the median duration of DMR (58 months vs 66 months, P=0.002) were significantly shorter in the second-generation TKI compared with IM. In the median follow-up of 22 (6-118) months after TKI discontinuation, 88 patients (32.1%) had lost their MMR at a median of 6 (1-91) months; of the 53 patients (60.2%) who lost MMR within 6 months, the overall TFR rate was 67.9%, and the cumulative TFR rates at 12 and 24 months were 70.5% and 67.5%, respectively. Withdrawal syndrome occurred in 26 patients (9.5%) . For patients who restarted TKI treatment, 72 patients (83.7%) achieved DMR again at a median treatment of 4 (1 to 18) months. The univariate analysis showed that the TFR rate of patients treated with second-generation TKI was significantly higher than those who were treated with IM (77.5% vs 62.2%, P=0.041) . A further subgroup analysis found that the TFR rate of the second-generation TKI patients was significantly higher than those treated with IM (80.8% vs 62.2%, P=0.026) . No significant difference was found in the second-generation TKI used as the first line treatment compared with those who were treated with IM (69.0% vs 62.2%, P=0.599) . The multivariate analysis results showed that second-generation TKI treatment was an independent prognostic factor affecting TFR in patients who discontinued TKI ( RR=1.827, 95% CI 1.015-3.288, P=0.044) . Conclusion:In the clinical setting, more CML patients rapidly achieved TFR using second-generation TKI than IM treatment.

Objective To explore the effect of C-X-C motif chemokine ligand-13 (CXCL-13) on the proliferation and migration of human bone marrow mesenchymal stem cells (BMSCs) by network pharmacology. Methods To predict that the targets of CXCL-13 on BMSCs by online database. Metascape was used to perform gene ontology (GO) of the targets and Kyoto encyclopedia of genes and genomes (KEGG) pathway was used to perform enrichment analysis. The protein interaction analysis was performed by STRING 11.0 database, and the protein module of core gene was screened by using the cytoHubba 0. 1 of Cytoscape 3. 8. We divided BMSCs into control group, CXCL-13 group and PI3K inhibitor group. MTT assay, flow cytometric analysis and Transwell cell migration assay were respectively used to detect the absorbance (A) value of BMSCs in each group, the apoptosis rate and the number of cell migration. The protein contents of epidermal growth factor (EGF) and vascular endothelial growth factor (VEGF) in BMSCs supernatant were determined by ELISA. Western blotting was used to detect the protein expression of Akt and phosphorylated Akt (p-Akt) of BMSCs in each group. Results It was predicted that 21 targets of CXCL-13 effect on BMSCs. There were 32 biological processes related to cell proliferation include stem cell proliferation, regulation of endothelial cell proliferation and positive regulation of smooth muscle cell proliferation. There were 22 biological processes related to cell migration include regulating cell migration, amebic cell migration and endothelial cell migration. There were 40 KEGG pathways including cancer pathway, PI3K-Akt signaling pathway and MAPK signaling pathway. The core proteins included tumor protein P53 (TP53), epidermal growth factor receptor (EGFR), heat shock protein 90 kD alpha class B member 1 (HSP90AB1), protein kinase Ca (PRKCA), estrogen receptor 2 (ESR2) and prostaglandin E receptor 4 (PTGER4). Compared with other groups, the absorbance (A) value and cell migration number of BMSCs in CXCL-13 group increased significantly (P< 0. 01, 71=15), and the apoptosis rate decreased significantly (P<0. 01, n= 15). However, absorbance value, apoptosis rate and migration number of BMSCs in PI3K inhibitor group were contrary to those in CXCL-13 group (P<0. 01, n= 15). Compared with the control group, the protein contents of EGF and VEGF in BMSCs of CXCL-13 group increased significantly (P<0. 01, n= 15), and the relative expression of Akt and p-Akt increased significantly (P<0. 01, n = 9). However, the protein content of EGF and VEGF, and the relative expression of Akt and p-Akt in PI3K inhibitor group were opposite. Conclusion Through activating PI3K-Akt pathway, CXCL-13 may promote BMSCs paracrine EGF and VEGF proteins, and improve proliferation and migration of BMSCs, as well as inhibit BMSCs apoptosis.

Objective To investigate the estimation of early and mid-term wound age by a combination of four mRNAs, the DNA polymerase delta-interacting protein 3 （POLDIP3） mRNA, regulator of chromosome condensation 1 like （RCC1L） mRNA, proline-rich 5 （PRR5） mRNA, and ribonucleic acid export 1 （RAE1） mRNA in rats skeletal muscles. Methods The model of rat skeletal muscle contusion was established, and then contusion area muscle tissue was extracted 4, 8, 12, 16, 20, 24, 28, 32, 36, 40, 44 and 48 h after injury. Histomorphological changes during the repair process after rat skeletal muscle contusion were observed. The relative expressions of Poldip3, Rcc1l, Prr5 and Rae1 mRNAs were detected by reverse transcription real-time quantitative polymerase chain reaction （RT-qPCR）. Different stages of wound age were classified by using the expression patterns of four genes at various time points after injury. The accuracy of the results was verified by Fisher discriminant analysis. Results Histomorphological results showed that the repair process after skeletal muscle contusion occurred with the prolonging of time. Through combination of the expression trends of the four kinds of mRNAs, the 48 h after injury could be divided into three periods, 4-12 h, 16-28 h and 32-48 h. The Fisher discrimination method showed that the classification accuracy rates of the three periods were 83.3%, 75.0% and 73.3%, respectively. Conclusion The classification discrimination based on the relative expression of every gene has a higher accuracy, and the accuracy of wound age estimation with combination of mRNA relative expressions is higher than that with a single indicator. By combining with Fisher discrimination method, this method can be used for early and mid-term wound age estimation.
Animals ; Contusions/metabolism* ; Muscle, Skeletal/metabolism* ; RNA, Messenger/genetics* ; Rats ; Rats, Sprague-Dawley ; Time Factors